COVID pneumonia is a lung infection caused by SARS CoV-2, the virus that causes COVID-19. It causes fluid and inflammation in your lungs. Worsening difficulty with breathing is the most common symptom of COVID-19 progressing to COVID pneumonia. It’s important to go to the ER if you have symptoms of COVID pneumonia, as it can get worse quickly.
COVID pneumonia is an infection in your lungs caused by SARS-CoV-2, the virus that causes COVID-19. You can get pneumonia as a complication of being sick with COVID-19. As your immune system attacks the infection in your lungs, they get inflamed and fill with fluid, making it hard to breathe.
The type of pneumonia associated with COVID-19 is almost always in both lungs at the same time (bilateral). Interstitial tissue is what surrounds your lung’s air sacs, blood vessels and airways. Interstitial lung disease causes scarring or other lung damage. Bilateral interstitial pneumonia in COVID-19 is lung damage on both sides as a result of COVID-19-related pneumonia. This usually happens after the initial (infectious) phase, often in people who have long COVID (post-acute sequelae of SARS CoV-2, or PASC).
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COVID-19 is a respiratory illness caused by the virus SARS-CoV-2. The virus infects your airways and damages your lungs. To fight off the infection, your immune system causes inflammation, which can also cause damage and allow fluid to leak into the small air sacs of your lungs. This is called pneumonia.
Yes, you can get pneumonia when infected with COVID-19. The virus that causes COVID-19 can infect your lungs, causing pneumonia. Sometimes you can also get infected with a bacteria that causes pneumonia while your immune system is weakened (this is called a superinfection). If you’re on a ventilator to help you breathe while you’re sick with COVID-19, you’re at higher risk for ventilator-associated pneumonia.
COVID-19 and COVID pneumonia are best described as different stages of the same illness. COVID-19 is a respiratory illness caused by the SARS-CoV-2 virus, and COVID pneumonia is a complication of COVID-19 that causes inflammation and fluid in your lungs.
All pneumonias cause inflammation and fluid in your lungs. But research suggests that the SARS-CoV-2 virus that causes COVID pneumonia moves differently through your lungs than other viruses and bacteria that cause pneumonia.
COVID pneumonia spreads across your lungs slowly, using your own immune system to spread, which means it tends to last longer and cause damage in more places. Other pneumonias cause acute disease — symptoms come on all at once — but don’t last as long.
You’re at an increased risk of getting very sick with COVID-19, including COVID pneumonia, if you:
You're also at an increased risk if you’re living with:
About 15% of people with COVID-19 develop serious complications, including COVID pneumonia. Worldwide, that means more than 77 million people to date have had severe cases of COVID-19.
The symptoms of COVID pneumonia can be similar to those of an initial COVID-19 infection. If any of these symptoms are new or get worse, seek medical attention or go to the nearest ER, as they may be signs of COVID-19 progression to pneumonia:
While pneumonia and COVID-19 can cause many similar symptoms, the biggest indicator that a COVID-19 infection has worsened is trouble breathing. If you have shortness of breath and it’s getting worse, or if you feel like you can’t get air, go the nearest ER.
COVID pneumonia is caused when your immune system attacks an infection of the SARS-CoV-2 virus in your lungs. This makes the small sacs in your lungs (alveoli) swell and leak fluids.
In most pneumonias, bacteria or a virus reproduces itself and spreads throughout your lung or lungs quickly. It’s like a fire that rapidly spreads from tree to tree, causing a raging wildfire in no time.
On the other hand, in COVID pneumonia, research suggests that the virus infects small areas of your lungs at the same time and settle in. The virus then uses your immune system to start spreading out into other parts of your lung over time. You can think of it like bonfires burning at different campsites. After the bonfires burn for a while, their embers drift into other areas, causing new fires and spreading the damage in a slow burn.
The virus that causes COVID-19 is contagious — it can spread from person to person when you’re infected and you cough, sneeze, talk or even breathe near someone else. Pneumonia is a condition in your lungs you can get when you have COVID-19. Someone else could get COVID-19 from you if you have COVID pneumonia, but they won’t necessarily end up getting pneumonia themselves.
It’s also possible that you could have COVID-19 and get a bacterial infection that causes pneumonia at the same time (superinfection). The bacterial infection is contagious and could be spread to other people, who could get pneumonia from it.
To diagnose COVID pneumonia, your healthcare provider will ask about your symptoms and conduct a physical exam. They’ll listen to your lungs with a stethoscope and take your blood pressure, temperature and oxygen level. They will probably use a swab to take a sample from your nose to confirm that you have COVID-19 or to rule out an infection with other viruses.
They may perform or order additional tests, including imaging, blood tests or sputum (spit) tests.
Your provider may perform tests that look at your lungs for signs of infection, measure how well your lungs are working and examine blood or other body fluids to confirm a COVID-19 infection and to look for other possible causes for pneumonia.
Tests a provider may perform include:
If you’re diagnosed with COVID pneumonia, it’s likely that you’ll be admitted to the hospital. Treatments you might receive include:
The best way to prevent COVID pneumonia is to take steps to reduce your risk of getting COVID-19. Getting vaccinated against COVID-19 and other causes of pneumonia plus a few simple habits are the best ways to reduce your risk.
There are vaccines for both COVID-19 and other causes of pneumonia that you could get infected with at the same time as COVID-19. Getting vaccinated against them reduces your risk of getting sick to begin with and reduces your risk of serious illness, like COVID pneumonia, if you do get sick.
In addition to getting vaccinated, you can help reduce your risk of getting severe COVID-19 with some healthy habits:
There’s no standard timeline for how long COVID pneumonia lasts. How you feel with COVID pneumonia may change day by day. Some days you may think you’re getting better, but you may feel worse again before it’s over. For moderate illness, you may feel better in three to six weeks. For more severe illness, it can take months to recover. How soon you will feel better depends on:
Follow-up with your healthcare provider if you have ongoing health concerns after being treated for COVID pneumonia.
COVID pneumonia is a complication of a COVID-19 infection, on a spectrum of how sick you can get from the SARS-CoV-2 virus. You can think of a COVID-19 infection in stages of severity:
As long as hospitals aren’t overwhelmed, the survival rate for COVID pneumonia is about 80%. When there’s a surge and hospitals are overwhelmed, deaths from COVID pneumonia (mortality) can double. Seeking treatment as soon as possible increases your chance of survival and a quicker recovery.
Once you’ve been released from the hospital, there are a few things you can do at home to continue your recovery:
As you begin to recover from COVID pneumonia, you shouldn’t struggle to breathe anymore. Your healthcare provider should be able to reduce the number of machines that help you breathe or give you oxygen if your condition is improving.
Once you’ve returned home, feeling like you’re up to returning to some of your normal activities is a good sign that you are continuing to recover.
If you have any COVID-19 symptoms such as loss of your sense of taste or smell, sore throat, fever, cough or shortness of breath, get tested for COVID-19. Contact your healthcare provider if you’re at risk for severe COVID-19 or if you have questions about managing your symptoms.
Go to the emergency room or call 911 if you have COVID-19 and have any new or worsening symptoms, especially if you’re struggling to breathe, feel confused, can’t seem to stay awake or your skin, lips or nails appear blue.
A note from Cleveland Clinic
Some people have very mild symptoms of COVID-19, while others get very sick with conditions like COVID pneumonia. Make sure you keep a close eye on your symptoms — especially if you’re over the age of 65 or have an ongoing medical condition that puts you at risk for severe illness with COVID-19.
The virus can cause a lot of damage over time, so don’t hesitate to call your healthcare provider or go to the ER if your symptoms worsen. Not being able to breathe or stay awake, feeling confused and having your skin, lips or nails turn blue are not normal symptoms and need to be checked out right away.
Last reviewed by a Cleveland Clinic medical professional on 08/10/2022.
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