November 12: World Pneumonia Day

Interview to Angelo Coppola, Professor at UniCamillus

Today the World Pneumonia Day is celebrated all around the world through an awareness campaign “PneumoLight”, “Light for education and prevention of pneumonia – 2020-2024”, organized by the Association for the support and information of family members and pneumonia patients (Neumoai).

The event also aims to raise public awareness of the risks of pneumonia, a disease aggravated by the global pandemic caused by Covid-19.

According to the Ministry of Health, in fact, it could increase deaths from pneumonia by more than 75%.

Angelo Coppola, Professor of Diseases of the Respiratory System in the Degree Course in Medicine and Surgery and in the Three-Year Degree Course in Radiology, Diagnostic Imaging and Radiotherapy Techniques of UniCamillus, highlights in this interview the importance of safeguarding the lungs in all age groups and also explains Coronavirus pneumonia.

Why is it important to dedicate a World Day to Pneumonia?

Pneumonia is a form of acute respiratory infection that affects the lower airways, particularly the air sacs which are the site where respiratory exchanges take place.

According to the Global Burden of Disease Study 2019, lower respiratory tract infections currently represent the fourth cause of mortality in the general population with a particularly significant impact in the pediatric and older population. According to data released by the World Health Organization (WHO), pneumonia is the leading cause of infectious death in children worldwide, accounting for 15% of all deaths among children under the age of 5.

It is important to underline that pneumonia can be prevented through immunization, nutritional interventions and controlling environmental risk factors, and moreover, it can be effectively treated with drugs such as antibiotics, ut only one third of the children affected by pneumonia receive the needed treatment, accordin to the WHO data.

Due to all this reasons, it is important to devote a moment to reflect on this great public health problem, also in consideration of the fact that we are all called to a greater awareness of the problem and we must implement strategies that will allow us to reduce its impact worldwide.

Could it indicate the differences between interstitial pneumonia caused by Covid and the classic lobar pneumonia?

Pneumonia represents a large group of diseases that can be caused by a number of agents, including viruses, bacteria and fungi. We can classify pneumonia according to different criteria such as epidemiological (community pneumonia, hospital pneumonia, etc.), etiological (bacterial, viral pneumonia, etc.) or anatomo-pathological (alveolitis, interstitial pneumonia, etc.).

On the basis of these factors we ususally distinguish two forms of pneumonia:

– Typical pneumonia, which commonly represents the community-acquired pneumonia, generally of a bacterial nature, which predominantly determines a more or less extensive involvement of the air sacs (for example it can affect an entire lobe of the lung, giving rise to the so-called lobar pneumonia) which can be well visualized in radiological examinations. Clinically it causes cough, high fever and chills, treatment is mainly based on antibiotics.

– Atypical pneumonia, on the other hand, represents a form in which the supporting structures of the lung, defined as pulmonary interstitium, are more involved, and more frequently it can be caused by viruses and some bacteria. Generally it can have a more subtle clinical behavior, characterized by fever or low-grade fever, diffuse myalgias and an irritating cough that can last for some time and lead to advanced inflammatory scenarios. In these cases it is important to suspect atypical pneumonia to confirm the diagnosis with targeted examinations and to set the necessary therapy.

Our time is profoundly marked by the pandemic spread of the new Coronavirus SARS-CoV-2, capable of causing in some subjects a predominantly interstitial (atypical) pneumonia that can involve, in an acute and violent way, a large part of the lung tissue. In subjects seriously ill with COVID-19, we observe a widespread inflammatory involvement of the lungs that often leads subjects to a condition of respiratory failure, due to the fact that the respiratory system is no longer able to perform its functions. In these patients, in addition to medical therapies, it is necessary to resort to supportive treatments such as non-invasive mechanical ventilation in order to support ventilatory functions. This infection represents a dramatic challenge that we all face and that we are called to fight by putting into practice the rules that allow us to limit the spread of the virus, such as the use of masks, social distancing, correct hygiene of the hands and other behaviors recommended by ministerial guidelines.

What are, in your opinion, the most important messages to spread to raise public awareness on this pathology, especially in the situation we are currently living?

Considering all that we have just said, it is clear that lower respiratory tract infections represent, taken together, a dramatic global problem, albeit with different characteristics and forms. We must underline that pneumonia represents a pathology that can be effectively prevented through immunization and prevention strategies that include vaccination, nutritional therapy and the control of environmental risk factors. We also have pharmacological therapies that allow us to cure patients with pneumonia in most cases. All this forces us, as citizens but also as a community, to have greater awareness of this huge public health problem, because only by paying attention to the problem can we take important steps forward.

We also cannot ignore how the ongoing SARS-CoV-2 pandemic has inevitably turned the spotlight on respiratory infections. In this very circumstance, unfortunately, we touch firsthand the importance of implementing those preventive measures that allow, first of all, to stem the spread of the infection. All this cannot be separated from correct and widespread information that enable individuals and communities to be fully aware, as already mentioned above, not only of the risks but also of the weapons we have to fight and win this battle such as the use of masks, social distancing, correct hand hygiene and all behaviors recommended by ministerial guidelines.