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Comparison of clinical characteristics of patients with pandemic SARS-CoV-2-related and community-acquired pneumonias in Hungary – a pilot historical case-control study
GeroScience ( IF 5.3 ) Pub Date : 2020-11-11 , DOI: 10.1007/s11357-020-00294-x
Viktor J Horváth 1 , Noémi Hajdú 1 , Orsolya Vági 1 , Karolina Schnábel 1 , Emese Szelke 1 , Anna E Körei 1 , Magdolna Békeffy 1 , Márk M Svébis 1 , Beatrix A Domján 1 , Tamás Berényi 2 , István Takács 1 , Zoltán Ungvári 3, 4, 5 , Attila Kun 6 , Ádám G Tabák 1, 7, 8
Affiliation  

The distinction between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–related and community-acquired pneumonias poses significant difficulties, as both frequently involve the elderly. This study aimed to predict the risk of SARS-CoV-2-related pneumonia based on clinical characteristics at hospital presentation. Case-control study of all patients admitted for pneumonia at Semmelweis University Emergency Department. Cases (n = 30) were patients diagnosed with SARS-CoV-2-related pneumonia (based on polymerase chain reaction test) between 26 March 2020 and 30 April 2020; controls (n = 82) were historical pneumonia cases between 1 January 2019 and 30 April 2019. Logistic models were built with SARS-CoV-2 infection as outcome using clinical characteristics at presentation. Patients with SARS-CoV-2-related pneumonia were younger (mean difference, 95% CI: 9.3, 3.2–15.5 years) and had a higher lymphocyte count, lower C-reactive protein, presented more frequently with bilateral infiltrate, less frequently with abdominal pain, diarrhoea, and nausea in age- and sex-adjusted models. A logistic model using age, sex, abdominal pain, C-reactive protein, and the presence of bilateral infiltrate as predictors had an excellent discrimination (AUC 0.88, 95% CI: 0.81–0.96) and calibration (p = 0.27–Hosmer-Lemeshow test). The clinical use of our screening prediction model could improve the discrimination of SARS-CoV-2 related from other community-acquired pneumonias and thus help patient triage based on commonly used diagnostic approaches. However, external validation in independent datasets is required before its clinical use.



中文翻译:

匈牙利大流行性 SARS-CoV-2 相关性肺炎和社区获得性肺炎患者临床特征的比较——一项试点历史病例对照研究

区分严重急性呼吸系统综合症冠状病毒 2 (SARS-CoV-2) 相关肺炎和社区获得性肺炎存在很大困难,因为两者都经常涉及老年人。本研究旨在根据医院就诊时的临床特征预测 SARS-CoV-2 相关肺炎的风险。塞梅尔维斯大学急诊科所有因肺炎入院的患者的病例对照研究。病例(n = 30)是 2020 年 3 月 26 日至 2020 年 4 月 30 日期间被诊断为 SARS-CoV-2 相关肺炎(基于聚合酶链反应试验)的患者;控制 ( n= 82) 是 2019 年 1 月 1 日至 2019 年 4 月 30 日期间的历史性肺炎病例。以 SARS-CoV-2 感染为结果,使用就诊时的临床特征建立逻辑模型。SARS-CoV-2 相关肺炎患者更年轻(平均差,95% CI:9.3,3.2-15.5 岁),淋巴细胞计数较高,C 反应蛋白较低,双侧浸润更常见,双侧浸润较少见年龄和性别调整模型中的腹痛、腹泻和恶心。使用年龄、性别、腹痛、C 反应蛋白和双侧浸润作为预测因子的逻辑模型具有出色的辨别力(AUC 0.88,95% CI:0.81-0.96)和校准(p= 0.27–Hosmer-Lemeshow 检验)。我们的筛查预测模型的临床应用可以提高 SARS-CoV-2 与其他社区获得性肺炎相关的鉴别能力,从而帮助基于常用诊断方法对患者进行分类。然而,在临床使用之前,需要在独立数据集中进行外部验证。

更新日期:2020-11-12
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