A Guide to COVID-19 Pneumonia

COVID pneumonia is a complication of COVID-19, the illness caused by the SARS-CoV-2 virus. It might affect the body differently than other types of pneumonia.

COVID-19 can lead to a range of symptoms, including a cough, fever, and dyspnea (difficulty breathing). Most people infected with the virus experience mild to moderate symptoms, or no symptoms at all. However, the virus can cause more significant symptoms, including the development of pneumonia, a severe respiratory infection. This might require hospitalization or mechanical ventilation and can be life-threatening.

The research remains sparse at this point, but here's what you need to know about COVID pneumonia, including symptoms and possible treatment options.

The Link Between COVID-19 and Pneumonia

Some patients with COVID-19 develop pneumonia, an infection of tiny air sacs in the lungs (alveoli) that can cause mild to severe illness. In fact, the World Health Organization (WHO) first called the virus novel coronavirus-infected pneumonia (NCIP) before shortening the name to COVID-19. The SARS-CoV-2 virus was also first identified in Wuhan, China due to cases of "pneumonia of unknown etiology," or unknown cause.

Viruses are a common cause of pneumonia. "In the case of COVID-19, the virus can damage your alveoli and cause fluid to build in your lungs as your body fights the infection," Raymond Casciari, MD, a pulmonologist at St. Joseph Hospital in Orange, California, told Health.

COVID-19 Pneumonia vs. Other Pneumonia

COVID-19 pneumonia seems to be a more severe form of pneumonia. For example:

• It appears to last longer and cause more damage.
• It seems to infect several small areas of the lung at once, which is different from many forms of pneumonia that infect large lung areas.
• It might be more inflammatory.
• People with COVID-19 pneumonia are more likely to have pneumonia that affects both lungs.

COVID-19 pneumonia is different from other forms of pneumonia in that it doesn't necessarily cause people to get seriously ill right after they're infected. "You don't get sick immediately as you do with a lot of other viruses," Dr. Casciari said. "Then, in some people, the virus just explodes in the lungs, causing severe illness."

COVID-19 takes over ACE-2 receptors in the lungs and uses them to spread the virus across the lungs. As the infection spreads, it causes lung damage as well as symptoms like fever and low blood pressure. It can also spread to and damage organs like the kidneys, brain, and heart.

COVID pneumonia might have a few particular characteristics, including:

• Low blood oxygen levels
• Altered lung perfusion (decreased blood flow to the lungs)
• Relative lack of dyspnea (shortness of breath)
  

Symptoms

Symptoms of COVID-19 pneumonia are generally similar to other forms of pneumonia. Possible symptoms include:

• Cough
• Fever
• Shortness of breath
• Stabbing chest pain that gets worse when you breathe deeply or cough
• Loss of appetite
• Fatigue

People with COVID-19 pneumonia will often also have symptoms of COVID-19, including:

• Fever or chills
• Cough
• Shortness of breath or difficulty breathing
• Fatigue
• Muscle or body aches
• Headache
• New loss of taste or smell
• Sore throat
• Congestion or runny nose
• Nausea or vomiting
• Diarrhea

Risk Factors

Healthcare providers can't necessarily predict who will develop COVID-19 pneumonia. However, some people are considered at a higher risk than others. Older age is considered the strongest risk factor for COVID-19 complications. Other risk factors include:

• Asthma
  
• Diabetes
• Chronic kidney disease
• Chronic liver disease, such as cirrhosis
• Human immunodeficiency virus (HIV)
  
• Underlying heart or lung condition
• Taking immunosuppressant medication
  
• Smoking
• Pregnancy or recent pregnancy
  

Diagnosing COVID Pneumonia

A healthcare professional will want to confirm that you do indeed have COVID-19, likely through a swab or sample of respiratory secretions that can detect the genetic material of the SARS-CoV-2 virus. They will also inquire about your symptoms.

Medical imaging tests are often used to diagnose pneumonia, including pneumonia resulting from COVID-19. These tests include:

• X-ray: This test uses radiation to create two-dimensional images.
  
• Computed tomography (CT) scan: This test uses X-rays to generate multiple image "slices" that, together, recreate a three-dimensional image.
• Lung ultrasonography (LUS): This ultrasound test uses sound waves to generate images. LUS is useful in detecting damage and healing of lesions on the lungs later in the infection

Research suggests a high likelihood of CT abnormalities more than three months after COVID pneumonia. CT scans might show lung abnormalities such as:

• Ground glass opacities (a "ground glass" appearance)
• A reticular pattern (resembles a net or honeycomb)
• Displacement of lung structures

Other tests might include:

• Pulse oximetry: This is important for diagnosing infection severity, but results can be affected by factors like skin thickness and temperature. Therefore, it's used in combination with other testing.
• Pulmonary function test (PFT): A test that measures lung functioning
• Echocardiogram: An imaging test that uses sonography (ultrasound) to produce images of your heart
• Blood tests: This might include a complete blood count (CBC), a comprehensive metabolic panel (CMP), and antibody testing
  

Treatment

Healthcare providers have typically been treating pneumonia from COVID-19 with the antiviral medication remdesivir and anti-inflammatory medications like the steroid dexamethasone.

Your healthcare provider will also likely perform follow-up tests like the ones used for diagnosis to monitor how the infection is progressing.

Seek medical care if you develop symptoms of COVID-19 pneumonia. Symptoms of COVID-19 that require emergency medical treatment include:

• Difficulty breathing
• Persistent chest pain or pressure
• Pale, gray, or blue skin, lips, or nail beds

This is not an exhaustive list. Always contact your healthcare provider if you have any concerning symptoms.

Potential Complications

People with COVID-19 pneumonia might have complications. Severe complications of COVID-19 (compared to other types of pneumonia) could be because the virus causes a longer duration of illness.

Short-term complications can include acute respiratory distress syndrome (ARDS), a serious form of respiratory failure that makes the alveoli fill with fluid.

However, most complications of COVID pneumonia involve long-term lung abnormalities, especially in severe cases where people require ventilation. These abnormalities include:

• Fibrosis: Damaged and scarred lung tissue
• Restrictive lung disease: A group of conditions characterized by reduced lung volume
• Reduced diffusion capacity: Impaired ability to move oxygen from the air to your blood

A Quick Review

COVID pneumonia is pneumonia caused by COVID-19. It's a complication that can lead to long-lasting lung abnormalities. Risk factors, including older age, are similar to risk factors for COVID-19 and pneumonia. However, symptoms and effects appear to be longer-lasting and more damaging than other types of pneumonia.

Reach out to a healthcare provider if you are concerned that you've developed pneumonia as a result of COVID-19. Treatment can help reduce the risk of long-term complications.

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.