International Journal of Infectious Diseases (Feb 2022)

Bacteraemic pneumococcal pneumonia and SARS-CoV-2 pneumonia: differences and similarities

  • Leyre Serrano Fernández, MD,
  • Luis Alberto Ruiz Iturriaga, MD, PhD,
  • Pedro Pablo España Yandiola, MD, PhD,
  • Raúl Méndez Ocaña, MD,
  • Silvia Pérez Fernández,
  • Eva Tabernero Huget, MD,
  • Ane Uranga Echeverria, MD, PhD,
  • Paula Gonzalez Jimenez, MD,
  • Patricia García Hontoria, MD,
  • Antoni Torres Martí, MD, PhD,
  • Rosario Menendez Villanueva, MD, PhD,
  • Rafael Zalacain Jorge, MD, PhD

Journal volume & issue
Vol. 115
pp. 39 – 47

Abstract

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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.

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