Miyashita Naoyuki, Nakamori Yasushi, Ogata Makoto, Fukuda Naoki, Yamura Akihisa, Ishiura Yoshihisa, Nomura Shosaku
Division of Respiratory Medicine, Infectious Disease and Allergology, First Department of Internal Medicine, Kansai Medical University, 2-3-1 Shinmachi, Hirakata 573-1191, Osaka, Japan.
Department of Emergency Medicine, Kansai Medical University Medical Center, 10-15 Fumizonocho, Moriguchi 570-8507, Osaka, Japan.
J Clin Med. 2022 Feb 12;11(4):964. doi: 10.3390/jcm11040964.
is one of the major causative pathogens of community-acquired pneumonia (CAP). CAP is clinically and radiologically distinct from bacterial CAPs. One feature of the Japanese Respiratory Society (JRS) guidelines is a trial to be carried out to differentiate between pneumonia and bacterial pneumonia for the selection of antibiotics. The purpose of the present study was to clarify the clinical and radiological differences of the CAP and coronavirus disease 2019 (COVID-19) CAP. This study was conducted at 5 institutions and assessed a total of 210 patients with CAP and 956 patients with COVID-19 CAP. The median age was significantly younger in patients with CAP than COVID-19 CAP. Among the clinical symptoms, cough and sputum were observed more frequently in patients with CAP than those with COVID-19 CAP. However, the diagnostic specificity of these findings was low. In contrast, loss of taste and anosmia were observed in patients with COVID-19 CAP but not observed in those with CAP. Bronchial wall thickening and nodules (tree-in-bud and centrilobular), which are chest computed tomography (CT) features of CAP, were rarely observed in patients with COVID-19 CAP. Our results demonstrated that there were two specific differences between CAP and COVID-19 CAP: (1) the presence of loss of taste and/or anosmia and (2) chest CT findings.
是社区获得性肺炎（CAP）的主要致病病原体之一。CAP在临床和影像学上与细菌性CAP不同。日本呼吸学会（JRS）指南的一个特点是进行一项试验，以区分病毒性肺炎和细菌性肺炎，从而选择抗生素。本研究的目的是阐明CAP与2019冠状病毒病（COVID-19）相关CAP在临床和影像学上的差异。本研究在5家机构进行，共评估了210例CAP患者和956例COVID-19相关CAP患者。CAP患者的年龄中位数明显低于COVID-19相关CAP患者。在临床症状方面，CAP患者咳嗽和咳痰的发生率高于COVID-19相关CAP患者。然而，这些发现的诊断特异性较低。相比之下，COVID-19相关CAP患者出现味觉丧失和嗅觉减退，而CAP患者未出现。CAP的胸部计算机断层扫描（CT）特征，如支气管壁增厚和结节（树芽征和小叶中心结节），在COVID-19相关CAP患者中很少见。我们的结果表明，CAP与COVID-19相关CAP之间存在两个特定差异：（1）味觉丧失和/或嗅觉减退的存在；（2）胸部CT表现。
