Medicina · 2025
[COVID-19 and non-COVID-19 pneumonia, a comparative study].
Сравнительное исследованиеАннотация на английскомСтатьяМногоцентровое исследованиеСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Zlotogora Melani, Reyna Santiago T M, Correa Barovero María A, Wendebourg Milagros, Badariotti Hernán, Cavalli Valentina, Roggero Matías, Venencia Ricardo, Torino Giuliana, Cravero Constanza, Kahn Nicole, De Leonardi Paula, Rodríguez Bonazzi Silvina, Tarditi Barra Ayelen, Douthat Barrionuevo Augusto, Villada Sofía, Fernández Pehuén, Albertini Ricardo A, Saad Emanuel J
Аннотация
INTRODUCTION: The clinical management of pneumonia in hospitalized patients remains a constant medical challenge, particularly during the SARS-CoV-2 pandemic, due to its heterogeneous presentation and the need for timely diagnostic and therapeutic decisions. The objective of this study was to describe the frequency and clinical characteristics of community-acquired pneumonia (CAP) and COVID-19 pneumonia in hospitalized patients, and to evaluate the performance of various prognostic scores.
MATERIALS AND METHODS: This was a retrospective analytical study conducted at two tertiary care hospitals in Córdoba, Argentina. Patients aged over 18 years with a diagnosis of CAP or COVID-19 pneumonia who were hospitalized between March 2020 and October 2021 were included. Pregnant women were excluded.
RESULTS: A total of 1176 patients with COVID-19 pneumonia and 124 with CAP were included. COVID-19 pneumonia occurred more frequently in males (748 [63.6%] vs. 66 [53.2%]; p=0.02) and in younger patients (median age= 60; IQR= 49-71 vs. median=70.5; IQR= 52-80; p<0.001). Severe forms were more frequent in COVID-19 cases (723 [61.5%] vs. 61 [49.2%]; p=0.003), as was progression from mild to severe illness (103/529, 19.5% vs. 3/75, 4%; p<0.001). At admission, CURB-65 and qSOFA scores identified most cases as low risk; however, the 4C mortality and CALL scores showed better performance in predicting complications. In-hospital mortality was similar between groups (143/1176, 12.2% vs. 14/124, 11.3%; p=0.78).
DISCUSSION: Hospitalized pneumonia cases, whether COVID-related or not, predominantly affected patients with comorbidities. Prognostic stratification using the 4C mortality and CALL scores demonstrated better predictive performance for unfavorable outcomes.
MATERIALS AND METHODS: This was a retrospective analytical study conducted at two tertiary care hospitals in Córdoba, Argentina. Patients aged over 18 years with a diagnosis of CAP or COVID-19 pneumonia who were hospitalized between March 2020 and October 2021 were included. Pregnant women were excluded.
RESULTS: A total of 1176 patients with COVID-19 pneumonia and 124 with CAP were included. COVID-19 pneumonia occurred more frequently in males (748 [63.6%] vs. 66 [53.2%]; p=0.02) and in younger patients (median age= 60; IQR= 49-71 vs. median=70.5; IQR= 52-80; p<0.001). Severe forms were more frequent in COVID-19 cases (723 [61.5%] vs. 61 [49.2%]; p=0.003), as was progression from mild to severe illness (103/529, 19.5% vs. 3/75, 4%; p<0.001). At admission, CURB-65 and qSOFA scores identified most cases as low risk; however, the 4C mortality and CALL scores showed better performance in predicting complications. In-hospital mortality was similar between groups (143/1176, 12.2% vs. 14/124, 11.3%; p=0.78).
DISCUSSION: Hospitalized pneumonia cases, whether COVID-related or not, predominantly affected patients with comorbidities. Prognostic stratification using the 4C mortality and CALL scores demonstrated better predictive performance for unfavorable outcomes.