What you need to know about pneumonia

Pneumonia - a chest infection that affects the lungs - sometimes follows flu, but it can also be a complication of COVID-19. It's also possible to catch pneumonia without having flu or COVID-19 first. We'll help yourecognise the symptoms of pneumonia, and explain how it might be avoided.

Symptoms of pneumonia

Pneumonia is an infection of lung tissue, and has similar symptoms to bronchitis, an infection of the larger tubes in the lungs, called bronchi.

These symptoms are:

• A cough.

• Breathlessness.

• Wheezing.

• A high and/or low temperature.

However, people tend to feel even more unwell with pneumonia than with bronchitis. Pneumonia, like other chest infections, may require hospital treatment.

In serious cases, pneumonia:

• Can make you cough up bloody or rust-coloured spit and mucus - this is not a symptom of bronchitis. Anyone who coughs up blood should be seen by a doctor immediately as it could be a symptom of life threatening conditions such as a pulmonary embolism.

While anyone can get pneumonia, some people are more vulnerable than others. At-risk groups for pneumonia include people over 65, children under two, people with long-term (chronic) health diagnoses and people who have compromised immune systems.

Most cases of pneumonia are caused by bacteria or viruses. Bacterial pneumonia can be treated with antibiotics; all types of pneumonia respond well if the patient gets bed rest and plenty of fluids.

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When do I need medical help?

Dr Andy Whittamore is a GP in Portsmouth, and the clinical lead at the British Lung Foundation and Asthma UK.

"Viral infections are not treated with antibiotics," he explains, "but I'd still advise you call your GP if the infection goes on for more than a few days, causes difficulty breathing or chest pain, and especially if there's blood in your spit." You can also use the NHS 111 online or phone service if you are concerned that you're experiencing symptoms of pneumonia.

If you have pneumonia and experience breathlessness, if you feel confused, or someone caring for you says you're getting confused, seek emergency treatment. In rare cases, pneumonia can lead to sepsis - and this is life-threatening.

Pneumonia and the elderly

If you're elderly, it's even more important that your pneumonia is recognised and treated, as you have a higher chance of developing severe pneumonia. This can sometimes cause long-term and life-threatening complications, such as breathing problems and organ failure.

As you get older, your body may struggle more to fight the infection, as your immune system weakens over time. Many older people live in nursing homes and have extended stays in hospitals, and this is where pneumonia often passes between people. These are both dangerous environments to contract pneumonia - people in nursing homes are likely to have underlying conditions, while hospitals often carry strains of pneumonia that are more difficult to treat with antibiotics.

The stakes are high for the elderly, so being extra careful to reduce the chances of catching it are all the more important.

COVID-19 and pneumonia

Viral pneumonia can be caused by COVID-19, so if you're worried about how you're feeling it's important to look at the pattern of your symptoms.

"The main symptoms of COVID that we know to look out for are a dry cough, sore throat, loss of taste or smell, tiredness, aches and pains, and high temperature," he says. A high temperature is classed as 37.8°C or over.

If you have COVID-19 symptoms, you should test yourself and avoid close contact with others if the test is positive. You may be eligible to book a test on the NHS. If your symptoms get more severe - for example, the breathlessness gets worse- seek help by calling 111 or the relevant number for your region . In an emergency, phone 999 for an ambulance.

Prevention

Whilst not all cases of pneumonia are preventable, there are things you can do to reduce your risk.

Stay active

Exercise helps keep your lungs working at their best - whether it's 10K runs or a short daily walk, as long as you get breathless or break a sweat it counts. Experts recommend doing 30 minutes, five times a week.

When we move, we make our muscles stronger - and we also make them more efficient. For those of us with breathing problems or conditions like asthma, it also confronts fear of getting breathless and improves confidence - making the next time we exercise a tiny bit less intimidating.

It's harder to stay active in the winter than it is in the summer, and in particular people with lung problems sometimes find that cold weather makes breathlessness or a cough worse.

Smoking can also contribute to breathlessness and coughing. GPs and pharmacists are always happy to help you find a suitable way to quit or you can refer yourself to a quit smoking service on the NHS.

Keep warm

Heating your house and wrapping yourself up in warm clothes both reduce your risk of getting chest infections, Dr Whittamore advises. Keeping warm is particularly important if you're over 65, have health conditions or aren't very mobile - in this case, you should try to make sure your home is heated to at least 18°C. A report by Public Health England also found a link between cold homes, and conditions including asthma and pneumonia.

Treat underlying conditions

People with underlying respiratory conditions like asthma, COPD and pulmonary fibrosis are at higher risk of pneumonia. But taking steps to help when it is warmer, reduces risk when cold, wet weather really sets in.

"The message I give to patients with an underlying condition is to stay on top of their disease as much as they can," Dr Whittamore says.

Staying on top, he explains, means taking medication prescribed for the condition, and if symptoms seem bad at the moment - for example, using a salbutamol (blue ‘reliever’) inhaler three times a week or more - see a GP or asthma nurse to get more help.

If symptoms seem worse, it might be because the lungs are already a little bit infected or inflamed, which can make it easier for new infections like pneumonia to take hold. Solving these before winter sets in reduces the risk of getting chest infections, especially pneumonia.

Further reading

1. Public Health England: Local action on health inequalities: Fuel poverty and cold home-related health problems.