Pneumonia And Coronavirus- DoctorOnCall

Answered by: Dr Mohd Ramzdhan Bin Mohd Masdar
Updated on: April 25, 2020

Question:
Good day to you doctor. I’m a Malaysian student who is currently studying in London. My neighbor recently got sick with the picture manifested by him just like COVID-19 infection. So, I was terrified to hear the news because my grandmother is a high risk individual with a lot of co-morbidity and she frequently talks to the neighbour. However, I was informed that he’s just having pneumonia and allowed home. But I read somewhere that the complication of COVID-19 is pneumonia. So, I was wondering isn't that he had COVID-19 with complication now? Thank you
Answer:
Good day to you too. Thank you for your question. You are right about pneumonia is one of the complications of COVID-19 infection. However, since your neighbour already visited the doctor and since he was being discharged home, I believe that the doctor there had concluded that he’s not having COVID-19 infection. For your information, apart from COVID-19, other kinds of viruses, bacteria and also fungus can cause pneumonia. To know further, let’s read the article below.

First of all, let's understand what pneumonia is. It is a lung infection that might be triggered by bacteria, fungus, or virus. As other infections do, it invokes the body’s immune system leading to an influx of inflammatory mediators causing inflammation in the air sacs inside the lungs known as alveoli. This condition causes the alveoli to be filled with fluid and pus. Hence the exchange of gases is interrupted and makes the sufferer difficult to breathe.

Coronavirus would usually cause mild symptoms such as dry cough and fever. However, in severe cases of coronavirus infection, it can cause pneumonia. The symptoms of it are, such as:

  • Shortness of breath or breathlessness
  • Rapid heartbeat
  • Rapid breathing
  • Dizziness
  • Heavy sweating

This occurs once the virus gets access into the lungs and subsequently causes damage to the cells and tissue that lines the alveoli. This damage then causes tissue to break off and clog the alveoli. From here onward a similar mechanism as mentioned above happened, where interruption of gas exchange occurs and makes the sufferer difficult to breathe. 

This picture of severe infection due to coronavirus only occurs 15% among individuals that contracted the infection. The patient would require oxygen treatment or in more severe cases, they would need ventilators.

Although everyone can actually develop pneumonia once they are infected by the virus, those aged >65 years are at higher risk while those at the age of more than 85 are at the highest risk to get it. Besides, individuals with other health problems such as asthma, heart problems, diabetes, high blood pressure are at higher risk. Since we’re depending on the immune system to fight off the virus, naturally those with weakened immune systems tend to get on the severe end of the spectrum of this infection. They are such as smokers, untreated or uncontrolled HIV, cancer patients that undergo chemotherapy, or those that are under immunosuppressant.

On top of that, individuals that get pneumonia might also develop acute respiratory distress syndrome (ARDS). It is a type of respiratory failure which can get worse quickly and is life-threatening. However, fast recognition and appropriate management can treat this condition.

Thus, what is the management and treatment of pneumonia in coronavirus infection? First of all, we’ll need to support the patient as needed. This is such as oxygen, ventilator, and also fluid therapy. Since this is a new virus, we’re still doing clinical trials on several drugs and treatments used for other conditions. In Malaysia, drugs that we’re practicing are hydroxychloroquine or chloroquine as an alternative which is used to treat malaria. Apart from that, Lopinavir/Ritonavir that is usually used in HIV infection will be added if the previous drug is inadequate. Lastly, Ribavarin which is an antiviral medication used to treat RSV infection, hepatitis C or other virus infection will be added in a more severe case of pneumonia.

Nevertheless, prevention is better than cure. Always practice proper handwashing. If soap and water are not available, use hand sanitizer. Stay put at home and practice social distancing when going outside. Regularly clean and disinfect surfaces in your home that you touch often, such as doorknob, table, phone, and laptop. Make it a habit not to touch your face without washing your hands. If you fall into the high-risk group, avoid visiting anyone who’s sick or even better, avoid others as much as you can. It’s better to be safe than sorry. Together, we can win against this virus!

 



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