Breathe in, breathe out. I sit on my couch with my hands on my head to expand my chest and eyes closed, concentrating intensely on my breathing. There is a tightness in my chest and, no matter how hard I try, I cannot seem to fill my lungs with enough air. I take a shallow breath — followed by another — until I eventually begin to hyperventilate, panicking that I cannot breathe.
I have lived with asthma throughout my life and have experienced episodes like this for as long as I can remember. I have tried all the tricks there are to help with breathing: taking my normal inhalers, exercising more, meditating and even taking turmeric pills. Shortness of breath is a frustrating experience. The feeling of not being able to get air into the deepest parts of your lungs can be scary. Unfortunately, as COVID-19 spreads across the globe, more and more people are experiencing shortness of breath — one of the symptoms of the virus.
In medicine, shortness of breath is commonly referred to as dyspnea. COVID-19 particularly causes acute dyspnea from pneumonia, an inflammation of the lungs due to the viral infection. Because of this inflammation, oxygen in the lungs has a harder time reaching the blood. This creates the sensation of shortness of breath.
Luis Mancheno, a 33-year-old attorney from Brooklyn, was one of many COVID-19 victims to suffer from shortness of breath. His symptoms began in mid-March with fatigue, mild body aches, a fever and a dry cough. After a few days, he felt a “hard pressure on [his] chest that would not go away” and claimed he could not talk because of how much energy he spent trying to breathe — a feeling that many asthmatics and other sufferers of dyspnea can experience.
While many COVID-19 patients may experience a fever and a dry cough like Luis, the fact that Luis suffered from shortness of breath suggested that his case was severe. Later that night, Luis’s dyspnea had worsened so much that he went to the emergency room where the medical team put him on a ventilator, a device that forces pressurized oxygen through severely inflamed lungs straight to the bloodstream to help alleviate the shortness of breath sensation. After his recovery, he stated during an interview with Vox, “the desperation I felt when I couldn’t breathe was a horrendous feeling I don’t wish for anybody.”
For patients like Luis who are suffering from dyspnea due to a COVID-19 infection, the Centers for Disease Control and Prevention (CDC) guideline is to seek medical attention. This is because 10% of COVID-19 patients with shortness of breath can rapidly deteriorate and develop acute respiratory distress syndrome (ARDS). ARDS is a build up of fluid in the alveoli of the lungs, causing less oxygen to reach the bloodstream. This often occurs a few hours to a few days after the infection and typically occurs along with low blood pressure, confusion and extreme fatigue. Many of these patients with ARDS must be put on ventilators.
If you, a friend or a family member experience shortness of breath due to COVID-19, you may need to seek medical help for the infected individual. In the meantime, remain calm. Remaining calm can be challenging when you feel like you are not getting enough air, but panicking and stressing may increase hyperventilation and worsen the feeling of not being able to breathe.
Shortness of breath is, essentially, a sensation of not intaking enough air. The fact that shortness of breath is a sensation means there is an aspect — to some extent — that is psychological as well. As an asthmatic, I have occasionally gotten so anxious about experiencing another frustrating episode of dyspnea that my stress itself would worsen my shortness of breath — simply due to psychological factors such as anxiety and stress. Remaining calm may help in mild dyspnea; however, if the infected individual’s shortness of breath becomes severe and the individual experiences chest pain, lightheadedness or blue lips, go to the emergency room immediately.
If you know anyone worried about coming down with the virus, advise them to stay home, stay calm and breathe. The best things one can do to reduce his or her chance of infection are to maintain distance from social settings and limit unnecessary social interactions. If you or anyone you know experience shortness of breath due to anxiety during this pandemic, activities to take care of yourself such as eating healthy, exercising, taking time to unwind and connecting with others over the phone may help reduce feelings of anxiety and stress.
This is my own story living with dyspnea as an asthmatic. While my experiences may not necessarily be the same as the experiences of COVID-19 patients, I aim to shed some light on the sensation these patients — as well as other sufferers of dyspnea — experience during shortness of breath episodes. Through this letter, I hope to help you empathize with patients you see in the hospital who are fighting for each breath, whether that is due to the COVID-19 virus or any other illness-causing dyspneic symptoms. If you or anyone you know begin to experience dyspnea due to any reason during this pandemic, I empathize with you.
Columnist
University of Miami Miller School of Medicine
Meghan is a second year medical student in the MD-MPH program at the University of Miami Miller School of Medicine in Miami, Florida class of 2023. In December of 2018, she graduated from Washington University in St. Louis with a Bachelor of Arts in political science and a minor in biological anthropology. She has written for The Denver Post (Denver, Colorado), has been a writer and editor for Washington University Student Life (St. Louis, Missouri), and has been published on KevinMD.com. She enjoys skiing, snowboarding, baking, dancing, and playing piano in her free time. In the future, Meghan would like to incorporate medical journalism into her career as a physician.
Life, Liberty, and the Pursuit of Healthiness
As doctors-in-training, we are not often exposed to the fundamental legal tenants of healthcare and medicine. But law and policy play a significant role in how we will practice -- including but not limited to the role of legal documents such as the Constitution on health policy, the impact of Supreme Court cases on healthcare legislation, and the role of international organizations and governmental decisions in global health. By discussing topics in medical law, public health policy, and the government's role in healthcare, we can better understand the intersection between the duties of physicians on the clinical level and the involvement of medicine on a national level.