Toplum Kökenli Pnömoniyi COVID-19 Pnömonisinden Ayırmak Mümkün Mü?

Abstract

Objectives: Coronavirus disease-2019 (COVID-19) caused a pandemic, which has been going on for about 1 year. How long the pandemic will continue remains uncertain. Determining the etiology of pneumonia is the most important point for the treatment approach. In this study, it was aimed to determine the parameters that might be useful in the differentiation of community-acquired pneumonia (CAP) from COVID-19 pneumonia. Materials and Methods: CAP group consisted of 53 people who applied to the infectious diseases polyclinic and chest diseases polyclinic between 01.12.2019 and 30.01.2020 in our country, including the periods when the incidence of CAP increased and influenza peaked, and were hospitalized after being diagnosed with pneumonia. For the COVID-19 pneumonia group, 37 patients with Severe Acute Respiratory Syndrome-Coronavirus-2 detected by polymerase chain reaction from the combined nasal throat swab and with computed tomography showing lesions consistent with COVID-19 were included. Results: Age, leukocyte count, neutrophil count, monocyte count and C-reactive protein (CRP) were significantly higher in pneumonia patients in the CAP group. In receiver operating characteristic analysis, positive predictive value of age CRP monocyte count formula was 0.83 and negative predictive value was 0.75. Conclusion: The age difference between the groups was used in different studies on the etiology of pneumonia. It has been thought that the detection of monocytes in the tissues in postmortem studies in COVID-19 pneumonia may be due to consumption. Higher CRP detection in CAP compared to covid pneumonia was found to be similar to the literature. Our study has shown that the formulation containing monocytes, CRP and age factors, which were found to be statistically significantly different, is suitable for use in diagnostic differentiation.

Keywords

• Community-Acquired Pneumonia
• COVID-19
• Monocyte

References

1. 1. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395:1054-1062.
2. 2. He R, Lu Z, Zhang L, et al. The clinical course and its correlated immune status in COVID-19 pneumonia. J Clin Virol. 2020;127:104361.
3. 3. Fontanarosa PB, Bauchner H. COVID-19-Looking Beyond Tomorrow for Health Care and Society. JAMA. 2020;323:1907-1908.
4. 4. Wunderink RG. Community Acquired Pneumonia. Evidence- Based Critical Care. 2019:155-160. https://link.springer.com/ chapter/10.1007/978-3-030-26710-0_20
5. 5. Murdoch KM, Mitra B, Lambert S, et al. What is the seasonal distribution of community acquired pneumonia over time? A systematic review. Australas Emerg Nurs J. 2014;17:30-42.
6. 6. Faust JS, Del Rio C. Assessment of Deaths From COVID-19 and From Seasonal Influenza. JAMA Intern Med. 2020;180:1045-1046.
7. 7. Şimşek Yavuz S, Ünal S. Antiviral treatment of COVID-19. Turk J Med Sci. 2020:611-619.
8. 8. Lim WS, van der Eerden MM, Laing R, et al. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax. 2003;58:377-382.

9. 9. Kuluöztürk M, İn E, Telo S, et al. Efficacy of copeptin in distinguishing COVID-19 pneumonia from community-acquired pneumonia. J Med Virol. 2021;93:3113-3121.
10. 10. Almirall J, Rofes L, Serra-Prat M, et al. Oropharyngeal dysphagia is a risk factor for community-acquired pneumonia in the elderly. Eur Respir J. 2013;41:923-928.
11. 11. Vinogradova Y, Coupland C, Hippisley-Cox J. Risk of pneumonia in patients taking statins: population-based nested case-control study. Br J Gen Pract. 2011;61:e742-e748.
12. 12. Müllerova H, Chigbo C, Hagan GW, et al. The natural history of communityacquired pneumonia in COPD patients: a population database analysis. Respir Med. 2012;106:1124-1133.
13. 13. Liu KC, Xu P, Lv WF, et al. Differential diagnosis of coronavirus disease 2019 from community-acquired-pneumonia by computed tomography scan and follow-up. Infect Dis Poverty. 2020;9:118.
14. 14. Cillóniz C, Cardozo C, García-Vidal C. Epidemiology, pathophysiology, and microbiology of community acquired pneumonia. Ann Res Hosp. 2018;2:1- 11.
15. 15. Sahuquillo-Arce JM, Menéndez R, Méndez R, et al. Age-related risk factors for bacterial aetiology in community-acquired pneumonia. Respirology. 2016;21:1472-1479.
16. 16. Goldstein E, Lipsitch M, Cevik M. On the Effect of Age on the Transmission of SARS-CoV-2 in Households, Schools, and the Community. J Infect Dis. 2021;223:362-369.
17. 17. Oster AM, Caruso E, DeVies J, Hartnett KP, et al. Transmission Dynamics by Age Group in COVID-19 Hotspot Counties - United States, April-September 2020. MMWR Morb Mortal Wkly Rep. 2020;69:1494-1496.
18. 18. Zhou Y, Guo S, He Y, et al. COVID-19 Is Distinct From SARS-CoV-2-Negative Community-Acquired Pneumonia. Front Cell Infect Microbiol. 2020;10:322.
19. 19. Tang X, Du RH, Wang R, et al. Comparison of Hospitalized Patients With ARDS Caused by COVID-19 and H1N1. Chest. 2020;158:195-205.
20. 20. Shen C, Tan M, Song X, et al. Comparative Analysis of Early-Stage Clinical Features Between COVID-19 and Influenza A H1N1 Virus Pneumonia. Front Public Health. 2020;8:206.
21. 21. Sun Y, Koh V, Marimuthu K, et al. Epidemiological and Clinical Predictors of COVID-19. Clin Infect Dis. 2020;71:786-792.
22. 22. Merad M, Martin JC. Pathological inflammation in patients with COVID-19: a key role for monocytes and macrophages. Nat Rev Immunol. 2020;20:355- 362.
23. 23. Gómez-Rial J, Rivero-Calle I, Salas A, et al. Role of Monocytes/Macrophages in Covid-19 Pathogenesis: Implications for Therapy. Infect Drug Resist. 2020;13:2485-2493.
24. 24. Pence BD. Severe COVID-19 and aging: are monocytes the key? Geroscience. 2020;42:1051-1061.
25. 25. Martinez FO, Combes TW, Orsenigo F, et al. Monocyte activation in systemic Covid-19 infection: Assay and rationale. EBioMedicine. 2020;59:102964.
26. 26. Kvedaraite E, Hertwig L, Sinha I, et al. Major alterations in the mononuclear phagocyte landscape associated with COVID-19 severity. Proc Natl Acad Sci U S A. 2021;118:e2018587118.
27. 27. Meidaninikjeh S, Sabouni N, Marzouni HZ, et al. Monocytes and macrophages in COVID-19: Friends and foes. Life Sci. 2021;269:119010.
28. 28. https://www.cdc.gov/nchs/data/nhanes/nhanes_01_02/l11_b_met_c_ reactive_protein.pdf
29. 29. Li Y, Wang H, Wang F, et al. Comparison of hospitalized patients with pneumonia caused by COVID-19 and influenza A in children under 5 years. Int J Infect Dis. 2020;98:80-83.