[COVID-19 and non-COVID-19 pneumonia, a comparative study].

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.