Pneumonia causes death in patients, what is the process like?

A patient with suspected COVID-19 who is being treated at RSUP Dr. Kariadi passed away. The patient died after four days of intensive care. However, the factor that causes death is not COVID-19, but infection with legionella bacteria which causes complaints similar to pneumonia.

Each year, pneumonia affects approximately 450 million people worldwide. According to a study in the journal The Lancet, pneumonia caused 3 million deaths in 2016 and is one of the most common causes of death. So, what makes pneumonia so deadly?

How does pneumonia cause death?

Pneumonia is a disease of the lungs caused by a viral, bacterial or fungal infection. This disease causes inflammation, fluid buildup in the lungs, and even pus buildup in the alveoli or the small air sacs in the lungs.

Patients with healthy bodies usually recover from pneumonia after 1-3 weeks of treatment. However, pneumonia can also have more dangerous effects, including death in people with certain conditions.

Pneumonia begins when a pathogen (germs) enters the respiratory tract by coughing, sneezing, or talking in close proximity to an infected patient. The presence of pathogens then triggers inflammation and swelling of the alveoli in the lungs.

The lungs play an important role in the delivery of oxygen throughout the body. However, inflammation and swelling prevent the lungs from functioning normally. The vital organs end up not getting enough oxygen supply.

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Pneumonia may not directly cause death, but this disease causes the patient's body to continue to produce an inflammatory reaction to fight the infection. This response results in a drop in blood pressure and further reduced blood flow to vital organs.

The vital organs end up deprived of both blood and oxygen supply. The combination of the two then interferes with the function of the heart, kidneys and other organs that are important for supporting the patient's life. This will make the patient's condition deteriorate.

Over time, the patient also has difficulty breathing because the alveoli in his lungs fill with fluid or pus. Without immediate treatment, pneumonia is very severe and can even cause death within hours.

Factors that increase the risk of death from pneumonia

Anyone can get pneumonia, but there are a number of factors that increase the risk of infection and make the disease even more dangerous. These factors include the cause of pneumonia, age, health conditions, lifestyle, and environment.

Here are the factors to watch out for:

1. Causes of pneumonia

Any type of pneumonia can cause death, but the risk depends on the type of germ that caused the disease. Pneumonia due to viruses, for example, tends to be mild and the symptoms appear slowly. However, viral infections can be more complicated than bacteria and fungi.

Bacterial pneumonia is usually more severe and the symptoms can appear suddenly. If not treated properly, bacteria can enter the bloodstream and lead to more dangerous complications.

Meanwhile, fungal pneumonia was more common in patients with weak immune systems. Yeast infection can also cause serious complications such as bacterial pneumonia.

2. Age

Pneumonia is more likely to cause death in children under two years of age, because their immune systems are not fully developed. This disease is even the leading cause of death in children in the United States, as quoted from the American Thoracic Society.

Apart from children, the elderly aged 65 years and over are also at risk of experiencing severe complications due to pneumonia. The reason is that the elderly have a weaker immune system making it difficult for their bodies to fight infection.

3. Pre-existing medical conditions

Pneumonia often causes serious complications and death in patients who have developed a serious illness or have certain medical conditions. Here are a number of conditions to watch out for:

• Diseases affecting the lungs such as asthma, cystic fibrosis, and chronic obstructive pulmonary disease.
• Heart disease, sickle red blood cell, and diabetes.
• Recently had a cold or flu.
• Undergo intensive care and on a ventilator to breathe.
• Has difficulty coughing or swallowing so that saliva and food debris can enter the lungs, leading to infection.
• Having a weakened immune system due to HIV or AIDS, chemotherapy, steroid use, or other causes.

4. Surrounding environment

Long-term exposure to pollutants, chemicals, and secondhand smoke can increase the risk of pneumonia and its complications. Apart from death, pneumonia can also cause complications in the form of:

• meningitis (infection of the lining of the brain)
• bacteremia (a condition where bacteria enter the bloodstream)
• kidney failure
• respiratory system failure
• sepsis (a dangerous condition resulting from the body's massive immune response to fight infection)

5. Lifestyle

The patient's lifestyle also influences the severity of pneumonia. Pneumonia can cause serious complications and death in patients who use illegal drugs, smoke, and consume alcohol excessively.

Pneumonia can cause severe complications in patients with certain conditions, sometimes even leading to death. This disease is also one of the complications of COVID-19 which is now endemic in a number of countries.

Although pneumonia is not necessarily a sign of COVID-19, don't ignore the symptoms that appear. Get checked out immediately if you experience breathing problems or a cough that doesn't go away. Early examination is very important to support recovery.