Clinical Differences between Community-Acquired Mycoplasma pneumoniae Pneumonia and COVID-19 Pneumonia

Miyashita, Naoyuki; Nakamori, Yasushi; Ogata, Makoto; Fukuda, N.; Yamura, Akihisa; Ishiura, Yoshihisa; Nomura, Shosaku

doi:10.3390/jcm11040964

Cited by 9 publications

(6 citation statements)

References 17 publications

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“…Analysis of the laboratory findings in our study showed that there were significant differences between the two groups in mean leucocyte count, N%, L%, ALT levels, AST levels, LDH levels and incidence of accelerated PCT. Similar to a previous study, the perpheral leucocyte count of the patients with MPP is usually normal at less than 10,000/UL ( 17 ). The higher leucocyte counts and PCT levels may suggest that the inflammation of Streptococcus pneumoniae pneumonia is more serious than that of Mycoplasma pneumoniae pneumonia.…”

Section: Discussionsupporting

confidence: 84%

Clinical differences between Mycoplasma pneumoniae pneumonia and Streptococcus pneumoniae pneumonia: a case control study

Ruan,

Fu,

Ying

2024

Front. Pediatr.

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IntroductionMycoplasma pneumoniae pneumonia (MPP) and Streptococcus pneumoniae pneumonia (SPP) are frequent causes of respiratory tract infection, the aims of the study were to explore the differences in clinical features between children with MPP and those with SPP.MethodsThis retrospective study included admitted children who were diagnosed with MPP or SPP over 5 years from January 2015 to January 2020. Children with MPP were compared to children with SPP in terms of clinical features.Results506 patients with MPP were compared to 311 patients with SPP in terms of clinical differences. The MPP group with a median age of 60 [29–89] months and the SPP group with a median age of 24 [10–40] months. Patients with MPP were older and had a higher occurrence of receiving antibiotics before admission, fever, dry cough, polypnea and diarrhea than patients with SPP (all p < 0.01). Patients with SPP were more likely to have wheezing, cyanosis and irritability (all p < 0.01). Laboratory findings in our study showed that there were significant differences between MPP and SPP patients in mean leucocyte count, neutrophil % (N%), lymphocyte % (L%), ALT levels, AST levels, LDH levels and incidence of accelerated procalcitonin (PCT) (all p < 0.01). Lower age, no dry cough, no polypnea, lower LDH levels, and higher PCT might lead to the diagnosis of SPP. Our study showed that age had a higher accuracy in predicting MPP than LDH levels, with an age >48.5 months shown to be an independent predictive factor for the early evaluation and identification of MPP.DiscussionIn conclusion, patients with MPP and SPP usually present with fever, cough and some nonspecific symptoms. Our study showed that age, dry cough, polypnea, LDH levels, and PCT levels were independent predictive factors associated with MPP and SPP.

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Section: Discussionsupporting

confidence: 84%

Clinical differences between Mycoplasma pneumoniae pneumonia and Streptococcus pneumoniae pneumonia: a case control study

Ruan,

Fu,

Ying

2024

Front. Pediatr.

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“…Эти симптомы выявлялись и по данным других исследований [6,7]. Помимо этого, для бактериальной пневмонии были характерны наличие мокроты и боли в грудной клетке [6][7][8][9]. Односторонний характер инфильтрации, как признак ВБП, также описан другими исследователями [6,10,11].…”

Section: рис номограмма вероятности наличия у пациента с внебольнично...unclassified

Development of a model for the differential diagnosis of community-acquired bacterial pneumonia and viral lung injury in hospitalized adult patients

Kupriushina,

Strelkova,

Yasneva

et al. 2024

GCP

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Relevance. During and after the COVID-19 pandemic, viruses have become a more common cause of pulmonary infections in adults; therefore, the distinction between viral lung injury and community-acquired bacterial pneumonia is of increasing importance. Aim. Development of a model for differentiating community-acquired bacterial pneumonia and viral lung injury, including COVID-19. Materials and methods. This retrospective case–control study included 300 adult patients with viral lung injury and 100 adult patients with community-acquired bacterial pneumonia. Clinical, laboratory, and instrumental data were analyzed, significant factors were selected by which the samples differed, and a model was developed using logistic regression to distinguish between community-acquired bacterial pneumonia and viral lung damage, including COVID-19. Results. The developed model included the following parameters: total protein level, neutrophil/lymphocyte index, heart rate, unilateral infiltration on CT or chest x-ray, vasopressor prescription in the first 24 h of hospitalization, altered level of consciousness, chills, and fatigue. The model had the following characteristics: AUC = 0.94 (0.92–0.96), AUC_PR = 0.84 (0.76 to 0.92), prediction accuracy — 90%, sensitivity — 76%, specificity — 95%, positive predictive value — 83 %. Conclusion. The use of this model can facilitate the differential diagnosis of community-acquired bacterial pneumonia and viral lung injury, including COVID-19, in adults in general wards and intensive care units.

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“…В нашем исследовании у пациентов с ВБП чаще на блюдались одышка, наличие мокроты, боль в грудной клетке, насморк, озноб и снижение уровня сознания, для вирусного поражения легких была более харак терна общая слабость, при этом озноб и общая сла бость оказались наиболее значимыми симптомами и в многофакторном регрессионном анализе. Похожие дан ные есть и в литературе: выделение мокроты [5][6][7][8], на рушение сознания [7], боль в грудной клетке [7,8] чаще описывают при бактериальной пневмонии, а общую сла бость [5] -при COVID19.…”

Section: Introductionunclassified

“…Среди возбудителей бактериальной пневмонии наиболее вы сокая доля была характерна для Streptococcus pneumoniae, в группе вирусного поражения легких преобладал SARSCoV2. В многофакторном анализе наличие озноба (ОШ и 95% ДИ: 22,1 [6,6], р < 0,001), односторонней инфильтрации по данным рентгенографии или КТ ОГК (ОШ и 95% ДИ: 17,9 [7,1], р < 0,001), снижение уровня сознания (ОШ и 95% ДИ: 3,2 [1,[2][3][4][5][6][7][8]5], р = 0,019), назначение вазопрессоров в первые 24 ч. госпитализации (ОШ и 95% ДИ: 11,8 [2,9], р = 0,002), более высокие значения ЧСС (ОШ и 95% ДИ: 9,1 [2,6], р = 0,003) и ин декса нейтрофилы/лимфоциты (ОШ и 95% ДИ: 1,4 [1,1-1,9], р = 0,021), а также отсутствие об щей слабости (ОШ и 95% ДИ: 0,2 [0,08-0,4], р < 0,001) и более низкие значения общего белка (ОШ и 95% ДИ: 0,2 [0,02-1,00], р = 0,049) более характерны для бактериальной пневмонии по сравнению с вирусным поражением легких. Выводы.…”

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Differential diagnosis of community-acquired bacterial pneumonia and viral lung injury in hospitalized adults

Strelkova,

Kupryushina,

Yasneva

et al. 2023

CMAC

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Objective. Identification of clinical, laboratory, and instrumental factors more common in bacterial pneumonia compared to viral pneumonia, including COVID-19. Materials and Methods. This retrospective case-control study included hospitalized adults with communityacquired bacterial pneumonia and viral lung injury, including COVID-19. Patients were included taking into account age, gender, hospitalization department (general ward or ICU), and Charlson comorbidity index. Clinical, demographic, laboratory, and instrumental data on admission were studied. Unadjusted odds ratios (OR) were calculated using univariate logistic regression (for quantitative indicators) and contingency table analysis (for categorical indicators); adjusted OR were calculated using multivariate logistic regression. Results. The community-acquired bacterial pneumonia group included 100 patients, and the viral lung injury group included 300 patients. Among the causative agents of bacterial pneumonia, Streptococcus pneumoniae was the most common; in the group of viral lung injury, SARS-CoV-2 predominated. In multivariate analysis, the presence of chills (OR and 95% CI: 22.1 [6.8–72.6], p < 0.001), unilateral infiltration according to X-ray or computer tomography (OR and 95% CI: 17.9 [ 7.3–44.1], p < 0.001), altered level of consciousness (OR and 95% CI: 3.2 [1.2–8.5], p = 0.019), use of vasopressors in the first 24 hours of hospitalization ( OR and 95% CI: 11.8 [2.5–55.9], p = 0.002), higher heart rate (OR and 95% CI: 9.1 [2.2–38.6], p = 0.003) and neutrophil/lymphocyte index (OR and 95% CI: 1.4 [1.1–1.9], p = 0.021), as well as the absence of fatigue (OR and 95% CI: 0.2 [0.08–0.40], p < 0.001) and lower total protein (OR and 95% CI: 0.2 [0.02–1.00], p = 0.049) are more typical for bacterial pneumonia compared to viral lung injury. Conclusions. Differential diagnosis between community-acquired bacterial pneumonia and viral lung injury, including COVID-19, requires a comprehensive analysis of clinical, laboratory, and instrumental data.

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Clinical Differences between Community-Acquired Mycoplasma pneumoniae Pneumonia and COVID-19 Pneumonia

Cited by 9 publications

References 17 publications

Clinical differences between Mycoplasma pneumoniae pneumonia and Streptococcus pneumoniae pneumonia: a case control study

Clinical differences between Mycoplasma pneumoniae pneumonia and Streptococcus pneumoniae pneumonia: a case control study

Development of a model for the differential diagnosis of community-acquired bacterial pneumonia and viral lung injury in hospitalized adult patients

Differential diagnosis of community-acquired bacterial pneumonia and viral lung injury in hospitalized adults

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