What's The Connection Between COPD & Pneumonia?

Maria Tesoro-Morioka

Pneumonia is a dangerous lung infection. According to data from the Centers for Disease Control and Prevention (CDC), pneumonia accounts for 1.5 million visits to the emergency room. About 47,601 deaths occur each year due to pneumonia symptoms. 

If your loved one already suffers from chronic obstructive pulmonary disease (COPD), they are at a higher risk of developing pneumonia. Unfortunately, when combined with COPD, pneumonia can be especially hazardous. On their own, each condition can cause damage to the lungs and impair lung function. Together, COPD and pneumonia raise the risks of severe complications. 

What is COPD? 

Most people believe that COPD stands alone as one disease. In truth, COPD is a category of long-term progressive illnesses that impacts lung function. Two of the primary diseases that fall under the category of COPD are chronic bronchitis and emphysema. 

Progressive illnesses worsen with time and typically have no cure. 

Both worldwide and within the U.S., COPD is the third leading cause of disease-related death. In general, COPD is the fourth leading cause of death in the U.S. behind unintentional injuries, cancer, accidents, and heart disease. Approximately 86% of COPD deaths occur in people who are 65 years of age, making older adults the most vulnerable population when it comes to the condition. 


COPD symptoms include:

  • An ongoing productive cough is also known as a “smoker’s cough.” A productive cough produces mucus, also known as phlegm or sputum. 

  • Shortness of breath (difficulty breathing) when performing physical activities. 

  • A whistling or wheezing sound when a person breathes. 

  • Tightness or heaviness in the chest. 


COPD symptoms may come and go, with flare-ups called “exacerbations.” 

An acute exacerbation of COPD, when symptoms become severe, may require a visit to a health care provider for assessment and treatment. These symptoms can differ from person to person, with varying degrees of severity. Respiratory infections like pneumonia can cause flare-ups and may even result in hospitalization.


How Does Lung Function With COPD Work?


COPD occurs due to lung damage, typically stemming from cigarette smoking. Other risk factors for COPD include exposure to air pollutants or environmental toxins. 

Prolonged exposure to these lung irritants can cause inflammation and increased mucus production, which can injure the delicate internal structure of the lungs. 

The symptoms of COPD occur because of at least one or more of the following effects of continuous cigarette smoking or air pollution: 

  • The air tubes (bronchioles) and tiny sacs (alveoli) within the lungs become rigid, losing their elasticity and resilience.

  • Walls between air sacs become compromised or completely break down. 

  • Inflammation affects the airways, becoming thick and swollen. 

  • An excessive amount of mucus obstructs the airways and prevents healthy airflow. 


There’s no cure for COPD. If left untreated, COPD can negatively impact a person’s quality of life and may even become fatal. 

Fortunately, however, a diagnosis of COPD is not the end. COPD treatments can prevent further lung damage and slow the condition’s progress. One treatment intervention for COPD is the prevention of infections that can cause pneumonia. 

What is Pneumonia? 

Pneumonia is a lung infection that results in inflamed air sacs within the lungs. These air sacs are vital for the exchange of oxygen and carbon dioxide. Oxygen from inhaled air and carbon dioxide from blood gets exchanged within these air sacs. These air sacs must be free of fluid and obstructions for optimal exchange of gasses. 

The alveoli become filled with pus, fluid, and mucus with pneumonia. This liquid prevents air from moving freely through the lungs, causing breathing problems. Individuals with pneumonia might need to exert a tremendous amount of effort to perform a minimal amount of breathing. 

Some cases of pneumonia are mild. Other cases, however, may require hospitalization. The symptoms of pneumonia aren't always apparent and a worsening of symptoms may occur quickly. The symptoms of pneumonia may include: 


  • Sweating

  • Chills

  • Fever

  • Productive cough

  • Colored (yellow or green) or bloody sputum 

  • Shortness of breath

  • Shallow and fast breathing 

  • A sharp or stabbing chest pain with inhalation 

  • Extreme tiredness

  • A loss of appetite


Older adults may experience the following pneumonia symptoms: 

  • Dehydration 

  • Poor appetite 

  • Abdominal pain due to repetitive and prolonged coughing 

  • Confusion


The American Thoracic Society places an emphasis on caring and prevention for pneumonia, particularly in older adults and those who have community-acquired pneumonia. 

Older adults and people with severe COPD are at a higher risk for pneumonia and experiencing severe complications. Some complications that older adults are at an increased risk for are:


  • A proliferation of bacteria in the blood can stem from bacteria within the lungs. This bacteria in the blood may spread to other parts of the body. 

  • Buildup in the lungs of infected fluid, which may require drainage or surgery. 

  • A lung abscess from the overgrowth of infectious waste may need surgery or antibiotics. 

Because their baseline lung functioning is already impaired and their immune systems are weaker, older adults with chronic obstructive pulmonary disorder and pneumonia have a higher incidence of complications.


How Are  COPD & Pneumonia Related?

Pneumonia can wreak havoc on a lung that’s already damaged, as is the case with a lung disease like COPD. Conversely, if you or your loved one already has COPD, pneumonia is more likely to develop– which can do additional damage to already damaged lungs. 

Therefore, experiencing both pneumonia and COPD simultaneously can result in serious complications, causing long-term damage to the lungs and other organs. Having comorbidity (experiencing two diseases simultaneously) of two significant lung conditions presents a dangerous situation and may result in a worsening of both illnesses.

Due to pneumonia-causing inflammation which limits airflow, pneumonia can become a particularly harmful illness among COPD patients. Pneumonia patients may become deprived of oxygen (hypoxic). 

If you or your loved one doesn’t get enough oxygen, they may develop irreversible brain damage, kidney injury, or experience a stroke or heart attack. Pneumonia can also progress into a potentially fatal condition called acute respiratory failure. 


What Are The Treatment Options for Pneumonia & COPD?


Individuals with COPD who develop pneumonia usually need medical attention and are given an immediate hospital admission. Diagnostic tests like chest x-rays, CT scans, sputum samples, and lung function tests can help to target the type of pneumonia and determine treatments. 

Treatments used for people with COPD and pneumonia may include: 


  • Antibiotics

  • Bronchodilator

  • Corticosteroids and glucocorticoids

  • Oxygen therapy or supplementation

  • Mechanical ventilation


Quick identification and intervention are of utmost importance when people with COPD potentially have pneumonia. More importantly, pneumonia can be prevented. 


Pneumonia Vaccine & Infection Prevention


The CDC encourages people with COPD to take special precautions to prevent pneumonia. 

Good hand hygiene is the first step to preventing bacterial infections that can cause pneumonia. Because their risk of pneumonia is high, it‘s vital for people with COPD and older adults to adhere to their health care provider’s recommended vaccination schedules. 

Maintaining the yearly flu, Covid-19, and pneumococcal vaccination requirements helps the immune system fend off infectious diseases that cause pneumonia. The pneumococcal vaccine works against the most common cause of pneumonia, streptococcus pneumonia. In short, prevention is the best way to avoid developing pneumonia when you or your loved one has COPD.