Pneumonia

It is when the end of your breathing pipes, the air sacks, become inflamed (hot, red, swollen) and filled with fluid (when blood vessel leaks) and/or pus.

• It can be caught by breathing in bacterial, viruses, fungi (rare), breathing in foreign object or anything harmful to body (rare).
• People who have a weak immune system or smoke are particularly vulnerable.

Why is this happening?

• Our body (immune system) overreacts to anything harmful (see causes below) and this causes an increase of inflammation in our body, if this inflammation occurs in the lungs , it is called pneumonia.
• If the immune system reacts even further , it may affect the rest of the body and this can lead to septic shock where ones blood pressure drops to dangerously low levels and organs stop working properly or fail completely.

For diagnosis:

• Using a stethoscope

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Diagnosis Tests

CURB- 65: Each question counts for one point

C– Confusion

U (bun- Blood Urea Nitrogen) levels – greater than 19 mg/dL ( greater than 7 mmol/L urea) – (this optional as one does not always have the measurements)?

R– Respiratory rate of more than 30 breaths per min?

B– Blood pressure systolic [top number is less than 90 or diastolic (bottom number less than 60)]?

65 – The person is 65 years and over?

• If one score 0 – please see your medical doctor on the same day
• If one score 1-2 – Please go to hospital
• If score 3 or more please do not wait phone for an ambulance

Oxygen Saturation test (via Oxygen level meter)

• Oxygen saturation (SpO₂) is an important diagnostic tool for COVID-19 pneumonia, and measures the amount of haemoglobin-bound oxygen and free oxygen.
• The partial pressure of arterial O₂ (PaO₂) is measured by arterial blood gas monitoring. In healthy individuals, SpO₂ is usually >95%.
• In patients with chronic lung disease or sleep apnoea, SpO₂ can range between 88–92%.

McNicholas W, Kent, Mitchell. Hypoxemia in patients with COPD: cause, effects, and disease progression. COPD 2011;:199. doi:10.2147/copd.s10611

• In SARS-CoV-2 infection, patients have low SpO₂ levels.
• A phenomenon known as ‘silent hypoxia’ is reported, where patients present with minimal symptoms yet have significantly reduced pulse oximetry readings below 91%, particularly in the short term.

Attaway AH, Scheraga RG, Bhimraj A, et al. Severe covid-19 pneumonia: pathogenesis and clinical management. BMJ 2021;:n436. doi:10.1136/bmj.n436

Chandra A, Chakraborty U, Pal J, et al. Silent hypoxia: a frequently overlooked clinical entity in patients with COVID-19. BMJ Case Rep 2020;13:e237207. doi:10.1136/bcr-2020-237207