8 Risk Factors for Severe Pneumonia 

Pneumonia is an infection of the lungs that ranges from mild to life-threatening. It is generally spread through close contact with an infected person, meaning anyone can catch pneumonia. However, the illness disproportionately affects some populations, including the young, the elderly, and the immunocompromised.  

Recognizing that you or a loved one is at higher risk for pneumonia can save lives. It is possible to make lifestyle changes that reduce your chances of becoming seriously ill. The pneumonia vaccine is also a critical step for people who are most susceptible to pneumonia.

What is Pneumonia?

Pneumonia is an infection causing inflammation in the air sacs (alveoli) within the lungs. The lungs can fill up with fluid and pus, causing fever, coughs, and breathing difficulty. It can be caused by either bacterial or viral infection.  

Bacterial pneumonia is a contagious form of pneumonia. It is caused by several different types of bacteria, the most common being Streptococcus pneumoniae. The pneumococcal vaccine helps prevent bacterial pneumonia. It is also treatable with antibiotics.

Viral pneumonia can spread easily amongst people through coughs and sneezes. It usually develops after infection with a common illness, such as the flu, COVID-19, or the RSV virus. Since it is viral, it cannot be treated with antibiotics. Your doctor may prescribe an antiviral medicine or suggest rest and symptom management.

What is Severe Pneumonia?

Severe pneumonia is identified when the heart, circulatory system, or kidneys begin to fail or if the lungs cannot absorb sufficient oxygen. Patients with severe pneumonia are hospitalized under intensive care treatment and may require mechanical ventilation.

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8 Risk Factors for Severe Pneumonia in the Philippines

Pneumonia is the fifth leading cause of death in the Philippines. Let’s drill down into 8 risk factors that make you more susceptible to severe pneumonia in the Philippines.  

Young Age

When young children have pneumonia, they have a much higher risk of it becoming severe. In the Philippines, pediatric pneumonia accounts for 22% of all deaths in children aged 1 to 5. This is because their underdeveloped immune system leaves them more vulnerable to severe pneumonia.

Pneumonia is particularly dangerous for children who are obese or have underlying lung conditions. These children have higher odds of ICU admission or mechanical ventilation.

To prevent severe illness, the CDC recommends the pneumococcal vaccine (PCV 13) to children younger than two. If your child is over 2 and unvaccinated, they can still be immunized with the pneumonia vaccine. A doctor can advise you of the proper pneumococcal vaccine schedule.

Old Age

As you grow older, the immune system weakens. This leaves people over 65 years of age more susceptible to developing severe pneumonia. It is the second leading cause of death among Filipino seniors.

Risk factors that put seniors at an even higher risk of severe pneumonia include:

• Older age: As age increases, so does the risk of hospitalization and complications.

• Congestive heart failure: A serious infection, such as pneumonia, increases stress on the heart. This can lead to heart failure or heart attack in patients with heart problems. Patients with congestive heart failure are at 4 times greater risk of death with pneumonia than others.

• Diabetes mellitus: If you have high blood sugar caused by diabetes, your immune system doesn’t function as well. This leaves diabetics more susceptible to severe infection from common illnesses, such as pneumonia.

• Nursing home residency: Nursing Home Acquired Pneumonia (NHAP) occurs when a resident has long-term exposure to a nursing home or care facility. Nursing Home Acquired Pneumonia has become one of the most common causes of mortality in nursing homes.

• Unvaccinated adults: have higher risks of mortality and hospitalization without the pneumococcal vaccine.

The Center for Disease Control recommends immunization with the pneumonia vaccine (PCV15 or PCV20) for adults 65 years or older.

Being Underweight (Adults)

The Philippines has one of the highest populations of underweight people in the world, ranking above Nigeria, Ethiopia, and Brazil. Studies have shown that being underweight makes you more susceptible to pneumonia. This could be due to poor nutrition, which can affect immune function. Underweight adults take longer to recover from pneumonia and spend more time in the hospital.  

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Hospitalization (Hospital-acquired pneumonia)

If you’re in the hospital, your immune system is already defending against injury or illness. This can leave you more susceptible to secondary infections. Hospitals are also breeding grounds for drug-resistant germs, including a type of pneumonia called hospital-acquired pneumonia. This form of the disease is more dangerous and resilient to treatment than pneumonia acquired in the community.  

Chronic Disease

Chronic diseases weaken the immune system, putting patients at greater risk for developing severe pneumonia. Some chronic illnesses that affect the immune system and are common among Filipinos are:

• Diabetes: Diabetic patients have a higher risk of severe pneumonia, which can sometimes be fatal. The CDC reports that those with diabetes have 3 times a greater chance of dying from pneumonia.
• Lung Diseases: Lung conditions such as asthma, COPD, and tuberculosis can increase the risk of severe pneumonia, as the lungs are already weakened by disease.
• Heart diseases: People with heart conditions face a higher risk of heart failure when they get pneumonia.  

Smoking

Tobacco smokers have a weakened immune response to any kind of infection. Smoking damages the lining of the lungs, which normally filters the pneumococcal pneumonia bacteria out in healthy lungs.

Smokers with pneumonia are also more vulnerable to sepsis and tend to need hospitalization at a younger age, even without comorbid conditions. Overall, smoking increases the risk of dying within 30 days of pneumonia’s onset. The CDC recommends the pneumonia vaccine (PPSV 23) for smokers.

Alcohol Abuse

People who consume alcohol daily have weaker immune systems, making them easy targets for viral and bacterial infections. Excessive alcohol use also contributes to heart disease which compounds the risk of severe pneumonia. Heavy drinking increases the risk of severe pneumonia in the following ways:

• People who abuse alcohol are 10 times more likely to get pneumonia than those who are not.
• Heavy drinkers are 4 times more likely to die from pneumonia than non-drinkers.

Being Immunocompromised

People with compromised immunity are at a higher risk of acquiring severe pneumonia since they cannot fight off viruses and bacteria. Conditions and diseases that compromise immunity include:

• HIV/AIDS: Patients suffering from HIV/AIDS lose CD4 cells in the body, which leaves their immunity weak. Bacterial pneumonia is quite common in HIV patients.
• Organ Transplant: Pneumonia continues to be one of the most common infections in organ transplant recipients, especially in kidney transplants. After one month of the procedure, patients are at high risk due to bacterial pathogens.
• Cancer: Chemotherapy patients have weak immunity, and according to doctors, they are also often exposed to resistant pneumococcal bacteria in the hospital. Moreover, lung cancer patients are prone to getting pneumonia and have a high mortality rate.
• Steroid abuse: Patients who use steroids for the long term develop a high risk of pulmonary infections, including pneumonia. Steroids cause a delay in the immune response. As the duration and steroid dosage increase, patients become more prone to severe pneumonia.

What Should You Do if You're at Risk for Severe Pneumonia?

The pneumonia vaccine significantly reduces your risk of becoming sick or hospitalized. As another layer of protection, you can get immunized against common illnesses that progress to pneumonia, such as the flu and COVID-19.  Lifestyle changes, such as decreasing alcohol consumption, quitting smoking, and improving your diet, can also boost your immunity against severe pneumonia.

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