tetano
Editor, Senior Moderator
J Infect Chemother
. 2022 Dec 22;S1341-321X(22)00330-0.
doi: 10.1016/j.jiac.2022.12.007. Online ahead of print.
Assessment of the pneumonia severity score in community-acquired and nursing and healthcare-associated pneumonia due to COVID-19
Naoyuki Miyashita[SUP] 1 [/SUP], Yasushi Nakamori[SUP] 2 [/SUP], Makoto Ogata[SUP] 3 [/SUP], Naoki Fukuda[SUP] 3 [/SUP], Akihisa Yamura[SUP] 3 [/SUP], Yoshihisa Ishiura[SUP] 4 [/SUP]
Affiliations
Abstract
Introduction: The Japanese Respiratory Society (JRS) pneumonia guidelines recommend simple predictive rules, the A-DROP scoring system, for assessment of the severity of community-acquired pneumonia (CAP) and nursing and healthcare-associated pneumonia (NHCAP). We evaluated whether the A-DROP system can be adapted for assessment of the severity of coronavirus disease 2019 (COVID-19) pneumonia.
Methods: Data from 1141 patients with COVID-19 pneumonia were analyzed, comprising 502 patients observed in the 1st to 3rd wave period, 338 patients in the 4th wave and 301 patients in the 5th wave in Japan.
Results: The mortality rate and mechanical ventilation rate were 0% and 1.4% in patients classified with mild disease (A-DROP score, 0 point), 3.2% and 46.7% in those with moderate disease (1 or 2 points), 20.8% and 78.3% with severe disease (3 points), and 55.0% and 100% with extremely severe disease (4 or 5 points), indicating an increase in the mortality and mechanical ventilation rates in accordance with severity (Cochran-Armitage trend test; p = <0.001). This significant relationship between the severity in the A-DROP scoring system and either the mortality rate or mechanical ventilation rate was observed in patients with COVID-19 CAP and NHCAP. In each of the five COVID-19 waves, the same significant relationship was observed.
Conclusions: The mortality rate and mechanical ventilation rate in patients with COVID-19 pneumonia increased depending on severity classified according to the A-DROP scoring system. Our results suggest that the A-DROP scoring system can be adapted for the assessment of severity of COVID-19 CAP and NHCAP.
Keywords: A-DROP; COVID-19; Community-acquired pneumonia; Nursing and healthcare-associated pneumonia; Pneumonia severity; SARS-CoV-2.
. 2022 Dec 22;S1341-321X(22)00330-0.
doi: 10.1016/j.jiac.2022.12.007. Online ahead of print.
Assessment of the pneumonia severity score in community-acquired and nursing and healthcare-associated pneumonia due to COVID-19
Naoyuki Miyashita[SUP] 1 [/SUP], Yasushi Nakamori[SUP] 2 [/SUP], Makoto Ogata[SUP] 3 [/SUP], Naoki Fukuda[SUP] 3 [/SUP], Akihisa Yamura[SUP] 3 [/SUP], Yoshihisa Ishiura[SUP] 4 [/SUP]
Affiliations
- PMID: 36567049
- DOI: 10.1016/j.jiac.2022.12.007
Abstract
Introduction: The Japanese Respiratory Society (JRS) pneumonia guidelines recommend simple predictive rules, the A-DROP scoring system, for assessment of the severity of community-acquired pneumonia (CAP) and nursing and healthcare-associated pneumonia (NHCAP). We evaluated whether the A-DROP system can be adapted for assessment of the severity of coronavirus disease 2019 (COVID-19) pneumonia.
Methods: Data from 1141 patients with COVID-19 pneumonia were analyzed, comprising 502 patients observed in the 1st to 3rd wave period, 338 patients in the 4th wave and 301 patients in the 5th wave in Japan.
Results: The mortality rate and mechanical ventilation rate were 0% and 1.4% in patients classified with mild disease (A-DROP score, 0 point), 3.2% and 46.7% in those with moderate disease (1 or 2 points), 20.8% and 78.3% with severe disease (3 points), and 55.0% and 100% with extremely severe disease (4 or 5 points), indicating an increase in the mortality and mechanical ventilation rates in accordance with severity (Cochran-Armitage trend test; p = <0.001). This significant relationship between the severity in the A-DROP scoring system and either the mortality rate or mechanical ventilation rate was observed in patients with COVID-19 CAP and NHCAP. In each of the five COVID-19 waves, the same significant relationship was observed.
Conclusions: The mortality rate and mechanical ventilation rate in patients with COVID-19 pneumonia increased depending on severity classified according to the A-DROP scoring system. Our results suggest that the A-DROP scoring system can be adapted for the assessment of severity of COVID-19 CAP and NHCAP.
Keywords: A-DROP; COVID-19; Community-acquired pneumonia; Nursing and healthcare-associated pneumonia; Pneumonia severity; SARS-CoV-2.