Comparison of clinical characteristics between coronavirus disease 2019 pneumonia and community-acquired pneumonia

Abstract

Objective: 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). Methods: 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 thirtyfour patients with CAP were enrolled for comparison. Results: Patients with COVID-19 pneumonia had lower levels of abnormal laboratory parameters (white blood cell count, lymphocyte count, procalcitonin level, erythrocyte sedimentation rate and Creactive 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 p < .05). The 30 day mortality was more than twice as high in patients with COVID-19 pneumonia (12% versus 5%; p ¼ .063), despite not reaching a statistically significant difference. Conclusions: 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.

Efficacy of copeptin in distinguishing COVID‐19 pneumonia from community‐acquired pneumonia

“…Also, early recognition of COVID‐19 patients and hospitalization of severe forms are vital due to different treatment approaches and high mortality rates. It has been observed in some recent studies that various biomarkers, such as leukocyte count, lymphocyte count, red cell distribution width (RDW), procalcitonin, sedimentation, and CRP, have beneficial effects in distinguishing COVID‐19 pneumonia from CAP 11,12 . Patients with COVID‐19 pneumonia were found to have significantly lower leukocyte, neutrophil, and lymphocyte counts compared to patients to CAP in our study.…”

“…It has been observed in some recent studies that various biomarkers, such as leukocyte count, lymphocyte count, red cell distribution width (RDW), procalcitonin, sedimentation, and CRP, have beneficial effects in distinguishing COVID-19 pneumonia from CAP. 11,12 Patients with COVID-19 pneumonia were found to have significantly lower leukocyte, neutrophil, and lymphocyte counts compared to patients to CAP in our study. In addition, procalcitonin levels were found to be lower in the COVID-19 group, while there was no statistical difference between the two groups in terms of CRP levels.…”

“…It is known that COVID‐19 causes multiorgan involvement, has a more severe course, and has more common lung involvement compared to CAP. It was determined that COVID‐19 patients have higher intensive care unit admission, development of acute respiratory distress syndrome, mechanical ventilation attachment, and mortality rates compared to CAP patients 11 . Therefore, hemodynamic and osmotic disorders are expected to be more severe in COVID‐19 patients.…”

“…[8][9][10] It has been shown that some laboratory tests, such as leukocyte count, lymphocyte count, and C-reactive protein (CRP) used routinely, can be useful in distinguishing COVID-19 pneumonia from CAP. 11,12 Copeptin levels are known to increase with infectious stimuli. It has been shown in the studies that serum copeptin levels increase in infectious diseases, such as CAP, ventilator-associated pneumonia, lower respiratory tract infections, and sepsis, and this increase is associated with poor prognosis.…”

“…It has been shown that some laboratory tests, such as leukocyte count, lymphocyte count, and C‐reactive protein (CRP) used routinely, can be useful in distinguishing COVID‐19 pneumonia from CAP 11,12 . Copeptin levels are known to increase with infectious stimuli.…”