Pneumonia and COVID-19

The relationship between pneumonia associated with COVID-19 has become an object of study and research worldwide. How is it treated? Is it possible to prevent it? How does it evolve? In the following, I will try to explain what is known to date about this pathology.

Pneumonia is an infection of the lung, the origin of which is found in multiple microorganisms, the most common being bacteria and viruses found in the air we all breathe.

Thus, the main difference between viral pneumonia and bacterial pneumonia is the organism that caused it. Prior to the emergence of SARS-CoV2 in December 2019, the most common pneumonias were bacterial pneumonias, with an average of eight out of ten.

Bacterial pneumonia can be treated with antibiotics, which are effective in most cases. However, in order to combat viral pneumonia, your only option is to administer symptomatic treatment and prophylactic coverage. Treatment is administered as the symptoms appear: antipyretics if fever appears, oxygen if respiratory distress appears…

Can pneumonia be prevented?

The answer to this question cannot be categorical, since pneumonias – neither viral nor bacterial – can be absolutely prevented, although it is true that there is a relative prevention, based on common sense. Thus, leading a healthy lifestyle (not smoking, eating a balanced and healthy diet, exercising regularly…), avoiding sudden changes in temperature (not being underdressed when it is cold or overdressed when it is hot) and following basic hygiene measures (use of a mask, social distance, frequent hand washing…) can help prevent pneumonia.

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What does the pneumonia caused by COVID-19 look like?

In this case, we are talking about viral pneumonia, although it is totally different from the usual viral pneumonias before the current pandemic. Until the advent of SARS-CoV2, the most common viruses causing pneumonia were influenza virus (both A and B), parainfluenza virus, respiratory syncytial virus and adenovirus.

When a person was affected by these viruses, pneumonia manifested within 48 to 72 hours after contact. However, pneumonia caused by SARS-CoV2 occurs much later, between the sixth and seventh day or until the tenth or twelfth day. This may give the impression that the patient is getting better, when in fact he or she is getting worse, but is not showing symptoms.

In turn, a study published in the journal Nature states that viral involvement in cases of COVID-19 pneumonia is more aggressive compared to other cases of viral pneumonia.

Pneumonia in the second and third waves: is it different?

As such, the pneumonia is the same. What has changed significantly is the organism causing the pneumonia, commonly referred to as the “strain”. The current strains are causing a higher rate of infection and, although still under investigation, appear to be more aggressive.

Are the new strains of coronavirus more dangerous to the lungs?

At present, there is no evidence to prove the danger of respiratory infection in each of the strains. What is known is that some strains of SARS-CoV2 are more aggressive and contagious, such as the British strain, although nothing has been demonstrated for the lungs.

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After COVID-19 pneumonia, are there any possible sequelae in the lungs?

In this aspect, pneumonia caused by COVID-19 usually resolves completely in most cases. Thus, the wide range of therapies used (mechanical ventilation, corticosteroids, monoclonal drugs, etc.) is ensuring that the sequelae are not significant and that respiratory involvement is resolved in most cases.

However, the small percentage of patients who suffer severe pneumonia, with severe acute respiratory syndrome, which in some cases has a disastrous prognosis, should not be overlooked. It should be noted that the continued use of respiratory support or assistance can lead to stiffening of the pulmonary architecture, resulting in shortness of breath, especially on exertion.

For more information, consult a specialist in Pneumology.