Jiang Juan, Wan Rongjun, Pan Pinhua, Hu Chengping, Zhou Rihua, Yin Yiping, Zhou Ting, Huang Hua, Li Yuanyuan
Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan Province, People's Republic of China.
Medical Center of Tuberculosis, The Second People's Hospital of Chenzhou, Chenzhou, Hunan Province, People's Republic of China.
Infect Drug Resist. 2020 Oct 2;13:3401-3408. doi: 10.2147/IDR.S264132. eCollection 2020.
The pandemic of coronavirus disease 2019 (COVID-19) has become a global public health problem. It is important for clinical physicians to differentiate COVID-19 from other respiratory infectious diseases caused by viruses, such as human adenovirus.
This was a retrospective observational study. We analyzed and compared the clinical manifestations, laboratory findings and radiological features of two independent cohorts of patients diagnosed with either COVID-19 (n=36) or adenovirus pneumonia (n=18).
COVID-19 did not show a preference in males or females, whereas 94.4% of patients with adenovirus pneumonia were males. Fever and cough were common in both COVID-19 and adenovirus pneumonia. But the median maximal body temperature of the adenovirus pneumonia cohort was significantly higher than in COVID-19 (<0.001). Furthermore, 77.8% of patients with adenovirus pneumonia had a productive cough versus only 13.9% of COVID-19 patients (<0.001). Compared with adenovirus pneumonia, constitutional symptoms were less common in COVID-19, including headache (16.7% vs 38.9%, =0.072), sore throat (8.3% vs 27.8%, =0.058), myalgia (8.3% vs 61.1%, <0.001) and diarrhea (8.3% vs 44.4%, =0.002). Furthermore, patients with COVID-19 were less likely to develop respiratory failure (8.3% vs 83.3%, <0.001) and showed less prominent laboratory abnormalities, including lymphocytopenia (61.1% vs 88.9%, =0.035), thrombocytopenia (2.8% vs 61.1%, <0.001), elevated procalcitonin (2.8% vs 77.8%, <0.001) and elevated C-reactive protein (36.1% vs 100%, <0.001). Besides, a higher percentage of patients with adenovirus pneumonia showed elevated transaminase, myocardial enzymes, creatinine and D-dimer compared with COVID-19 patients. On chest CT, the COVID-19 cohort was characterized by peripherally distributed ground-glass opacity and patchy shadowing, while the adenovirus pneumonia cohort frequently presented with consolidation and pleural effusion.
There were many differences between patients diagnosed with COVID-19 and those with adenovirus pneumonia in their clinical, laboratory and radiological characteristics. Compared with adenovirus pneumonia, COVID-19 patients tended to show a lower severity of illness.
2019年冠状病毒病（COVID-19）大流行已成为一个全球公共卫生问题。对于临床医生而言，将COVID-19与其他由病毒引起的呼吸道传染病（如人类腺病毒）区分开来很重要。
这是一项回顾性观察研究。我们分析并比较了两个独立队列的患者的临床表现、实验室检查结果和影像学特征，其中一个队列的36例患者被诊断为COVID-19，另一个队列的18例患者被诊断为腺病毒肺炎。
COVID-19在男性和女性中无明显偏好，而94.4%的腺病毒肺炎患者为男性。发热和咳嗽在COVID-19和腺病毒肺炎中都很常见。但腺病毒肺炎队列的最高体温中位数显著高于COVID-19（<0.001）。此外，77.8%的腺病毒肺炎患者有咳痰，而COVID-19患者中只有13.9%有咳痰（<0.001）。与腺病毒肺炎相比，COVID-19患者的全身症状较少见，包括头痛（16.7%对38.9%，P=0.072）、咽痛（8.3%对27.8%，P=0.058）、肌痛（8.3%对61.1%，<0.001）和腹泻（8.3%对44.4%，P=0.002）。此外，COVID-19患者发生呼吸衰竭的可能性较小（8.3%对83.3%，<0.001），且实验室异常表现不那么突出，包括淋巴细胞减少（61.1%对88.9%，P=0.035）、血小板减少（2.8%对61.1%，<0.001）、降钙素原升高（2.8%对77.8%，<0.001）和C反应蛋白升高（36.1%对100%，<0.001）。此外，与COVID-19患者相比，更高比例的腺病毒肺炎患者转氨酶、心肌酶、肌酐和D-二聚体升高。胸部CT检查时，COVID-19队列的特征是外周分布的磨玻璃影和斑片状阴影，而腺病毒肺炎队列常表现为实变和胸腔积液。
诊断为COVID-19的患者与腺病毒肺炎患者在临床、实验室和影像学特征方面存在许多差异。与腺病毒肺炎相比，COVID-19患者的病情严重程度往往较低。
