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Relationship between Pneumonia and COVID-19

Relation between COVID - 19 and Pneumonia

Posted on : December 27, 2020 by Clinic One on COVID-19


What is Pneumonia?

Pneumonia is an infection of our lungs that results in the inflammation of the air sacs called alveoli (tiny air compartments that hold the air for the exchange of oxygen).

Eventually, the infection fills the air sacs with fluid and pus making it difficult to breathe. It may result in shortness of breath, cough, fever, chest pain, chills, or fatigue.

In normal cases, you might be recommended some cough medicine, and pain relievers to remove chest pain while in some serious conditions you might need assistance for breathing with a machine called ventilators.

Pneumonia can be the result of viral infections such as that of Covid-19, the flu, or the common cold. While, it can also be the result of bacteria, fungi, or other micro-organisms.


What is Sars-Cov-2 (Covid-19)?

Sars-Cov-2 named Covid-19 is a novel coronavirus that has emerged in 2019 and had since spread across the globe to be declared as a pandemic.

It has surpassed the infection number, mortality, and spatial range that have been covered by two previous coronaviruses namely Severe Acute Respiratory Syndrome (Sars-CoV) and Middle East Respiratory Syndrome (Mers-CoV).

It generally brings respiratory complications in the lungs among others such as viral pneumonia which can even be fatal.


So what is the relation between Pneumonia and Covid-19?

We have to delve deeper into how the infection starts for Covid-19 to know the relation between Pneumonia and Covid-19.

The Covid-19 infection starts when the respiratory droplets of the infected person enter into our upper respiratory tract where the virus multiplies and reaches our lungs after some time.

Eventually, the virus damages the alveoli (air sacs) of the lungs and its surrounding tissues where all the exchange of oxygen occurs into our bloodstream.

Thus this condition develops into pneumonia where the air sacs are filled with fluid, dead cells resulting in inflammation, coughing, and shortness of breath.

Patients with Covid-19 pneumonia could also develop Acute Respiratory Distress Syndrome (ARDS) which is a kind of progressive respiratory failure when our alveoli are filled with fluid.


Is there a difference between Covid-19 pneumonia and a normal one?

For the most part, it’s very difficult to know if a patient is having pneumonia due to Covid-19 or other respiratory infections before you get tested for Covid-19.

And it is too early to elucidate the differences in a comprehensive manner to date.

Nevertheless, some preliminary studies comparing the CT scans and laboratory tests suggest that there are certain key differences in the clinical features of pneumonia due to Covid-19 and others and those are

  1. Pneumonia due to Covid-19 affects both lungs while pneumonia due to other respiratory conditions tends to affect only one.
pneumonia and covid-19 affecting lungs
  1.  Lungs have a characteristic “ground glass” appearance via CT scan in pneumonia linked to Covid-19.
  2. Abnormalities are seen in a liver function for pneumonia associated with Covid-19.
  3. Vaccination against Pneumonia has already been developed and approved whereas there is no vaccines yet developed against Covid-19.


What are the symptoms associated?

Symptoms of Covid-19 pneumonia are similar to pneumonia due to other respiratory illnesses and these include fever, chills, cough, shortness of breath, chest pain (that is experienced while breathing deep or coughing), and fatigue.

While most cases of Covid-19 include moderate symptoms and some may have mild pneumonia. But a large-scale study in China has demonstrated that almost 14 percent of the cases can be serious while 5 percent of cases can be critical.

Individuals with serious cases can experience serious pneumonia that is associated with trouble breathing and low oxygen levels while critical cases may need ventilators to assist breathing.

Additionally, some cases of pneumonia may even progress to Acute respiratory distress syndrome (ARDS).


Who is at most risk of developing serious Covid-19 pneumonia?

Some people are at a higher risk of contracting serious Covid-19 pneumonia such as

  1. Older adults (especially 65 years and older) and those living in a long-term care facility such as a nursing home and assisted living facility.
  2. Peoples with an underlying health condition are more susceptible to serious pneumonia cases related to Covid-19, for example, peoples with asthma, COPD (Chronic Obstructive Pulmonary Disorder), diabetes, heart conditions, liver disease, chronic kidney disease, and obesity.
  3. People with a weakened immune system: Immunocompromised peoples with a weaker immune system are more prone to have serious pneumonia associated with the Covid-19. Such peoples include
    • Peoples who are taking medications for autoimmune conditions to suppress their immune system.
    • People who are undergoing cancer treatment.
    • People who have received an organ transplant or a bone marrow transplant.
    • People having HIV.


How can Covid-19 pneumonia be diagnosed?

The most efficient way of diagnosing Covid-19 and pneumonia associated with it is to monitor all the symptoms mentioned above such as dry cough, fever, chills, shortness of breath, and chest pain.

If these physiological symptoms match with your condition you are likely to have Covid-19 infection and hence you should be aware of pneumonia associated with it.

But more precise lab tests such as a PCR test that detects viral genetic material in your nasal or respiratory swabs can give you the most accurate results. 

Moreover, doctors may also elucidate Covid-19 pneumonia using X-Rays and CT-Scans to visualize the changes in your lungs due to pneumonia due to Covid-19.


How can Covid -19 be treated?

No medication or vaccines has been approved against Covid- 19 till today.

And most of the treatments are just supportive care that involves easing your symptoms and making sure that you receive optimum oxygen if you develop pneumonia.

Only people with serious bouts of pneumonia need oxygen therapy while most critical cases may even need ventilators to assist their breathing.


What are the long term effects?

Some CT Scans done on the patients with pneumonia associated with the Covid-19 reveals 66 out of 70 peoples still possessed the lung lesions even after they have been discharged from the hospital.

Similarly, a study that has followed up on 71 patients infected with SARS (another family of coronavirus) reveals that lung lesions that they have developed decreased significantly after a year that they recovered.

Hence it is wise to assume that you may have a lasting effect on your lungs due to lung damage associated with a serious case of pneumonia due to Covid-19 infection. 


What are the preventive measures against Covid – 19?

Even though it may not be possible to avoid this highly transmissible virus, here are things that can be done to minimize the risk of contracting the virus or to mitigate the adverse conditions posed by Covid-19.

  1.  Maintaining social distancing while in public or inside the closed doors, and maintaining hygiene by frequent hand washing.
  1. Adopting healthy lifestyle habits that will boost your immune system such as a healthy diet, healthy routine, and getting enough sleep.
  2. Managing your pre-existing medical condition by taking all medications as directed and following up on the physicians’ directions.
  3. In the case where you have contracted Covid-19, you should monitor your symptoms constantly and stay in touch with your health care provider if in case your symptoms worsen.


Summary:

While most cases of Covid-19 are mild and goes without severe complications, but some 14% of people may experience serious pneumonia and some 5% may need critical care. Similarly, for the most part, there are no symptomatic differences between pneumonia caused by a respiratory illness and that caused by Covid-19 but still, detailed CT Scans could reveal some anatomical changes. And lastly, even though there is no medication available to date for Covid-19, the best measure to take would be adopting healthy lifestyle habits to boost your immune system, facilitating supportive care for the patients, and ensuring that they are receiving enough oxygen if they succumb to pneumonia associated with Covid-19.



References:
Ben Hu, Hua Guo, Peng Zhou, and Zheng-Li-Shi et al (2020), Characteristics of Sars-Cov-2 and Covid-19, Nature reviews
Meredith Goodwin (June 9th, 2020), Want to know about Covid-19 and Pneumonia, Health line magazine
WebMD, Coronavirus, and Pneumonia, Article


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