Lung Health In The Post-Pandemic World: Why It Becomes Even More Critical As You Age

As we enter the fifth year since COVID-19 first emerged, the world has largely moved on from the pandemic. However, for millions of people—especially those who survived the virus—COVID-19 remains an enduring part of their daily lives. Research indicates that more than a third of COVID-19 patients develop symptoms that persist for over three months, a condition known as long COVID. Among these, breathlessness is one of the most frequently cited symptoms.

For many, particularly older adults, the pandemic has left lasting consequences on lung health. "Aging naturally compromises respiratory function, but post-COVID complications have made it an even more pressing concern," explains Dr. Harish Bhatia, Senior Consultant Chest Specialist & Physician.

COVID-19 survivors may experience lasting pulmonary damage, including fibrosis (scarring of lung tissue), thromboembolic diseases, and chronic inflammation. For aging individuals, who already experience natural declines in lung function, these post-viral complications significantly increase the risk of long-term respiratory issues.

"The COVID-19 pandemic reshaped global health, stressing respiratory care. For older adults, lung health is more critical now than ever; aging reduces the capacity and resilience of the lung. The world after the COVID-19 pandemic has presented other challenges, for instance, lingering viral infections and exposures to environmental pollutants that can contribute to pulmonary decline," adds Dr. Arun Chowdary Kotaru, Head and Senior Consultant, Pulmonology & Sleep Medicine.

How Aging Affects Lung Function

Lung function diminishes naturally with age due to a combination of structural and immunological changes. Dr. Bhatia outlines key reasons why people face greater respiratory challenges as they age:

Reduced Lung Elasticity

Over time, lung tissues lose elasticity, decreasing the lungs' ability to expand and contract efficiently. This results in reduced lung capacity and less effective breathing.

Weakened Respiratory Muscles

The diaphragm and intercostal muscles, crucial for breathing, weaken with age, making deep breaths and carbon dioxide expulsion more difficult.

Declining Ciliary Function

Cilia, tiny hair-like structures in the airways that help clear mucus and pathogens, slow down with age, increasing susceptibility to respiratory infections.

Compromised Immune Response

Immunosenescence, the gradual weakening of the immune system, impairs the body’s ability to fight respiratory infections and recover from lung damage.

These natural changes put older adults at a higher risk of developing conditions such as chronic obstructive pulmonary disease (COPD), pulmonary hypertension, and interstitial lung disease—especially if they have had prior COVID-19 infections.

Long COVID and Its Lasting Effects on Lung Health

COVID-19 has significantly increased the burden on respiratory health. "Post-viral lung fibrosis, persistent inflammation, and heightened risks of chronic respiratory conditions have become common concerns for aging adults recovering from COVID," explains Dr. Bhatia.

Long COVID, also known as Post-Acute Sequelae of SARS-CoV-2 Infection (PASC), affects many older adults, manifesting in symptoms such as:

- Persistent breathlessness

- Chronic fatigue

- Reduced exercise tolerance

- Increased susceptibility to respiratory illnesses

Even months or years after initial infection, some patients experience lingering effects, particularly those with pre-existing conditions. Pulmonary fibrosis, in particular, leads to decreased oxygen exchange, causing breathlessness and limiting physical activity.

Environmental Challenges and Air Pollution’s Role

Beyond long COVID, the post-pandemic world presents additional respiratory challenges, such as increased exposure to air pollution. "Air pollution is an invisible killer that accelerates lung aging and increases susceptibility to respiratory infections, lung inflammation, bronchial hyperresponsiveness, and pulmonary fibrosis," warns Dr. Arun. Fine particulate matter (PM2.5) and nitrogen dioxide are among the most harmful pollutants, leading to:

- Increased lung inflammation

- Bronchial hyperresponsiveness

- Higher risk of pulmonary fibrosis

These environmental factors further strain lung health in older populations, making proactive care essential.

Also Read- COVID Turns 5: Things We Have Learned And What Remains Unknown

Strategies to Protect Your Lungs as You Age

To counteract both natural aging and post-pandemic lung health concerns, Dr. Kotaru emphasizes a multifaceted approach that includes lifestyle modifications, medical interventions, and preventive strategies:

1. Avoid Environmental Pollutants

Pollution exacerbates respiratory issues. Exposure to tobacco smoke, dust, and chemicals can cause chronic lung irritation. Older adults should:

- Wear an N95 mask in dusty environments or when using strong chemical cleaners.

- Avoid smoking and secondhand smoke exposure.

- Reduce exposure to outdoor pollution, especially during high-smog days.

2. Improve Indoor Air Quality

Indoor pollutants can be just as harmful as outdoor air pollution. Simple adjustments can significantly improve lung health:

- Use an air purifier with HEPA filtration.

- Upgrade central air filtration systems.

- Ensure proper ventilation when cooking with gas stoves.

3. Prioritize Vaccination

Vaccinations are crucial in preventing severe respiratory illnesses. The Centers for Disease Control and Prevention (CDC) recommends older adults receive:

• Pneumococcal Vaccine – Protects against pneumonia, which disproportionately affects individuals over 65.
• COVID-19 Booster – While most older adults have received primary COVID-19 vaccinations, booster doses continue to be vital.
• Influenza Vaccine – Annual flu shots can prevent severe respiratory infections, reducing hospitalization risks.

4. Practice Pulmonary Rehabilitation and Breathing Exercises

Regular pulmonary function exercises can help strengthen the lungs and maintain capacity. Techniques such as diaphragmatic and pursed-lip breathing improve oxygen exchange and lung resilience.

5. Adopt a Lung-Friendly Diet

A diet rich in antioxidants and anti-inflammatory foods can improve lung health. Key recommendations include:

• Omega-3 Fatty Acids – Found in fish, flaxseeds, and walnuts, these reduce inflammation in the lungs.
• Antioxidant-Rich Foods – Leafy greens, berries, and citrus fruits support lung function.
• Hydration – Drinking enough water helps keep the airways clear of mucus buildup.

"The respiratory challenges of today require early detection and continuous management," concludes Dr. Kotaru. "In short, in the post-pandemic era, evolving respiratory challenges necessitate proactive lung care. Regular pulmonary function tests and consultation with pulmonologists can help detect age-related lung complications early on and manage them better for a better quality of life in later years."

Dr. Arun Chowdary Kotaru is Head and Senior Consultant of Pulmonology & Sleep Medicine at Artemis Hospitals in India

Dr. Harish Bhatia is the Founder Director of Rebreathe Clinic, Senior Consultant Chest Specialist & Physician with Apollo Hospital in India

Respiratory sequelae of COVID-19: pulmonary and extrapulmonary origins, and approaches to clinical care and rehabilitation. The Lancet Respiratory Medicine. 2023

The long-term effects of COVID-19 on pulmonary status and quality of life. PeerJ. 2023

Impact of COVID-19 on quality of life in survivors with pulmonary sequelae. Sci Rep. 2024