"There are a few main triggers that you should be aware of that may indicate you need to see a doctor."
In light of the current health crisis, it’s important that we educate ourselves not only on the Coronavirus, but on all of the different conditions that can occur as a result of it, so that we can be better prepared to protect ourselves and our loved ones.
In today’s post, Dr. Keller will talk about one of those conditions: pneumonia. As always, we’ll discuss what pneumonia is, what causes it, and what steps we can each take to help prevent it.
- 00:22:What is Pneumonia?
- 02:25:Pneumonia and COVID
- 03:18:Severity of Pneumonia
- 03:57:Symptoms of Pneumonia
- 05:33:When to Seek Medical Attention
- 07:04:High-Risk Categories
- 08:26:Diagnosing and Treating Pneumonia
- 10:01:Preventing Pneumonia
What is Pneumonia?
Pneumonia is a very common condition that can cause up to 50,000 deaths per year (in a normal year) in the United States. However, pneumonia is also one of the serious complications associated withCOVID-19, and can eventually lead to death or extremely severe sequelae. “Sequelae” refers to a condition that occurs as a result of a previous disease or injury.
Pneumonia, as you may know already, is an infection of the lungs — the term "pneumonia" means inflammation of the lungs. This typically happens when the lungs get inflamed by some kind of pathogen — it could be a bacteria, a virus, or a fungus — that's invading them. The immune system starts an attack, the lungs get inflamed, and they start to fill with either fluid or pus. This creates a really bad reaction in which the lungs are no longer able to do their job (oxygen exchange), which is really bad news.
If you picture the lungs as an upside-down tree, then you can think of the tree trunk as the trachea. The bronchi are the branches of the tree; if you've ever heard the term "bronchitis," that's an infection of the bronchi. Finally, the leaves of the tree are the alveoli, which are little sacks at the end of your airway in which the oxygen exchange takes place, (much like the oxygen-carbon dioxide exchange that takes place in a real tree). When the alveoli, or the leaves of your tree, get inflamed and compromised, you can't do the basic job of getting oxygen out of the air. This is why pneumonia can become so serious.
Pneumonia and COVID
COVID, as most of us know by now, is dramatically increasing the cases of pneumonia that we're seeing this year compared to last year. That is because the viral infection (COVID) starts to cause major inflammation in the lungs which leads to them filling up with fluid and pus. This can also cause a secondary bacterial infection on top of that.
Viruses are among the primary causes of pneumonia to begin with. For example during a normal year, you might contract the flu virus, or a bacteria like streptococcus that can cause pneumonia in one particular lobe, Other causes include mycoplasma, which is similar to bacteria and causes a less dramatic case of pneumonia called walking pneumonia, or a fungal infection, which is far less common, but can still lead to pneumonia.
Severity of Pneumonia
Pneumonia cases can vary widely in severity. Some people get a mild type of pneumonia, like walking pneumonia, which doesn’t drastically affect them. They might have a cough and feel a little run down, but most of the time they are still able to go out into the community. They might see their doctor, but many times they feel well enough that it passes on its own.
However, there are also much more severe cases of pneumonia like we're seeing now with COVID, where people really can't breathe, they get very high fevers, and they have to be hospitalized, or sometimes even intubated (or have a tube inserted into their lungs to help expand the lungs and breathe for them).
Symptoms of Pneumonia
We’re going to go over the symptoms of pneumonia, and discuss which ones should prompt you to seek medical attention. Symptoms of pneumonia include:
- Heaviness of the chest
- Chest pain when you're breathing in and out. Irritation of the walls of the lungs can make it feel very sensitive to breathe in and out and expand your chest
- A fever. Typically, a fever higher than 100°F is indicative of pneumonia.
- A cough that's more productive, where you're coughing up green or yellow sputum, can be a symptom of pneumonia.
- Fatigue or malaise that is more dramatic than what you might feel with a common cold.
- Chills and shakes, along with just feeling very run-down
When to Seek Medical Attention
Of course, a lot of these conditions do occur with other illnesses and conditions as well. You could experience them with aregular cold, or with less serious viral conditions, or even just fromnot getting enough sleep. So, how do you know when to seek medical attention?
There are a few main triggers that you should be aware of that may indicate you need to see a doctor:
- Shortness of breath.So, if you have a cough and some chest tightness, or some chest pain, that's okay if it's manageable for you. But if you start feeling like your respiration is compromised — like you're having to breathe more deeply or faster, you suddenly feel like you’re at a high altitude and just not getting enough air — that's a red alert and you should go seek medical attention right away.
- A fever higher than 102°F. When you start experiencing an abnormally high fever, it could mean that your lungs are so inflamed that they might be starting to leak bacteria into your whole body, affecting your systemic circulation. And that can lead to basically sepsis, which is a blood infection that can cause the whole system to essentially collapse. So, when your fever starts getting that high, it's indicative that your body is losing the fight against this pneumonia.
- A cough that is getting progressively worse. If your cough is getting increasingly bad and you’re seeing more yellow and green sputum coming up, that's a dangerous sign as well.
- Changes in mental status. This can happen more commonly in older people. If you start to see more confusion or disorientation in yourself or someone you’re caring for, that should be an alert to seek medical help.
There are some groups of people who are at higher risk for developing pneumonia, and of course these groups are also high-risk groups for COVID leading to pneumonia. These risk groups include:
- People over 60, or especially over 65.
- Children under the age of two. This is because pneumonia can be much more severe for them, since their immune system is not fully prepared to defend them, or to further support breathing if they get into trouble.
- People with underlying health conditions. This includes a wide range of issues; COPD fromsmoking,asthma,high blood pressure and other inflammatory conditions, autoimmune disorders, and more. All these underlying conditions can make pneumonia more serious.
- People with compromised immune systems. This could be a result of chemotherapy or other cancer drugs, HIV, or other chronic infections.
- People who smoke. If you smoke, you will inherently have less of a respiratory reserve and less of a capacity to offset some of the issues that might come up if you develop pneumonia.
So, those are the categories of people who definitely need to be on higher alert, and ready to seek medical attention, especially if they start experiencing some of the more severe symptoms mentioned above.
Diagnosing and Treating Pneumonia
Once you start experiencing those symptoms and visit the doctor, he or she will listen to your lungs to determine if it sounds like they have pus in them. If they are what the doctor refers to as “consolidated”, or you're not moving air well, they can move on to imaging. Typically, that's going to be an X-ray or a CAT scan of your chest so the doctor can see if there are areas of your lungs that are inflamed, filled up with fluid or pus, or not expanding well to allow the oxygen exchange to take place.
After you’ve been assessed and diagnosed, treatment begins. It's very important to get treatment early, so if you're worried about pneumonia, especially right now because of the Novel Coronavirus, then seek medical attention earlier: the sooner, the better, because the sooner you’re diagnosed, the more treatment options are available to your healthcare provider.
Treatment could involve putting you on an antibiotic to handle a bacterial infection that might be going on, or some kind of anti-inflammatory like a steroid. A steroid can really help reduce some of the inflammation that's leading to too much fluid building up in your lungs. There have recently been studies that have suggested that Dexamethasone, which is a kind of steroid, can help reduce the severity of the reactions of COVID specifically and therefore reduce the need for intubation or the likelihood of succumbing to the viral infection and the pneumonia.
As always, we like to talk about prevention. So, what can you do to prevent pneumonia?
Vaccines can be a very helpful prevention measure. If you are over a certain age range — typically that’s 50 or 60 — depending on your other health conditions, you should consider getting the pneumonia vaccine. There are two different vaccines out there, so talk to your doctor about which one is right for you, but these are designed to protect you from a wide range of bacterial pneumonias, which can often be very serious. Having that protection will also help prevent pneumonia from occurring as a result of COVID or another viral infection.
There are certain vaccines against viruses as well. The flu vaccine that you can get yearly can also help prevent pneumonias that are caused by the flu virus. Finally, as you might know, they are working on a COVID vaccine as well. We know there are a lot of people with concerns and doubts about vaccines in general, and of course a COVID vaccine doesn’t exist at the moment, but when that vaccine has been created, tested, and approved, it is likely to save lives, prevent the spread of COVID, and help reduce the severity of the reactions that might occur if you contract COVID.
Vaccines work by helping prime your body with proteins, usually from a certain virus or bacteria that your immune system then can recognize as foreign, and start responding with a host of proteins that can come and attack the real infection once it comes. So, vaccines are a great way to preemptively prime your immune system and get it ready so that when the attack comes, it has defenders in place.
General Healthy Habits
Take steps to make sure you'regetting adequate sleep, and controlling your underlying health conditions. So, if you havehigh blood pressure, ordiabetes, or anything like that, make sure that you're taking your medicines and practicing healthy lifestyle tips to keep those under control.
Eating healthy is also very important to our immune system, so make sure that you're getting your fruits and vegetables, and generally following ananti-inflammatory diet.
These are all things that can help your immune system and help reduce inflammation, and therefore reduce these dramatic inflammatory responses that can occur during a pneumonia process.
Supplementation for Immune Support
A couple of great supplements for immune support include: theSmarter Multivitamin (an organic food-based multivitamin),Smarter Vitamin D (a plant-based vitamin D3 with vitamin K2), andSmarter Sleep (a natural, gentle sleep aid). Consider taking those if you need extra help strengthening your immune system.
By all means continue to wash your hands frequently, don't touch your face, and wear a mask when you’re out in public so you can reduce the chances of contracting COVID or transmitting it to other people who might have a weaker immune system than you.