scholarly journals Clinical and radiological findings of adult hospitalized patients with community-acquired pneumonia from SARS-CoV-2 and endemic human coronaviruses

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245547 ◽  
Author(s):  
Moon Seong Baek ◽  
Min Jae Cha ◽  
Min-Chul Kim ◽  
Jin-Won Chung ◽  
Won-Young Kim ◽  
...  
Keyword(s):  
Tertiary Hospital ◽  
Clinical Findings ◽  
Community Acquired Pneumonia ◽  
Hospitalized Patients ◽  
The Novel ◽  
Reactive Protein ◽  
Radiologic Findings ◽  
The Republic ◽  
Human Coronaviruses

Endemic human coronaviruses (HCoVs) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are members of the family Coronaviridae. Comparing the findings of the infections caused by these viruses would help reveal the novel characteristics of SARS-CoV-2 and provide insight into the unique pathogenesis of SARS-CoV-2 infection. This study aimed to compare the clinical and radiological characteristics of SARS-CoV-2 and endemic HCoVs infection in adult hospitalized patients with community-acquired pneumonia (CAP). This study was performed at a university-affiliated tertiary hospital in the Republic of Korea, between January 1, 2015, and July 31, 2020. A total of 109 consecutive patients who were over 18 years of age with confirmed SARS-CoV-2 and endemic HCoVs were enrolled. Finally, 19 patients with SARS-CoV-2 CAP were compared to 40 patients with endemic HCoV CAP. Flu-like symptoms such as cough, sore throat, headache, myalgia, and prolonged fever were more common in SARS-CoV-2 CAP, whereas clinical findings suggestive of bacterial pneumonia such as dyspnea, leukocytosis with left shift, and increased C-reactive protein were more common in endemic HCoV CAP. Bilateral peripherally distributed ground-glass opacities (GGOs) were typical radiologic findings in SARS-CoV-2 CAP, whereas mixed patterns of GGOs, consolidations, micronodules, and pleural effusion were observed in endemic HCoV CAP. Coinfection was not observed in patients with SARS-CoV-2 CAP, but was observed in more than half of the patients with endemic HCoV CAP. There were distinctive differences in the clinical and radiologic findings between SARS-CoV-2 and endemic HCoV CAP. Further investigations are required to elucidate the mechanism underlying this difference. Follow-up observations are needed to determine if the presentation of SARS-CoV-2 CAP changes with repeated infection.

scholarly journals Comparison of the Characteristics of Asymptomatic and Presymptomatic Patients with Coronavirus Disease 2019 in the Republic of Korea

2021 ◽  
Vol 11 (4) ◽  
pp. 354-363
Author(s):  
Miri Hyun ◽  
Ji Yeon Lee ◽  
Jae Seok Park ◽  
Jin Young Kim ◽  
Hyun Ah Kim
Keyword(s):  
Clinical Manifestations ◽  
Tertiary Hospital ◽  
Chest Radiographs ◽  
Reactive Protein ◽  
Asymptomatic Patients ◽  
Group A ◽  
The Republic ◽  
Group B ◽  
Time Of Admission

Abstract Purpose This retrospective study aimed to evaluate the baseline characteristics of asymptomatic patients with coronavirus disease 2019 at admission and to follow-up their clinical manifestations and radiological findings during hospitalization. Methods Patients with coronavirus disease 2019 who were asymptomatic at admission were divided into two groups—those with no symptoms until discharge (group A) and those who developed symptoms after admission (group B). Patients who could not express their own symptoms were excluded. Results Overall, 127 patients were enrolled in the study, of whom 19 and 108 were assigned to groups A and B, respectively. The mean age and median C-reactive protein level were higher in group B than in group A. All patients in group A and one-third of patients in group B had normal initial chest radiographs; 15.8% and 48.1% of patients in groups A and B, respectively, had pneumonia during hospitalization. One patient in group B, whose condition was not severe at the time of admission, deteriorated due to aggravated pneumonia and was transferred to a tertiary hospital. Conclusion We summarize the clinical characteristics during hospitalization of patients with coronavirus disease 2019 who were purely asymptomatic at the time of admission. The majority of asymptomatic patients with coronavirus disease 2019 were discharged without significant events during hospitalization. However, it may be difficult to predict subsequent events from initial chest radiographs or oxygen saturation at admission.

scholarly journals Waning antibody responses in COVID-19: what can we learn from the analysis of other coronaviruses?

Infection ◽  
2021 ◽  
Author(s):  
Ali Hamady ◽  
JinJu Lee ◽  
Zuzanna A. Loboda
Keyword(s):  
Cross Reactivity ◽  
Antibody Responses ◽  
The Novel ◽  
Incidence And Mortality ◽  
Antibody Titres ◽  
Human Coronaviruses ◽  
Public Health Strategies ◽  
Antibody Dynamics

Abstract Objectives The coronavirus disease 2019 (COVID-19), caused by the novel betacoronavirus severe acute respiratory syndrome 2 (SARS-CoV-2), was declared a pandemic in March 2020. Due to the continuing surge in incidence and mortality globally, determining whether protective, long-term immunity develops after initial infection or vaccination has become critical. Methods/Results In this narrative review, we evaluate the latest understanding of antibody-mediated immunity to SARS-CoV-2 and to other coronaviruses (SARS-CoV, Middle East respiratory syndrome coronavirus and the four endemic human coronaviruses) in order to predict the consequences of antibody waning on long-term immunity against SARS-CoV-2. We summarise their antibody dynamics, including the potential effects of cross-reactivity and antibody waning on vaccination and other public health strategies. At present, based on our comparison with other coronaviruses we estimate that natural antibody-mediated protection for SARS-CoV-2 is likely to last for 1–2 years and therefore, if vaccine-induced antibodies follow a similar course, booster doses may be required. However, other factors such as memory B- and T-cells and new viral strains will also affect the duration of both natural and vaccine-mediated immunity. Conclusion Overall, antibody titres required for protection are yet to be established and inaccuracies of serological methods may be affecting this. We expect that with standardisation of serological testing and studies with longer follow-up, the implications of antibody waning will become clearer.

scholarly journals Clinical Features and Outcomes of Community-Acquired Pneumonia Caused by Haemophilus Influenza

2021 ◽  
Vol 8 (4) ◽  
Author(s):  
Saeed Shoar ◽  
Fernando H Centeno ◽  
Daniel M Musher
Keyword(s):  
Clinical Features ◽  
Alcohol Use Disorder ◽  
Pneumococcal Pneumonia ◽  
Severe Infection ◽  
Clinical Findings ◽  
Community Acquired Pneumonia ◽  
Equal Frequency ◽  
Haemophilus Influenza ◽  
Radiologic Findings ◽  
Viral Coinfection

Abstract Background Long regarded as the second most common cause of community-acquired pneumonia (CAP), Haemophilus influenzae has recently been identified with almost equal frequency as pneumococcus in patients hospitalized for CAP. The literature lacks a detailed description of the presentation, clinical features, laboratory and radiologic findings, and outcomes in Haemophilus pneumonia. Methods During 2 prospective studies of patients hospitalized for CAP, we identified 33 patients with Haemophilus pneumonia. In order to provide context, we compared clinical findings in these patients with findings in 36 patients with pneumococcal pneumonia identified during the same period. We included and analyzed separately data from patients with viral coinfection. Patients with coinfection by other bacteria were excluded. Results Haemophilus pneumonia occurred in older adults who had underlying chronic lung disease, cardiac conditions, and alcohol use disorder, the same population at risk for pneumococcal pneumonia. However, in contrast to pneumococcal pneumonia, patients with Haemophilus pneumonia had less severe infection as shown by absence of septic shock on admission, less confusion, fewer cases of leukopenia or extreme leukocytosis, and no deaths at 30 days. Viral coinfection greatly increased the severity of Haemophilus, but not pneumococcal pneumonia. Conclusions We present the first thorough description of Haemophilus pneumonia, show that it is less severe than pneumococcal pneumonia, and document that viral coinfection greatly increases its severity. These distinctions are lost when the label CAP is liberally applied to all patients who come to the hospital from the community for pneumonia.

scholarly journals Utility of procalcitonin, C-reactive protein and white blood cells alone and in combination for the prediction of clinical outcomes in community-acquired pneumonia

2015 ◽  
Vol 53 (4) ◽  
Author(s):  
Andriy Zhydkov ◽  
Mirjam Christ-Crain ◽  
Robert Thomann ◽  
Claus Hoess ◽  
Christoph Henzen ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Blood Cells ◽  
White Blood Cells ◽  
Community Acquired Pneumonia ◽  
Adverse Clinical Outcome ◽  
C Reactive Protein ◽  
Prognostic Information ◽  
Reactive Protein

AbstractThe added value of biomarkers, such as procalcitonin (PCT), C-reactive protein (CRP), and white blood cells (WBC), as adjuncts to clinical risk scores for predicting the outcome of patients with community-acquired pneumonia (CAP) is in question. We investigated the prognostic accuracy of initial and follow-up levels of inflammatory biomarkers in predicting death and adverse clinical outcomes in a large and well-defined cohort of CAP patients.We measured PCT, CRP and WBC on days 1, 3, 5, and 7 and followed the patients over 30 days. We applied multivariate regression models and area under the curve (AUC) to investigate associations between these biomarkers, the clinical risk score CURB-65, and clinical outcomes [i.e., death and intensive care unit (ICU) admission].Of 925 patients with CAP, 50 patients died and 118 patients had an adverse clinical outcome. None of the initial biomarker levels significantly improved the CURB-65 score for mortality prediction. Follow-up biomarker levels showed significant independent association with mortality at days 3, 5, and 7 and with improvements in AUC. Initial PCT and CRP levels were independent prognostic predictors of adverse clinical outcome, and levels of all biomarkers during the course of disease provided additional prognostic information.This study provides robust insights into the added prognostic value of inflammatory markers in CAP. Procalcitonin, CRP, and to a lesser degree WBC provided some prognostic information on CAP outcomes, particularly when considering their kinetics at days 5 and 7 and when looking at adverse clinical outcomes instead of mortality alone.

Antibiotic resistance of strains of Streptococcus pneumoniae isolated from hospitalized patients with community-acquired pneumonia in the republic of North Ossetia-Alania

2014 ◽  
Vol 20 (30) ◽  
pp. 105-108 ◽  
Author(s):  
Гатагонова ◽  
Tamara Gatagonova ◽  
Цаллагова ◽  
Olga Tsallagova ◽  
Болиева ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Streptococcus Pneumoniae ◽  
Antimicrobial Agents ◽  
Developed Countries ◽  
Community Acquired Pneumonia ◽  
Hospitalized Patients ◽  
The Republic ◽  
Definition Of ◽  
Low Activity ◽  
North Ossetia

An increase of antibiotic resistance of bacteria, in particular, Streptococcus pneumoniae, has been registered recently in most developed countries. This necessitates the study of regional characteristics of etiological structure of causative bacterial agents of community-acquired pneumonia and their sensitivity to antibiotics. The aim of the study was to study the spectrum of bacterial pathogens of community-acquired pneumonia and the sensitivity of Streptococcus pneumoniae to antimicrobial agents in hospitalized patients in the Republic of North Ossetia - Alania. Bacteriological examination of sputum with definition of sensitivity of isolated strains of bacteria to antibiotics was performed in 270 patients with community-acquired pneumonia. According to our data, the main causative agent of community-acquired pneumonia in hospitalized patients in the Republic of North Ossetia-Alania is Streptococcus pneumoniae. III generation cephalosporins, respiratory fluoroquinolones, macrolides, showed high activity against Streptococcus pneumoniae isolated from hospitalized patients. Low activity of natural and semi-synthetic penicillins was shown. The obtained results allow optimizing of antimicrobial therapy of community-acquired pneumonia caused by Streptococcus pneumoniae.

scholarly journals WITHDRAWN: TREATMENT FAILURE AND EMPIRIC ANTIBIOTIC CHOICE FOR HOSPITALIZED PATIENTS WITH COMMUNITY-ACQUIRED PNEUMONIA: Β-LACTAM/Β-LACTAMASE INHIBITOR COMBINED WITH MACROLID OR FLUOROQUINOLONE ALONE?

2019 ◽  
Vol 7 (7) ◽  
pp. 360-369
Author(s):  
Fatma Tokgoz Akyil ◽  
Sumeyye Alparslan Bekir ◽  
Aylin Gungor ◽  
Kubra Akyuz ◽  
Neslihan Kose ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Conflicts Of Interest ◽  
Pneumonia Severity Index ◽  
Severity Index ◽  
Community Acquired Pneumonia ◽  
Hospitalized Patients ◽  
Pneumonia Severity ◽  
Reactive Protein ◽  
Empiric Antibiotic ◽  
Lactamase Inhibitor

Background A considerable percentage of empirical antibiotic treatment fails in hospitalized patients with community-acquired pneumonia (CAP). β-lactams and macrolid (BLM) combination or respiratory fluoroquinolones (FQ) are the most frequently used in these patients. The aim of the present study is to compare the treatment failure (TF) rates in BLM and FQ treatment and to analyze the predictive factors of TF. Method Hospitalized patients who were initially treated with either BLM or FQ were included retrospectively and treatment results of the two regimens were compared. Results Of the 144 patients included in the study, the mean age was 67±16 and 102 (71%) were male. Each group constituted of 72 patients. Antibiotic selection did not alter TF rates, length of stay (LOS) and 30-day mortality. Baseline higher levels of leucocytes, neutrophils to lymphocytes ratio (NLR), C-reactive protein (CRP), BUN/albumin, lactate dehydrogenase/aspartat aminotransferase (LDH/AST) levels and pneumonia severity index (PSI) scores were detected as predictors of TF. Conclusion Empirical treatments with either BLM or FQ do not correlate with TF, LOS and 30-day mortality. NLR, BUN/albumin and LDH/AST may suggest TF. These inexpensive and easily-reachable parameters have the potential as predictors of the treatment outcome in CAP.   Notices of retraction Akyil, F. T., Bekir, S. A., Gungor, A., Akyuz, K., Kose, N., Turker, H., Akyil, M., & Sevim, T. (2019). TREATMENT FAILURE AND EMPIRIC ANTIBIOTIC CHOICE FOR HOSPITALIZED PATIENTS WITH COMMUNITY-ACQUIRED PNEUMONIA: Β-LACTAM/Β-LACTAMASE INHIBITOR COMBINED WITH MACROLID OR FLUOROQUINOLONE ALONE?. International Journal of Research -GRANTHAALAYAH, 7(7), 360-369. https://doi.org/10.29121/granthaalayah.v7.i7.2019.778 Article retracted by : EditorReason(s) for retraction : Author's conflicts of interest

scholarly journals A retrospective observational study to estimate use of biomarkers to predict severity of community acquired pneumonia in children

2021 ◽  
Author(s):  
Anam Bashir ◽  
Raheel Khan ◽  
Stephanie Thompson ◽  
Manuel Caceres
Keyword(s):  
Area Under The Curve ◽  
Retrospective Chart Review ◽  
Tertiary Hospital ◽  
Community Acquired Pneumonia ◽  
Pneumonia Severity ◽  
Neutrophil Lymphocyte Ratio ◽  
Reactive Protein ◽  
Hospital Patients ◽  
Minimal Research

Purpose: Multiple studies have investigated the role of biomarkers in predicting pneumonia severity in adults but minimal research exists for children. The aim of this study was to determine if the following biomarkers: white blood cell count (WBC), platelet count, C-reactive protein (CRP), procalcitonin (PCT), neutrophil-lymphocyte ratio, neutrophil count, or band count predict community associated pneumonia (CAP) severity in children. Methods: A retrospective chart review was conducted on pediatric patients (aged 60 days to 18 years) diagnosed with CAP, admitted to a regional, tertiary hospital. Patients were stratified into two severity cohorts, mild (no ICU care), and moderate /severe (required ICU care). Biomarker values were then compared between the severity cohorts and area under the curve (AUC), cut-off values, performance characteristics were calculated. Results: A total of 108 patients met inclusion criteria. Among the biomarkers examined, elevated levels of CRP (51.7 mg/L in mild vs. 104.8 mg/L in moderate/severe, p = 0.003, PCT (0.29 ng/ml in mild vs. 4.02 ng/ml in moderate/severe, p = 0.001) and band counts (8% in mild vs. 15% moderate/severe, p = 0.009) were associated with increased pneumonia severity. In predicting moderate/severe CAP, PCT had the highest AUC of 0.77 (p = 0.001) followed by bands AUC of 0.69 (p = 0.009) and CRP AUC of 0.67 (p = 0.003). The cut-off for PCT of 0.55ng/ml had a sensitivity of 83% and a specificity of 65%. A cut-off level of 53.1 mg/L for CRP had a sensitivity of 79% and specificity of 52%. A cut off level of 12.5% bands had a sensitivity of 61% and specificity of 71%. Conclusion: Biomarkers, in particular PCT, obtained early in hospitalization appear to perform as predictors for CAP severity in children and may be beneficial in guiding CAP management

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