tetano
Editor, Senior Moderator
Geroscience
. 2020 Nov 11.
doi: 10.1007/s11357-020-00294-x. Online ahead of print.
Comparison of clinical characteristics of patients with pandemic SARS-CoV-2-related and community-acquired pneumonias in Hungary - a pilot historical case-control study
Viktor J Horv?th[SUP] 1 [/SUP], No?mi Hajd?[SUP] 1 [/SUP], Orsolya V?gi[SUP] 1 [/SUP], Karolina Schn?bel[SUP] 1 [/SUP], Emese Szelke[SUP] 1 [/SUP], Anna E K?rei[SUP] 1 [/SUP], Magdolna B?keffy[SUP] 1 [/SUP], M?rk M Sv?bis[SUP] 1 [/SUP], Beatrix A Domj?n[SUP] 1 [/SUP], Tam?s Ber?nyi[SUP] 2 [/SUP], Istv?n Tak?cs[SUP] 1 [/SUP], Zolt?n Ungv?ri[SUP] 3 4 5 [/SUP], Attila Kun[SUP] 6 [/SUP], ?d?m G Tab?k[SUP] 7 8 9 [/SUP]
Affiliations
Abstract
The distinction between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related and community-acquired pneumonias poses significant difficulties, as both frequently involve the elderly. This study aimed to predict the risk of SARS-CoV-2-related pneumonia based on clinical characteristics at hospital presentation. Case-control study of all patients admitted for pneumonia at Semmelweis University Emergency Department. Cases (n = 30) were patients diagnosed with SARS-CoV-2-related pneumonia (based on polymerase chain reaction test) between 26 March 2020 and 30 April 2020; controls (n = 82) were historical pneumonia cases between 1 January 2019 and 30 April 2019. Logistic models were built with SARS-CoV-2 infection as outcome using clinical characteristics at presentation. Patients with SARS-CoV-2-related pneumonia were younger (mean difference, 95% CI: 9.3, 3.2-15.5 years) and had a higher lymphocyte count, lower C-reactive protein, presented more frequently with bilateral infiltrate, less frequently with abdominal pain, diarrhoea, and nausea in age- and sex-adjusted models. A logistic model using age, sex, abdominal pain, C-reactive protein, and the presence of bilateral infiltrate as predictors had an excellent discrimination (AUC 0.88, 95% CI: 0.81-0.96) and calibration (p = 0.27-Hosmer-Lemeshow test). The clinical use of our screening prediction model could improve the discrimination of SARS-CoV-2 related from other community-acquired pneumonias and thus help patient triage based on commonly used diagnostic approaches. However, external validation in independent datasets is required before its clinical use.
Keywords: Aging population; Case-control study; Pneumonia; Prediction; SARS-CoV-2.
. 2020 Nov 11.
doi: 10.1007/s11357-020-00294-x. Online ahead of print.
Comparison of clinical characteristics of patients with pandemic SARS-CoV-2-related and community-acquired pneumonias in Hungary - a pilot historical case-control study
Viktor J Horv?th[SUP] 1 [/SUP], No?mi Hajd?[SUP] 1 [/SUP], Orsolya V?gi[SUP] 1 [/SUP], Karolina Schn?bel[SUP] 1 [/SUP], Emese Szelke[SUP] 1 [/SUP], Anna E K?rei[SUP] 1 [/SUP], Magdolna B?keffy[SUP] 1 [/SUP], M?rk M Sv?bis[SUP] 1 [/SUP], Beatrix A Domj?n[SUP] 1 [/SUP], Tam?s Ber?nyi[SUP] 2 [/SUP], Istv?n Tak?cs[SUP] 1 [/SUP], Zolt?n Ungv?ri[SUP] 3 4 5 [/SUP], Attila Kun[SUP] 6 [/SUP], ?d?m G Tab?k[SUP] 7 8 9 [/SUP]
Affiliations
- PMID: 33174170
- DOI: 10.1007/s11357-020-00294-x
Abstract
The distinction between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related and community-acquired pneumonias poses significant difficulties, as both frequently involve the elderly. This study aimed to predict the risk of SARS-CoV-2-related pneumonia based on clinical characteristics at hospital presentation. Case-control study of all patients admitted for pneumonia at Semmelweis University Emergency Department. Cases (n = 30) were patients diagnosed with SARS-CoV-2-related pneumonia (based on polymerase chain reaction test) between 26 March 2020 and 30 April 2020; controls (n = 82) were historical pneumonia cases between 1 January 2019 and 30 April 2019. Logistic models were built with SARS-CoV-2 infection as outcome using clinical characteristics at presentation. Patients with SARS-CoV-2-related pneumonia were younger (mean difference, 95% CI: 9.3, 3.2-15.5 years) and had a higher lymphocyte count, lower C-reactive protein, presented more frequently with bilateral infiltrate, less frequently with abdominal pain, diarrhoea, and nausea in age- and sex-adjusted models. A logistic model using age, sex, abdominal pain, C-reactive protein, and the presence of bilateral infiltrate as predictors had an excellent discrimination (AUC 0.88, 95% CI: 0.81-0.96) and calibration (p = 0.27-Hosmer-Lemeshow test). The clinical use of our screening prediction model could improve the discrimination of SARS-CoV-2 related from other community-acquired pneumonias and thus help patient triage based on commonly used diagnostic approaches. However, external validation in independent datasets is required before its clinical use.
Keywords: Aging population; Case-control study; Pneumonia; Prediction; SARS-CoV-2.