What are the symptoms of pneumonia and can you get it in middle age?

15 April 2025, 17:35

What may start as a mild cough or general fatigue can quickly escalate if left unchecked.

Newcastle United head coach Eddie Howe has been diagnosed with pneumonia and is currently recovering in hospital.

The football club announced over the weekend that the 47-year-old had been feeling unwell for several days before being admitted on Friday evening. Howe watched his team’s 4-1 victory over Manchester United from his hospital bed and is set to miss both Wednesday’s home game against Crystal Palace and Saturday’s away trip to Aston Villa.

Howe’s diagnosis is a timely reminder that pneumonia isn’t just a concern for the very young or elderly – it can also affect those in midlife.

Dr Andy Whittamore, GP and clinical lead at Asthma + Lung UK, has broken down the key signs to watch for, and explained why pneumoniacan often be overlooked in middle age, and how you can lower your risk.

“Pneumonia is a chest infection which causes inflammation in the air sacs of the lungs,” explains Whittamore.

“I work as a GP, and I see lots of people come in with very mild chest infections, some get more severe ones and sometimes those more severe ones can develop into a pneumonia, so it just gets deeper into the lungs.

“The difference between chest infections and pneumonia is how severe they get. You might need more monitoring, oxygen treatment, and treatment in hospital with stronger medication.”

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Pneumonia is most commonly triggered by a bacterial or viral infection.According to the NHS website, it can be passed from person to person, or develop as a complication of other illnesses like flu, RSV, or COVID-19.

The NHS website also states that although less common, pneumonia can also be caused by a fungal infection and in some cases may result from inhaling food, drink, or vomit into the lungs, a condition known as aspiration pneumonia.

Pollen can also aggravate the lungs.

“When pollen is in the air, we all can get more mucus in the airways, and that means that, especially if you’ve got hay fever or asthma or chronic obstructive pulmonary disease (COPD), that extra mucus means that you can get infections trapped in the lungs easier,” explains Whittamore.

Common symptoms of pneumonia include a persistent cough, difficulty breathing, high fever, chest pain, body aches, extreme tiredness, and a loss of appetite, according to the NHS website.

Other signs to look out for include wheezing while breathing, and in babies, grunting noises can also be a red flag. In older adults, confusion can be another telltale symptom.“

If you’ve got a cough and a fever, and you’re developing breathlessness with it, then you should get an urgent review with your GP, or call 111 if your GP is closed,” advises Whittamore. “In more severe cases, people might feel that their breathing speeds up, or that their heart rate is getting faster, or they’re getting confused with it.”

The NHS website also states that these symptoms can start suddenly or gradually over a few days.

“In most cases, antibiotics and supportive care can get people back to their usual state, however some people do die of pneumonia,” says Whittamore. “Some people can also take as much as three or six months to recover from a bout of pneumonia.

“In addition, sometimes pneumonia can cause scarring of the lungs or damage to the lungs, which might give people problems going forward.”

Whittamore explained: “It’s usually elderly people or those with long-term conditions, especially lung conditions, that are more at risk because they can’t fight off the bugs in the same way and some cases are due to viruses and others due to bacteria."

“However, anyone of any age can get pneumonia.”

Certain factors can also increase your risk or severity of illness. These include smoking, long-term lung conditions (like asthma or COPD), chronic health issues (such as diabetes or heart, liver, or kidney disease), regular alcohol use, and a weakened immune system, according to BUPA.

“It’s less common for middle-aged people to get it, but not uncommon,” says Whittamore. “Eddie Howe could have an underlying condition or it could just be bad luck that he’s picked something up and it’s gone quite badly onto his chest.

“It could be that his body has been sort of holding up and doing really well until the point where it couldn’t, whereas the elderly and people who are less well, they quite often come see us earlier, because it’s affecting them more.”

You’ll usually be given antibiotics to treat pneumonia. Most people get better in two to four weeks, according to the NHS website.

“If I were seeing somebody with a chest infection in my GP surgery, we’d be giving them some antibiotic tablets like amoxicillin or doxycycline – they’re probably the most common two types,” says Whittamore. “And if people are going to hospital, then different hospitals have different combinations.

“Quite often, patients in hospital will have antibiotics delivered through a vein if they are that unwell which is called intravenous (IV) antibiotics.”

It’s not completely preventable, but there are a few things you can do to lower your risk.

“People who smoke are at a greater risk, so if somebody is smoker, then they should stop,” says Whittamore. “Also, if somebody has an underlying lung condition, like asthma or COPD or hay fever, then they should make sure they’re taking preventive medicines regularly and seek help if their symptoms start getting worse or becoming uncontrollable.”

Staying up to date with vaccinations is also key.

“The flu vaccine, the COVID vaccine and the RSV vaccine are good ways of preventing those types of viral chest infections and pneumonia,” says Whittamore.