The doctor called the possible reasons for getting Mikhalkov and Kostomarov in intensive care

At the beginning of the year, news appeared about hospitalizations in serious condition due to pneumonia of several famous people at once. Among them are director Nikita Mikhalkov and figure skater Roman Kostomarov. Their examples clearly show that pneumonia, requiring resuscitation, can occur at any age and even in completely healthy people. About why pneumonia develops, “MK” was told by the famous pulmonologist of the Clinical Center of Sechenov University, doctor of the highest category Alexander Palman.

According to media reports, on the night of January 9-10, figure skater Roman Kostomarov was taken to the hospital in serious condition. According to the latest data, he was in intensive care on ventilators and ECMO, but they decided to transfer him to a hospital in Kommunarka. It is also reported that doctors assess his condition as extremely serious, and he developed pneumonia as a result of a flu complication (supposedly a flu test gave a positive result).

Since January 5, 77-year-old director Nikita Mikhalkov has been in intensive care with pneumonia. Influenza was also initially cited as the reason for hospitalization. Then he was allegedly diagnosed with coronavirus. Now they write that he has idiopathic, pneumococcal, or polysegmental pneumonia.

According to telegram channels, Mikhalkov’s condition is deteriorating, but today the director himself unexpectedly wrote on the social network that a large amount of information about his health is “little true”: “I want to say that while I stay in the hospital, I continue to undergo examinations and receive the necessary treatment “.

… In the 21st century, pneumonia, despite the availability of antibiotics, remains a deadly disease and one of the leading causes of death in the world. According to the World Health Organization, pneumonia is one of the 10 most common causes of death.

Pneumonia causes inflammation in the lungs, causing the alveolar sacs to fill with fluid or pus, making ventilation and gas exchange difficult, causing fever, chills, difficulty breathing, and other symptoms. In Russia, the average duration of one case of pneumonia is 25.6 days, while labor losses reach about 25.5 thousand days per 100 thousand people annually.

Pneumonia is most often caused by bacteria, but viral and fungal infections of the lungs are also isolated. This disease can develop at any age, but it is most dangerous for children of the first 5 years of life and the elderly. Since the pathogen is transmitted by airborne droplets, anyone can become infected at any time of the year.

But why do some literally endure pneumonia on their feet, while others end up in a serious condition in intensive care? What does it depend on? We asked these and other questions to Dr. Alexander Davidovich Palman,

– The vast majority of pneumonia is bacterial. There are pathogens close to bacteria, they are called atypical, they are also affected by antibiotics, – says the expert.

– Viral pneumonia is also called atypical?

– In many media efforts, lung damage due to COVID-19 was called atypical viral pneumonia or covid-associated pneumonia. Indeed, viruses can cause lung damage, this has been known for a very long time. But COVID-19 develops a virus-associated lung injury that is not pneumonia per se. Influenza can also cause lung damage. It is believed that this does not happen as often as with covid. However, if everyone with the flu were to undergo massive CT scans, as was the case with the coronavirus, I think we would see as many frosted glasses.

Any respiratory virus has an application point. Some viruses “love” the nasopharynx, while others love the lower respiratory tract. In the second case, bronchitis caused by a virus develops, or damage to the lung tissue. With covid, a very small percentage of patients had bacterial complications. Now we have a classic winter situation: a person falls ill, a few days of high temperature, then it drops to subfebrile (slightly above 37C), a couple of weeks pass – and then the second burst of high temperature begins. In this case, the diagnosis can be made almost by phone: it is pneumonia. First, a viral infection disrupts the protective function of the lungs, as a result of which bacterial complications “sit down” on them.

What determines the severity of pneumonia?

– The answer to the question: “Why do some people do this, while others do it differently?” will be the same as the answer to the question “What would have happened to my grandmother if she had been born a grandfather?” Sometimes an elderly and/or debilitated patient becomes seriously ill. Or suffering from a serious illness that violates the immune system. Or taking immunosuppressive therapy. It is clear why this happened. But sometimes a young and healthy patient ends up in intensive care. In some cases, with bacterial or viral pneumonia, it is not clear why it happened one way or another. And so the patients ask: “Doctor, why, where does my pneumonia come from?” And sometimes I don’t know what to say to them. Naturally, older people are at risk precisely, therefore, patients over 60 have a higher risk of a severe course, which means that it is better for them to carry out not only antiviral, but also anti-pneumococcal vaccination. In the days of Dr. Chekhov, it was believed that pneumonia was sent down to people in order to clean up the elderly. Yes, there is an age risk factor. But this does not mean that patients of young ages do not suffer from severe pneumonia. And why one had a fever and passed, and the other – hospitalization and resuscitation, is difficult to understand. Elderly people have a worse prognosis, but in most cases they are curable.

In recent years, people get pneumonia no more and no less. And the mortality rate with them remains huge, and there are many hospitalizations with the most severe course – both among middle-aged politicians and among young pop performers. But when someone famous gets sick, it comes to the surface. In fact, this is a certain combination of circumstances: a famous person just took it and got sick. As well as other people about whose diseases no one knows.

REFERENCE “MK”. The risk group for developing pneumonia, in addition to the elderly and children, is people with immunodeficiency conditions, diabetes, asthma, chronic obstructive pulmonary disease (COPD). Smoking, alcoholism and adverse environmental factors also increase the likelihood of developing the disease. Pneumonia can be erased for a long time, it is not always visible on x-rays, and only manifest itself as serious complications, for example, “shock lung”. Every year more than a million (!) people suffer from pneumonia in Russia. However, only 500-600 thousand are diagnosed; the rest learn about the disease only in connection with the development of complications. And the mortality rate for this disease reaches 12%.