COVID-19 Is Distinct From SARS-CoV-2-Negative Community-Acquired Pneumonia
COVID-19 Is Distinct From SARS-CoV-2-Negative Community-Acquired Pneumonia
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COVID-19 与 SARS-CoV-2 阴性社区获得性肺炎不同
DOI：
10.3389/fcimb.2020.00322
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发表时间：
2020-06-16
影响因子：
5.7
通讯作者：
Li, Xiaohui
中科院分区：
文献类型：
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作者：
Zhou, Yutian;Guo, Shujin;Li, Xiaohui
背景：冠状病毒病（COVID-19）是一种传染性呼吸道疾病，已在全球迅速蔓延。许多研究已经评估了COVID-19的临床特征，但它与严重急性呼吸综合征冠状病毒2（SARS-CoV-2）阴性社区获得性肺炎（SN-CAP）的比较仍不清楚。此外，COVID-19死亡率与疾病严重程度相关，但尚未指定严重程度分级指标。我们的目的是分析COVID-19与SN-CAP相比的临床特征，并找到COVID-19疾病严重程度的指标。方法：入选确诊为COVID-19和SN-CAP的患者。分析了临床、影像学和实验室数据。结果：入组的COVID-19和SN-CAP患者人数分别为304和138。两组患者的年龄无显著差异。与SN-CAP相比，COVID-19患者的发热和呼吸困难症状更多;血细胞计数结果显示出显著差异。COVID-19患者的计算机断层扫描（CT）成像显示与疾病严重程度相关的斑片状毛玻璃影，而SN-CAP患者的CT成像显示斑片状高密度影。COVID-19患者被分为中度、重度和极重度组。重度和极重度组的白色细胞（WBC）、中性粒细胞、血小板、C反应蛋白（CRP）、淋巴细胞比率（NLR）、血小板与淋巴细胞比率（PLR）、肌钙蛋白I、肌酸酐和血尿素氮（BUN）水平升高。然而，他们的淋巴细胞水平、淋巴细胞比率和白蛋白水平降低。与年轻患者相比，年龄较大的COVID-19患者患有更多慢性疾病，WBC、中性粒细胞和CRP水平显著升高。结论：SN-CAP比COVID-19表现出更多的炎症反应。患有慢性病的老年人更容易感染COVID-19，并有很大的可能性发展为重症和重症感染。WBC、淋巴细胞、中性粒细胞、CRP、NLR、PLR、肌钙蛋白I、肌酐和BUN水平是COVID-19严重程度分级的重要指标。
Background: Corona virus disease (COVID-19) is an infectious respiratory disease that has spread rapidly across the world. Many studies have already evaluated the clinical features of COVID-19, but how it compares with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-negative community-acquired pneumonia (SN-CAP) is still unclear. Moreover, COVID-19 mortality is correlated with disease severity, but indicators for severity grading have not been specified. We aimed to analyze the clinical characteristics of COVID-19 in comparison with SN-CAP and find indicators for disease severity in COVID-19. Methods: Patients diagnosed with COVID-19 and SN-CAP were enrolled. Clinical, radiological, and laboratory data were analyzed. Results: The numbers of COVID-19 and SN-CAP patients enrolled were 304 and 138, respectively. The age of the patients was not significantly different between the groups. Compared with SN-CAP, COVID-19 patients had more symptoms of fever and dyspnea; and showed significant difference in blood count results. Computed tomography (CT) imaging of COVID-19 patients showed patchy ground-glass opacities that correlated with disease severity, whereas the CT imaging of SN-CAP patients showed patchy high-density shadows. COVID-19 patients were classified into moderate, severe, and critically severe groups. The severe and critically severe groups had elevated levels of white blood cells (WBC), neutrophils, platelets, C-reaction protein (CRP), lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), troponin-I, creatinine, and blood urea nitrogen (BUN). However, they had decreased levels of lymphocytes, lymphocyte ratio, and albumin. Compared with the younger patients, the older COVID-19 individuals had more chronic diseases and significantly elevated levels of WBC, neutrophil, and CRP levels. Conclusion: SN-CAP showed more inflammatory reaction than COVID-19. Old people with chronic diseases are more susceptible to COVID-19 and have a high likelihood of developing severe and critically severe infection. Levels of WBC, lymphocytes, neutrophils, CRP, NLR, PLR, troponin-I, creatinine, and BUN are important indicators for severity grading in COVID-19.