Bacteraemic pneumococcal pneumonia and SARS-CoV-2 pneumonia: differences and similarities
•In-hospital course and 30-day survival were compared between patients with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) pneumonia and bacteraemic pneumococcal community-acquired pneumonia (B-PCAP).•B-PCAP was associated with more severe disease on admission and a higher intensive ca...
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| Veröffentlicht in: | International journal of infectious diseases Jg. 115; S. 39 - 47 |
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01.02.2022
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| Abstract | •In-hospital course and 30-day survival were compared between patients with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) pneumonia and bacteraemic pneumococcal community-acquired pneumonia (B-PCAP).•B-PCAP was associated with more severe disease on admission and a higher intensive care unit admission rate compared with SARS-CoV-2 pneumonia.•The mortality rate for SARS-CoV-2 pneumonia was higher and deaths occurred later compared with B-PCAP.•Pneumonia severity scales underestimate the risk of death in patients with SARS-CoV-2 pneumonia.
To analyse differences in clinical presentation and outcome between bacteraemic pneumococcal community-acquired pneumonia (B-PCAP) and sSvere Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) pneumonia.
This observational multi-centre study was conducted on patients hospitalized with B-PCAP between 2000 and 2020 and SARS-CoV-2 pneumonia in 2020. Thirty-day survival, predictors of mortality, and intensive care unit (ICU) admission were compared.
In total, 663 patients with B-PCAP and 1561 patients with SARS-CoV-2 pneumonia were included in this study. Patients with B-PCAP had more severe disease, a higher ICU admission rate and more complications. Patients with SARS-CoV-2 pneumonia had higher in-hospital mortality (10.8% vs 6.8%; P=0.004). Among patients admitted to the ICU, the need for invasive mechanical ventilation (69.7% vs 36.2%; P<0.001) and mortality were higher in patients with SARS-CoV-2 pneumonia. In patients with B-PCAP, the predictive model found associations between mortality and systemic complications (hyponatraemia, septic shock and neurological complications), lower respiratory reserve and tachypnoea; chest pain and purulent sputum were protective factors in these patients. In patients with SARS-CoV-2 pneumonia, mortality was associated with previous liver and cardiac disease, advanced age, altered mental status, tachypnoea, hypoxaemia, bilateral involvement, pleural effusion, septic shock, neutrophilia and high blood urea nitrogen; in contrast, ≥7 days of symptoms was a protective factor in these patients. In-hospital mortality occurred earlier in patients with B-PCAP.
Although B-PCAP was associated with more severe disease and a higher ICU admission rate, the mortality rate was higher for SARS-CoV-2 pneumonia and deaths occurred later. New prognostic scales and more effective treatments are needed for patients with SARS-CoV-2 pneumonia.
[Display omitted] |
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| AbstractList | •In-hospital course and 30-day survival were compared between patients with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) pneumonia and bacteraemic pneumococcal community-acquired pneumonia (B-PCAP).•B-PCAP was associated with more severe disease on admission and a higher intensive care unit admission rate compared with SARS-CoV-2 pneumonia.•The mortality rate for SARS-CoV-2 pneumonia was higher and deaths occurred later compared with B-PCAP.•Pneumonia severity scales underestimate the risk of death in patients with SARS-CoV-2 pneumonia.
To analyse differences in clinical presentation and outcome between bacteraemic pneumococcal community-acquired pneumonia (B-PCAP) and sSvere Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) pneumonia.
This observational multi-centre study was conducted on patients hospitalized with B-PCAP between 2000 and 2020 and SARS-CoV-2 pneumonia in 2020. Thirty-day survival, predictors of mortality, and intensive care unit (ICU) admission were compared.
In total, 663 patients with B-PCAP and 1561 patients with SARS-CoV-2 pneumonia were included in this study. Patients with B-PCAP had more severe disease, a higher ICU admission rate and more complications. Patients with SARS-CoV-2 pneumonia had higher in-hospital mortality (10.8% vs 6.8%; P=0.004). Among patients admitted to the ICU, the need for invasive mechanical ventilation (69.7% vs 36.2%; P<0.001) and mortality were higher in patients with SARS-CoV-2 pneumonia. In patients with B-PCAP, the predictive model found associations between mortality and systemic complications (hyponatraemia, septic shock and neurological complications), lower respiratory reserve and tachypnoea; chest pain and purulent sputum were protective factors in these patients. In patients with SARS-CoV-2 pneumonia, mortality was associated with previous liver and cardiac disease, advanced age, altered mental status, tachypnoea, hypoxaemia, bilateral involvement, pleural effusion, septic shock, neutrophilia and high blood urea nitrogen; in contrast, ≥7 days of symptoms was a protective factor in these patients. In-hospital mortality occurred earlier in patients with B-PCAP.
Although B-PCAP was associated with more severe disease and a higher ICU admission rate, the mortality rate was higher for SARS-CoV-2 pneumonia and deaths occurred later. New prognostic scales and more effective treatments are needed for patients with SARS-CoV-2 pneumonia.
[Display omitted] To analyse differences in clinical presentation and outcome between bacteraemic pneumococcal community-acquired pneumonia (B-PCAP) and sSvere Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) pneumonia.OBJECTIVETo analyse differences in clinical presentation and outcome between bacteraemic pneumococcal community-acquired pneumonia (B-PCAP) and sSvere Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) pneumonia.This observational multi-centre study was conducted on patients hospitalized with B-PCAP between 2000 and 2020 and SARS-CoV-2 pneumonia in 2020. Thirty-day survival, predictors of mortality, and intensive care unit (ICU) admission were compared.METHODSThis observational multi-centre study was conducted on patients hospitalized with B-PCAP between 2000 and 2020 and SARS-CoV-2 pneumonia in 2020. Thirty-day survival, predictors of mortality, and intensive care unit (ICU) admission were compared.In total, 663 patients with B-PCAP and 1561 patients with SARS-CoV-2 pneumonia were included in this study. Patients with B-PCAP had more severe disease, a higher ICU admission rate and more complications. Patients with SARS-CoV-2 pneumonia had higher in-hospital mortality (10.8% vs 6.8%; P=0.004). Among patients admitted to the ICU, the need for invasive mechanical ventilation (69.7% vs 36.2%; P<0.001) and mortality were higher in patients with SARS-CoV-2 pneumonia. In patients with B-PCAP, the predictive model found associations between mortality and systemic complications (hyponatraemia, septic shock and neurological complications), lower respiratory reserve and tachypnoea; chest pain and purulent sputum were protective factors in these patients. In patients with SARS-CoV-2 pneumonia, mortality was associated with previous liver and cardiac disease, advanced age, altered mental status, tachypnoea, hypoxaemia, bilateral involvement, pleural effusion, septic shock, neutrophilia and high blood urea nitrogen; in contrast, ≥7 days of symptoms was a protective factor in these patients. In-hospital mortality occurred earlier in patients with B-PCAP.RESULTSIn total, 663 patients with B-PCAP and 1561 patients with SARS-CoV-2 pneumonia were included in this study. Patients with B-PCAP had more severe disease, a higher ICU admission rate and more complications. Patients with SARS-CoV-2 pneumonia had higher in-hospital mortality (10.8% vs 6.8%; P=0.004). Among patients admitted to the ICU, the need for invasive mechanical ventilation (69.7% vs 36.2%; P<0.001) and mortality were higher in patients with SARS-CoV-2 pneumonia. In patients with B-PCAP, the predictive model found associations between mortality and systemic complications (hyponatraemia, septic shock and neurological complications), lower respiratory reserve and tachypnoea; chest pain and purulent sputum were protective factors in these patients. In patients with SARS-CoV-2 pneumonia, mortality was associated with previous liver and cardiac disease, advanced age, altered mental status, tachypnoea, hypoxaemia, bilateral involvement, pleural effusion, septic shock, neutrophilia and high blood urea nitrogen; in contrast, ≥7 days of symptoms was a protective factor in these patients. In-hospital mortality occurred earlier in patients with B-PCAP.Although B-PCAP was associated with more severe disease and a higher ICU admission rate, the mortality rate was higher for SARS-CoV-2 pneumonia and deaths occurred later. New prognostic scales and more effective treatments are needed for patients with SARS-CoV-2 pneumonia.CONCLUSIONSAlthough B-PCAP was associated with more severe disease and a higher ICU admission rate, the mortality rate was higher for SARS-CoV-2 pneumonia and deaths occurred later. New prognostic scales and more effective treatments are needed for patients with SARS-CoV-2 pneumonia. To analyse differences in clinical presentation and outcome between bacteraemic pneumococcal community-acquired pneumonia (B-PCAP) and sSvere Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) pneumonia. This observational multi-centre study was conducted on patients hospitalized with B-PCAP between 2000 and 2020 and SARS-CoV-2 pneumonia in 2020. Thirty-day survival, predictors of mortality, and intensive care unit (ICU) admission were compared. In total, 663 patients with B-PCAP and 1561 patients with SARS-CoV-2 pneumonia were included in this study. Patients with B-PCAP had more severe disease, a higher ICU admission rate and more complications. Patients with SARS-CoV-2 pneumonia had higher in-hospital mortality (10.8% vs 6.8%; P=0.004). Among patients admitted to the ICU, the need for invasive mechanical ventilation (69.7% vs 36.2%; P<0.001) and mortality were higher in patients with SARS-CoV-2 pneumonia. In patients with B-PCAP, the predictive model found associations between mortality and systemic complications (hyponatraemia, septic shock and neurological complications), lower respiratory reserve and tachypnoea; chest pain and purulent sputum were protective factors in these patients. In patients with SARS-CoV-2 pneumonia, mortality was associated with previous liver and cardiac disease, advanced age, altered mental status, tachypnoea, hypoxaemia, bilateral involvement, pleural effusion, septic shock, neutrophilia and high blood urea nitrogen; in contrast, ≥7 days of symptoms was a protective factor in these patients. In-hospital mortality occurred earlier in patients with B-PCAP. Although B-PCAP was associated with more severe disease and a higher ICU admission rate, the mortality rate was higher for SARS-CoV-2 pneumonia and deaths occurred later. New prognostic scales and more effective treatments are needed for patients with SARS-CoV-2 pneumonia. Image, graphical abstract Objective: To analyse differences in clinical presentation and outcome between bacteraemic pneumococcal community-acquired pneumonia (B-PCAP) and sSvere Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) pneumonia. Methods: This observational multi-centre study was conducted on patients hospitalized with B-PCAP between 2000 and 2020 and SARS-CoV-2 pneumonia in 2020. Thirty-day survival, predictors of mortality, and intensive care unit (ICU) admission were compared. Results: In total, 663 patients with B-PCAP and 1561 patients with SARS-CoV-2 pneumonia were included in this study. Patients with B-PCAP had more severe disease, a higher ICU admission rate and more complications. Patients with SARS-CoV-2 pneumonia had higher in-hospital mortality (10.8% vs 6.8%; P=0.004). Among patients admitted to the ICU, the need for invasive mechanical ventilation (69.7% vs 36.2%; P<0.001) and mortality were higher in patients with SARS-CoV-2 pneumonia. In patients with B-PCAP, the predictive model found associations between mortality and systemic complications (hyponatraemia, septic shock and neurological complications), lower respiratory reserve and tachypnoea; chest pain and purulent sputum were protective factors in these patients. In patients with SARS-CoV-2 pneumonia, mortality was associated with previous liver and cardiac disease, advanced age, altered mental status, tachypnoea, hypoxaemia, bilateral involvement, pleural effusion, septic shock, neutrophilia and high blood urea nitrogen; in contrast, ≥7 days of symptoms was a protective factor in these patients. In-hospital mortality occurred earlier in patients with B-PCAP. Conclusions: Although B-PCAP was associated with more severe disease and a higher ICU admission rate, the mortality rate was higher for SARS-CoV-2 pneumonia and deaths occurred later. New prognostic scales and more effective treatments are needed for patients with SARS-CoV-2 pneumonia. |
| Author | Menendez Villanueva, Rosario Uranga Echeverria, Ane Pérez Fernández, Silvia Serrano Fernández, Leyre España Yandiola, Pedro Pablo Ruiz Iturriaga, Luis Alberto Tabernero Huget, Eva Méndez Ocaña, Raúl Gonzalez Jimenez, Paula García Hontoria, Patricia Zalacain Jorge, Rafael Torres Martí, Antoni |
| Author_xml | – sequence: 1 givenname: Leyre orcidid: 0000-0002-3149-0693 surname: Serrano Fernández fullname: Serrano Fernández, Leyre email: leyre.serranofernandez@osakidetza.eus organization: Pneumology Service, Hospital Universitario Cruces, Barakaldo, Bizkaia, Spain – sequence: 2 givenname: Luis Alberto surname: Ruiz Iturriaga fullname: Ruiz Iturriaga, Luis Alberto email: luisalberto.ruiziturriaga@osakidetza.eus organization: Pneumology Service, Hospital Universitario Cruces, Barakaldo, Bizkaia, Spain – sequence: 3 givenname: Pedro Pablo surname: España Yandiola fullname: España Yandiola, Pedro Pablo email: pedropablo.espanayandiola@osakidetza.eus organization: Pneumology Service, Hospital Universitario Galdakao-Usansolo, Galdakao, Bizkaia, Spain – sequence: 4 givenname: Raúl orcidid: 0000-0001-6300-9836 surname: Méndez Ocaña fullname: Méndez Ocaña, Raúl email: rmendezalcoy@gmail.com organization: Pneumology Service, Hospital Universitari i politècnic La Fe, Valencia, Spain – sequence: 5 givenname: Silvia surname: Pérez Fernández fullname: Pérez Fernández, Silvia email: silvia.perezfernandez@osakidetza.eus organization: Bioinformatics and Statistics Unit, Biocruces Bizkaia Health Research Institute, Barakaldo. Bizkaia, Spain – sequence: 6 givenname: Eva orcidid: 0000-0001-7255-9290 surname: Tabernero Huget fullname: Tabernero Huget, Eva email: e.tabernero.huguet@osakidetza.eus organization: Pneumology Service, Hospital Universitario Cruces, Barakaldo, Bizkaia, Spain – sequence: 7 givenname: Ane surname: Uranga Echeverria fullname: Uranga Echeverria, Ane email: ane.urangaecheverria@osakidetza.eus organization: Pneumology Service, Hospital Universitario Galdakao-Usansolo, Galdakao, Bizkaia, Spain – sequence: 8 givenname: Paula orcidid: 0000-0003-3386-5230 surname: Gonzalez Jimenez fullname: Gonzalez Jimenez, Paula email: paulagonzalezjimenez@gmail.com organization: Pneumology Service, Hospital Universitari i politècnic La Fe, Valencia, Spain – sequence: 9 givenname: Patricia surname: García Hontoria fullname: García Hontoria, Patricia email: patricia.garciahontoria@osakidetza.eus organization: Pneumology Service, Hospital Universitario Galdakao-Usansolo, Galdakao, Bizkaia, Spain – sequence: 10 givenname: Antoni surname: Torres Martí fullname: Torres Martí, Antoni email: atorres@clinic.cat organization: Pneumology Service, Hospital Clinic/Institut D´Investigacions Biomediques August Pi I Sunyer, University of Barcelona, Barcelona, Spain – sequence: 11 givenname: Rosario surname: Menendez Villanueva fullname: Menendez Villanueva, Rosario email: rosmenend@gmail.com organization: Pneumology Service, Hospital Universitari i politècnic La Fe, Valencia, Spain – sequence: 12 givenname: Rafael surname: Zalacain Jorge fullname: Zalacain Jorge, Rafael email: rafael.zalacainjorge@osakidetza.eus organization: Pneumology Service, Hospital Universitario Cruces, Barakaldo, Bizkaia, Spain |
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| Keywords | CRP OR CURB-65 CI Mortality PSI Community-acquired pneumonia Survival Process of care COVID-19 B-PCAP SARS-CoV-2 CAP IMV RT-PCR AEMPS ICU SEPAR Bacteraemic pneumococcal pneumonia COPD |
| Language | English |
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| Snippet | •In-hospital course and 30-day survival were compared between patients with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) pneumonia and... To analyse differences in clinical presentation and outcome between bacteraemic pneumococcal community-acquired pneumonia (B-PCAP) and sSvere Acute Respiratory... Image, graphical abstract Objective: To analyse differences in clinical presentation and outcome between bacteraemic pneumococcal community-acquired pneumonia (B-PCAP) and sSvere Acute... |
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| SubjectTerms | Bacteraemic pneumococcal pneumonia Community-acquired pneumonia COVID-19 Humans Intensive Care Units Mortality Pneumonia, Pneumococcal - complications Process of care Respiration, Artificial SARS-CoV-2 Survival |
| Title | Bacteraemic pneumococcal pneumonia and SARS-CoV-2 pneumonia: differences and similarities |
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