Department of Respiratory Medicine, West China Hospital Sichuan University-Ziyang Hospital, The First People's Hospital of Ziyang, Ziyang, China.
Department of Radiology, Shenzhen Second People's Hospital, Shenzhen, China.
Curr Med Res Opin. 2020 Nov;36(11):1747-1752. doi: 10.1080/03007995.2020.1830050. Epub 2020 Oct 13.
Coronavirus disease 2019 (COVID-19) has high morbidity and mortality, and spreads rapidly in the community to result in a large number of infection cases. This study aimed to compare clinical features in adult patients with coronavirus disease 2019 (COVID-19) pneumonia to those in adult patients with community-acquired pneumonia (CAP).
Clinical presentations, laboratory findings, imaging features, complications, treatment and outcomes were compared between patients with COVID-19 pneumonia and patients with CAP. The study group of patients with COVID-19 pneumonia consisted of 120 patients. One hundred and thirty-four patients with CAP were enrolled for comparison.
Patients with COVID-19 pneumonia had lower levels of abnormal laboratory parameters (white blood cell count, lymphocyte count, procalcitonin level, erythrocyte sedimentation rate and C-reactive protein level) and more extensive radiographic involvement. More severe respiratory compromise resulted in a higher rate of intensive care unit admission, acute respiratory distress syndrome (ARDS) and mechanical ventilation (36% vs 15%, 34% vs 15% and 32% vs 12%, respectively; all < .05). The 30 day mortality was more than twice as high in patients with COVID-19 pneumonia (12% versus 5%; = .063), despite not reaching a statistically significant difference.
Lower levels of abnormal laboratory parameters, more extensive radiographic involvement, more severe respiratory compromise, and higher rates of ICU admission, ARDS and mechanical ventilation are key characteristics that distinguish patients with COVID-19-associated pneumonia from patients with CAP.
新型冠状病毒病 2019(COVID-19)发病率和死亡率高,在社区中迅速传播,导致大量感染病例。本研究旨在比较成人 COVID-19 肺炎患者与成人社区获得性肺炎(CAP)患者的临床特征。
比较 COVID-19 肺炎患者和 CAP 患者的临床表现、实验室检查结果、影像学特征、并发症、治疗和转归。COVID-19 肺炎患者为研究组,共 120 例;选择同期 CAP 患者 134 例作为对照组。
COVID-19 肺炎患者异常实验室参数(白细胞计数、淋巴细胞计数、降钙素原水平、红细胞沉降率和 C 反应蛋白水平)水平较低,影像学累及范围较广。严重呼吸功能障碍导致更高的重症监护病房(ICU)入住率、急性呼吸窘迫综合征(ARDS)和机械通气发生率(36%比 15%,34%比 15%,32%比 12%;均 P<.05)。COVID-19 肺炎患者 30 天死亡率高于 CAP 患者(12%比 5%;P=.063),但差异无统计学意义。
异常实验室参数水平较低、影像学累及范围较广、呼吸功能障碍更严重以及 ICU 入住率、ARDS 和机械通气发生率更高,是 COVID-19 相关肺炎患者与 CAP 患者的主要区别特征。