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WHY PNEUMONIA SHOULD NOT BE IGNORED IN COVID TIMES

With a recent increase in the number of cases of Covid-19 pneumonia, doctors and health experts are suggesting that people should follow strict safety protocols and patients monitor their symptoms to stay ahead of severe complications.

With Covid-19 cases still mounting with every passing day, severe complications caused by the virus are also on the rise. Among these is pneumonia, which is being seen more commonly now, according to doctors.

Talking about the complication, Dr Behram Pardiwala, Director, Internal Medicine and Academics, Wockhardt Hospitals, South Mumbai says, “Many people with Covid-19 may exhibit mild symptoms such as cough, fever, and body pain. But there are a few who may get pneumonia in both the lungs. Covid pneumonia can be life-threatening. Older people or ones with comorbidities have a greater risk of getting Covid-19 pneumonia.”

Dr Pardiwala also points out, “Covid pneumonia can be termed as the manifestation of Covid-19. One may exhibit symptoms like breathing difficulties, cough, and even chest pain. This condition takes a toll on your lower respiratory tract tissues, and you will be required to be on a ventilator due to shortness of breath. One may suffer from regular pneumonia owing to the bacteria and viruses that may cause lung inflammation, pus, and breathing problems, but Covid pneumonia is serious and can increase mortality and morbidity.”

Speaking about its diagnosis, he suggests, “A blood test, an X-ray, and a CT scan can aid the diagnosis of this condition.” The diagnosis for Covid pneumonia is based on symptomatic presentation, RT-PCR swab for Covid-19 and a CT scan of the chest, says Dr Harish Chafle, Consultant Intensivist and Chest Physician, Global Hospital, Mumbai.

While there is no clear data showing that Covid pneumonia is causing more Covid-related deaths, doctors agree that the incidence of the infection has increased. “There was a 10% increase in the number of cases in the last week,” says Dr Chafle, “but in the last few days, the number of cases has come down,” he adds. Dr Pardiwala agrees that cases of pneumonia have increased during the pandemic, and people must continue adhering to Covid-19 protocols to keep safe.

Dr Rahul Bahot, Consultant, Respiratory Medicine at Jaslok Hospital and Research Centre, Mumbai says, “Anyone can get Covid-19 pneumonia, but it’s more likely to be in people who are 65 years or older. Those who are 85 or older are at the highest risk. People who live in nursing homes or have other health problems like moderate to severe asthma, lung disease, high blood pressure, heart disease, diabetes, liver disease, renal failure, severe obesity, or a body mass index (BMI) of 40 or higher also have higher chances of experiencing more severe illnesses with Covid-19.”

Covid-19 can cause lung complications such as pneumonia, sepsis and, in the most severe cases, acute respiratory distress syndrome or ARDS, which can lead to lasting harm to the lungs and other organs. Dr Davinder Kundra, Consultant – Pulmonology at HCMCT Manipal Hospitals, Dwarka in Delhi, informs, “In pneumonia, the lungs become filled with fluid and inflamed, limiting their ability to take in oxygen and causing shortness of breath, cough and other symptoms. For some people, breathing problems can become severe enough to require treatment at the hospital with oxygen or even a ventilator. As Covid-19 pneumonia progresses, ARDS, a form of lung injury or respiratory failure, may develop.” Patients with ARDS are often unable to breathe on their own and may require ventilator support to help circulate oxygen in the body.

Dr Kundra adds that Covid pneumonia can also lead to the exacerbation of bronchial asthma/COPD or underlying interstitial lung fibrosis. Post-Covid fibrosis is a well-known complication which is being seen in many patients who have recovered from Covid pneumonia, requiring long term oxygen support as well as frequent visits to healthcare facilities. As these patients have weaker immune systems post-recovery, they are prone to superinfection due to other bacterial, fungal and viral pathogens.

Dr Bahot adds that people with a weakened immune system may be more likely to suffer from serious Covid-19 infection itself. This includes smokers, people being treated for cancer, those who have had a bone marrow transplant, people who have HIV-AIDS which is not under control and anyone who takes medications that slow the immune system, like steroids. Dr Kundra adds that persons with chronic lung disease/chronic kidney disease/ chronic heart disease/post-transplant (solid organ or stem cell transplant) patients or immunosuppressed patients are also at a high risk of contracting severe Covid-19-related illnesses.

SYMPTOMS YOU SHOULD NEVER IGNORE

• Fever, dry cough and shortness of breath are common early signs of coronavirus. You may also experience fatigue, chills, nausea or vomiting, diarrhoea, belly pain, muscle or body aches, headache, loss of smell or taste, sore throat, congestion or a runny nose, pink eye and skin rashes.

• If your Covid-19 infection starts to cause pneumonia, you may notice things like a rapid heartbeat, shortness of breath or breathlessness, rapid breathing, dizziness and heavy sweating.

— By Dr Rahul Bahot, Consultant, Respiratory Medicine at Jaslok Hospital and Research Centre, Mumbai

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