Comparison of the clinical and laboratory characteristics of patients with COVID-19 and community-acquired pneumonia
Keywords:COVID-19, Pneumonia, Mortality, Diagnosis, Pulmonary complication
Background/Aim: It is challenging to discriminate between COVID-19 and community-acquired pneumonia due to similar clinical features, albeit of great importance. This study aimed to compare the clinical and laboratory characteristics between patients hospitalized due to COVID-19 pneumonia and those with community-acquired pneumonia (CAP). Methods: This retrospective cohort study included cases who were hospitalized with the diagnosis of COVID-19 between April and December 2020 and those hospitalized with the diagnosis of CAP during the same months in 2019. Statistical differences were investigated by comparing the clinical and laboratory characteristics of the two groups. Results: The study included 882 cases, comprising 755 with COVID-19 and 127 with CAP. In the COVID-19 pneumonia group, the mean age was lower, there were more women, the hospitalization period was longer, and the rates of hypertension and diabetes mellitus were higher compared to the CAP group (P<0.05). The white blood cell (WBC), urea, creatinine, albumin and platelet values were higher in the CAP group (P<0.05). The patients who died due to COVID-19 pneumonia had higher mean age, length of hospital stay, C-reactive protein, WBC, urea and creatinine values and lower albumin and platelet levels (P<0.05). The rates of hypertension, stroke history, coronary artery disease, congestive heart failure, diabetes mellitus and chronic kidney disease were higher among the patients that died in the COVID-19 group (P<0.001 for all). Conclusion: COVID-19 and community-acquired pneumonia differed from each other in terms of many clinical and laboratory characteristics.
Zhai P, Ding Y, Wu X, Long J, Zhong Y, Li Y. The epidemiology, diagnosis and treatment of COVID-19. Int J Antimicrob Agents. 2020;55(5):105955. doi: 10.1016/j.ijantimicag.2020.105955.
WHO Coronavirus (COVID-19) Dashboard. https://covid19.who.int/
Metlay JP, Waterer GW, Long AC, Anzueto A, Brozek J, Crothers K, et al. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019;200(7):e45-e67. doi: 10.1164/rccm.201908-1581ST.
Olson G, Davis AM. Diagnosis and Treatment of Adults With Community-Acquired Pneumonia. JAMA. 2020;323(9):885-6. doi: 10.1001/jama.2019.21118.
Cellina M, Orsi M, Bombaci F, Sala M, Marino P, Oliva G. Favorable changes of CT findings in a patient with COVID-19 pneumonia after treatment with tocilizumab. Diagn Interv Imaging. 2020;101(5):323-4. doi: 10.1016/j.diii.2020.03.010.
Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W, et al. Correlation of Chest CT and RT-PCR Testing for Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases. Radiology. 2020;296(2):E32-E40. doi: 10.1148/radiol.2020200642.
Fang Y, Zhang H, Xie J, Lin M, Ying L, Pang P et al. Sensitivity of Chest CT for COVID-19: Comparison to RT-PCR. Radiology. 2020;296(2):E115-E117. doi: 10.1148/radiol.2020200432.
Zhang W. Imaging changes in severe COVID-19 pneumonia. Intensive Care Med. 2020;46:583–5. doi: 10.1007/s00134-020-05976-w
Cao W. Clinical features and laboratory inspection of novel coronavirus pneumonia (COVID-19) in Xiangyang, Hubei. MedRxiv (2020). doi: 10.1101/2020.02.23.20026963
Umakanthan S, Sahu P, Ranade AV, Bukelo MM, Rao JS, et al. Origin, transmission, diagnosis and management of coronavirus disease 2019 (COVID-19). Postgrad Med J. 2020;96(1142):753-8. doi: 10.1136/postgradmedj-2020-138234.
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-9. doi: 10.1001/jama.2020.1585.
Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239-42. doi: 10.1001/jama.2020.2648.
Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA. 2020;323(20):2052-9. doi: 10.1001/jama.2020.6775.
Ciceri F, Castagna A, Rovere-Querini P, De Cobelli F, Ruggeri A, Galli L, et al. Early predictors of clinical outcomes of COVID-19 outbreak in Milan, Italy. Clin Immunol. 2020;217:108509. doi: 10.1016/j.clim.2020.108509.
Lanks CW, Musani AI, Hsia DW. Community-acquired Pneumonia and Hospital-acquired Pneumonia. Med Clin North Am. 2019;103(3):487-501. doi: 10.1016/j.mcna.2018.12.008..
Tian J, Xu Q, Liu S, Mao L, Wang M, Hou X. Comparison of clinical characteristics between coronavirus disease 2019 pneumonia and community-acquired pneumonia. Curr Med Res Opin. 2020;36(11):1747-52. doi: 10.1080/03007995.2020.1830050.
Han R, Huang L, Jiang H, Dong J, Peng H, Zhang D. Early Clinical and CT Manifestations of Coronavirus Disease 2019 (COVID-19) Pneumonia. AJR Am J Roentgenol. 2020;215(2):338-43. doi: 10.2214/AJR.20.22961.
Zhou Y, Guo S, He Y, Zuo Q, Liu D, Xiao M, Fan J, Li X. COVID-19 Is Distinct From SARS-CoV-2-Negative Community-Acquired Pneumonia. Front Cell Infect Microbiol. 2020;10:322. doi: 10.3389/fcimb.2020.00322.
Lin YH, Luo W, Wu DH, Lu F, Hu SX, Yao XY, et al. Comparison of clinical, laboratory, and radiological characteristics between SARS-CoV-2 infection and community-acquired pneumonia caused by influenza virus: A cross-sectional retrospective study. Medicine (Baltimore). 2020;99(44):e23064. doi: 10.1097/MD.0000000000023064.
Yang HJ, Zhang YM, Yang M, Huang X. Predictors of mortality for patients with COVID-19 pneumonia caused by SARS-CoV-2. Eur Respir J. 2020;56(3):2002439. doi: 10.1183/13993003.02439-2020.
Guo W, Li M, Dong Y, Zhou H, Zhang Z, Tian C, et al. Diabetes is a risk factor for the progression and prognosis of COVID-19. Diabetes Metab Res Rev. 2020:e3319. doi:10.1002/dmrr.3319.
Yan Y, Yang Y, Wang F, Ren H, Zhang S, Shi X, et al. Clinical characteristics and outcomes of patients with severe covid-19 with diabetes. BMJ Open Diabetes Res Care. 2020;8(1):e001343. doi: 10.1136/bmjdrc-2020-001343.
Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. China Medical Treatment Expert Group for Covid-19. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382(18):1708-20. doi: 10.1056/NEJMoa2002032.
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62. doi: 10.1016/S0140-6736(20)30566-3.
How to Cite
Copyright (c) 2021 Erdal Yavuz, Kasım Turgut
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.