Although the majority of COVID-19 cases are mild and manageable at home, some patients face higher risks of developing pneumonia as a result of COVID-19 infection. Pneumonia is an infection that affects the lungs and, if left untreated, can have serious health consequences.
In this guide, we explore everything you need to know about COVID-19 pneumonia, including the symptoms to watch out for, its effects on the body, and ways to treat and prevent the disease. Read on to learn more about COVID-19 pneumonia.
What is COVID pneumonia?
COVID pneumonia is a respiratory illness brought on by SARS-CoV-2, the virus that causes coronavirus disease. Pneumonia is a severe lung infection that is characterized by the inflammation of the alveoli or the tiny air sacs inside your lungs. When these sacs become inflamed, they are filled with pus and fluid, making it difficult and painful to breathe.
How does COVID-19 affect your lungs?
COVID-19 affects the lungs by sending the SARS-CoV-2 virus into the cells along the airways. Once it invades these cells, the virus overrides the cells’ ability to produce copies of itself. Instead, the virus creates more copies of SARS-CoV-2, spreading itself to other cells in the lungs and body.
To protect the body against the virus, the immune system sends out inflammatory cells all over the body. The inflammation – along with the virus cells – damages the air sacs in our lungs, creates scarring and stiffening, and allows fluid to build up. Eventually, this blocks oxygen from getting into your lungs, leading to a drop in blood oxygen levels.
Inflammation is an immune response that helps our bodies fight off infections. However, in some people, COVID-19 puts the immune system into overdrive.
According to research, this may be due to the SARS-CoV-2 virus’ ability to latch onto a type of cell receptor called ACE-2, which it uses as a “doorway” into the cells in our lungs. ACE-2 has inflammation-reducing capabilities. But when the virus piggybacks onto the receptor, the effect is lost and inflammation builds up.
Are COVID pneumonia and COVID-19 different illnesses?
COVID pneumonia can be considered a complication of COVID-19.
Not everyone who catches the coronavirus infection develops pneumonia. Conversely, not everyone who is diagnosed with pneumonia has COVID-19. Pneumonia can be caused by viruses such as COVID-19 and the flu, as well as bacteria, fungi, and other microorganisms.
What’s the difference between COVID pneumonia and other types of pneumonia?
A study published by researchers at Northwestern Medicine found that COVID-19 lasts longer and causes more damage to the lungs than typical pneumonia.
In typical pneumonia, the disease rapidly infects large areas of the lung. It can result in serious illness – with many symptoms appearing at the same time – but it doesn’t last very long. The COVID-19 virus, however, camps out across several smaller areas, infiltrates the lungs’ immune cells, then uses these to multiply over a short period of time.
In a sense, the COVID-19 virus has the same effect as “multiple wildfires” razing a forest. It damages the entire body slowly by affecting more and more organs as it spreads. Scientists believe this may also be what’s causing the chronic illness called post-COVID or long COVID – a combination of mid- and long-term symptoms that are experienced between a few weeks to several months after COVID infection.
Who is most at risk of getting COVID pneumonia?
People at higher risk of developing COVID pneumonia include:
- Middle-aged and older adults
- Nursing home residents who live in close quarters
- People with chronic lung diseases such as chronic obstructive pulmonary disease (COPD), cystic fibrosis, pulmonary fibrosis, moderate to severe asthma, and lung cancer
- People with heart disease
- People who have brain or nervous system conditions like stroke or dementia
- Diabetic and obese people
- Cancer patients
- People with certain blood disorders that can increase the severity of COVID-19 symptoms (i.e. sickle cell anemia or thalassemia)
- People with compromised immune systems such as PLHIV or those with chronic kidney disease
- People with congenital conditions such as Down syndrome or cerebral palsy
- People with mental health conditions like depression or schizophrenia
- People with substance abuse disorders
How many people with COVID-19 will get pneumonia?
Roughly 15% of people with COVID-19 experience serious complications, including pneumonia.
Note that a person’s risk of severe illness from COVID-19 goes up the more underlying medical conditions they have. A study found that 45.5% of US adults are at a higher risk of getting complications from COVID-19 because of underlying cardiovascular and respiratory disease, hypertension, diabetes, and cancer.
What Aare the symptoms of COVID pneumonia?
COVID pneumonia presents like a typical case of COVID-19. However, patients are advised to monitor worsening symptoms and seek medical attention to avoid progression into a more severe illness.
COVID pneumonia symptoms include:
- Shortness of breath
- Cough
- Chest pain or tightness that gets worse when you breathe deeply
- Extreme fatigue
- Fever or chills
- Confusion or agitation
- Bluish lips, nails, or skin
- Loss of appetite
People with COVID pneumonia may also experience other common symptoms of COVID, including:
- Sore throat
- Headache
- Nasal congestion or runny nose
- Loss of taste or smell
- Nausea
- Vomiting
- Diarrhoea
How do I know when my COVID-19 infection starts to cause pneumonia?
One major sign to look out for when you have the coronavirus disease is shortness of breath or any difficulty breathing that keeps getting worse. You should also watch out for a sudden drop in oxygen saturation. These two symptoms can be key indicators that the tiny air sacs in your lungs have filled with too much pus and fluid to allow you to keep breathing properly.
Failure to address worsening shortness of breath can result in hypoxia or low levels of oxygen in your tissues. Prolonged hypoxia can lead to brain and heart damage, which eventually leads to death.
Symptoms of hypoxia include:
- Confusion
- Restlessness
- Headache
- Anxiety
- Rapid breathing
- Rapid heart rate
- Shortness of breath or difficulty breathing
Patients who experience severe hypoxia may also exhibit a slow heart rate, bluish skin, or extreme restlessness.
What causes COVID pneumonia?
COVID-19 pneumonia is a serious complication of the COVID infection. It occurs when the SARS-CoV-2 virus infects and inflames the deep structures of the lung, leading to fluid buildup and reduced oxygen flow to vital organs.
How long does COVID-19 pneumonia last?
Patients recover from COVID pneumonia (and COVID-19) at varying rates depending on the severity of their illness. Those who experience mild to moderate symptoms may recover within three to six weeks. Those who experience a more severe illness may take several months to recover.
Other factors that affect the speed of one’s recovery include the patient’s age, the severity of their pneumonia, and the presence of other underlying medical conditions or complications.
According to one study, approximately half of older COVID-19 patients develop severe infections and 1 in 5 become critically ill. One in ten older patients dies from the disease. According to the Centers for Disease Control, the risk of death is 25 times higher in those ages 50 to 64 years old, 60 times higher in those 65 to 74 years, and 140 times higher in those ages 75 to 84 years.
What Aare the possible complications of COVID pneumonia?
Several severe complications could arise from worsening COVID pneumonia, including:
Acute respiratory distress syndrome
Also known as ARDS, acute respiratory distress syndrome is a serious condition is caused by fluid build-up and surfactant breakdown in the alveoli. When this happens, the lungs can no longer fill with air properly, leading to low blood oxygen.
In short, ARDS is a fatal form of lung failure that can quickly result in death if left untreated. Oftentimes, patients who reach this stage of the disease require ventilator support to breathe.
Pneumothorax
Pneumothorax or collapsed lung is a life-threatening complication that can happen to patients suffering from severe cases of COVID pneumonia. Pneumothorax occurs when air seeps into the space between your chest wall and lung. The leaked air then pushes on the outside of the lung, causing it to collapse.
Empyema
Empyema is characterized by pus in the cavity between the lung and the pleural space or its surrounding membrane. The infected fluid can put pressure on the lungs and cause chest tightness, shortness of breath, and pain.
Symptoms of empyema include:
- Dry cough
- Fever and chills
- Night sweats
- A general feeling of uneasiness
- Sudden unintended weight loss
- Chest pain that worsens with deep breathing
Kidney failure
COVID-19 patients who experience septic shock may eventually develop kidney failure due to their hearts not being able to pump enough blood to their kidneys.
Kidney failure is characterized by:
- Less frequent urination
- Swelling in the feet, ankles, or legs
- Difficulty breathing
- Nausea
- Confusion
- Weakness and fatigue
- Seizures
- Abnormal heartbeat
- Chest pressure or pain
Heart failure
Bacteria entering the heart and the stress that COVID and pneumonia put on the body may lead to heart failure. When a patient experiences heart failure, it means that their heart is too weak or stiff to pump enough blood to go around the body.
Some symptoms of heart failure include:
- Shortness of breath after mild activity or at rest
- Fatigue
- Lightheadedness and dizziness
- Fainting
- Swollen legs and ankles
How is COVID pneumonia diagnosed?
To diagnose COVID pneumonia, your healthcare provider will first have to confirm whether you actually have COVID-19. To do this, they will issue a nasal swab or collect a sputum sample for testing.
Once the COVID-19 infection is confirmed, your healthcare provider will request a chest x-ray or CT scan to look for abnormalities in your lungs. Chest CT scans are often better at revealing damaged areas in the lungs than x-rays.
Aside from imaging studies, doctors may recommend their patients undergo blood tests to monitor levels of lymphocytes, C-reactive protein, and oxygen – all of which could be indicators of a severe disease brought on by COVID pneumonia.
How to treat COVID pneumonia
Most people who are diagnosed with COVID pneumonia are admitted to the hospital. Under the guidance of a healthcare provider, patients are given the following treatments:
- Antiviral medications like remdesivir or nirmatrelvir/ritonavir, which can target the SARS-CoV-2 virus
- Antibiotics that fight off any bacterial infections you may acquire (note that antibiotics don’t work against viral infections)
- Corticosteroids like dexamethasone that minimize inflammation
- Monoclonal antibodies like tocilizumab, which also reduce inflammation
- IV fluids to reduce the risk of dehydration
- Supplemental oxygen given through a mask or nasal tube to help you get enough oxygen into your lungs
Aside from administering these treatments, doctors may also have to sedate patients and put them on a mechanical ventilator, especially if the patient can no longer breathe unsupported. Doctors may also place critical patients with heart and respiratory failure on an extracorporeal membrane oxygenation machine, a type of life support that takes over the functions of the heart and lungs.
How can I prevent COVID pneumonia?
To prevent COVID pneumonia (and COVID-19 in general), follow these steps:
Minimize your chances of contracting COVID-19
If you have an underlying condition that puts you at an increased risk of developing pneumonia or any other serious complication associated with COVID-19, make efforts to reduce your chances of contracting the virus.
This means maintaining a safe distance from others when you can, wearing masks in poorly ventilated areas, washing your hands regularly, and getting vaccinated and boosted for COVID-19.
Practice healthy habits
Maintaining a nutritious diet, staying hydrated, getting enough rest and sleep, exercising regularly, and managing stress can all strengthen your immune system and prevent you from becoming seriously ill should you contract COVID-19.
A weakened immune system puts you at a higher risk of getting very ill as a result of a COVID-19 infection, says the CDC.
Don’t delay testing and Treatment
If you suspect that you might have caught COVID-19, make sure to test right away. Rapid testing and early interventions limit the development of complications like pneumonia and long COVID.
The bottom line
COVID pneumonia is a serious lung infection that can occur in people who have COVID-19. Symptoms of COVID pneumonia include coughing, shortness of breath , and chest pain.
If you think you may have COVID pneumonia, it is important to see a doctor and start treatment as soon as possible. There is no specific cure for COVID pneumonia, but there are ways to manage the symptoms until you recover.
If you need further information on COVID pneumonia and how to fight the battle against prolonged COVID symptoms, reach out to us. Learn about our support and the Post-COVID programs we offer.
