Outcome of Hospitalized Pneumonia Patients with and without COVID-19: A Retrospective Cohort Study
Main Article Content
Keywords
acute kidney injury, COVID-19, mortality, pneumonia
Abstract
COVID-19 pneumonia and community-acquired pneumonia (CAP) have been associated with morbidity and mortality. The aim of this study was to evaluate the outcome of hospitalized patients with COVID-19 pneumonia versus CAP in terms of mortality. This was a retrospective cohort study conducted between pre-COVID-19 era (May 2019–November 2019) and COVID-19 era (May 2020–November 2020). The study included all adult patients with COVID-19 pneumonia (Group 1) and adult patients with CAP but are COVID-19 negative (Group 2). A total of 106 patients were included in the study, of which 56 were in the COVID-19 pneumonia group and 50 in the CAP group. Patients who developed acute kidney injury (AKI) were 60.7% (n = 34) in Group 1 and 48% (n = 24) in Group 2. Mortality occurred in 37.5% (n = 21) patients in Group 1 and 12.0% (n = 6) in Group 2 (P = 0.003). A total of 52 patients required admission to intensive care unit (ICU), of which 44.6% (n = 25) were in Group 1 and 54.0% (n = 27) in Group 2. Of the 58 patients who developed AKI, 3 (8.8%) patients in Group 1 passed away compared to none in Group 2. Moreover, 58.8% patients (n = 20) in Group 1 and 70.8% patients (n = 17) in Group 2 required ICU admission. Mortality rate in the ICU was 80.0% (n = 16) and 35.3% (n = 6) in Groups 1 and 2, respectively (P = 0.006). The overall mortality rate was higher in case of COVID-19 patients than those with CAP. In case of patients with AKI, mortality rate in the ICU was significantly higher in COVID-19 pneumonia patients compared to CAP patients.
References
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2. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al.Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet. 2020 Mar;395(10229):1054–62. 10.1016/S0140-6736(20)30566-3
3. Green MS, Peer V, Schwartz N, Nitzan D. The confounded crude case-fatality rates (CFR) for COVID-19 hide more than they reveal—A comparison of age-specific and age-adjusted CFRs between seven countries. PLoS One. 2020 Oct;15(10):e0241031. 10.1371/journal.pone.0241031
4. Ticona JH, Zaccone VM, McFarlane IM. Community-acquired pneumonia: A focused review. Am J Med Case Rep. 2021 Nov;9 (1):45. 10.12691/ajmcr-9-1-12
5. Peyrani P, Arnold FW, Bordon J, Furmanek S, Luna CM, Cavallazzi R, et al. Incidence and mortality of adults hospitalized with community-acquired pneumonia according to clinical course. Chest. 2020 Jan;157(1):34–41. 10.1016/j.chest.2019.09.022
6. Akyil FT, Yalcinsoy M, Hazar A, Cilli A, Celenk B, Kilic O, et al. Prognosis of hospitalized patients with community-acquired pneumonia. Pulmonology. 2018 May;24(3):164–9. 10.1016/j.rppnen.2017.07.010
7. Pieralli F, Vannucchi V, De Marzi G, Mancini A, Bacci F, Para O, et al. Performance status and in-hospital mortality of elderly patients with community acquired pneumonia. Intern Emerg Med. 2018 Jun;13(4):501–7. 10.1007/s11739-018-1822-1
8. Wang HE, Muntner P, Chertow GM, Warnock DG. Acute kidney injury and mortality in hospitalized patients. Am J Nephrol. 2012;35(4):349–55. 10.1159/000337487
9. Chen D, Yuan H, Cao C, Liu Z, Jiang L, Tan Y, et al. Impact of acute kidney injury on in-hospital outcomes in Chinese patients with community-acquired pneumonia. BMC Pulm Med. 2021 Dec;21:1–7. 10.1186/s12890-021-01511-9
10. Cheng X, Wu B, Liu Y, Mao H, Xing C. Incidence and diagnosis of acute kidney injury in hospitalized adult patients: A retrospective observational study in a tertiary teaching hospital in Southeast China. BMC Nephrol. 2017 Dec;18(1):1–8. 10.1186/s12882-017-0622-6
11. Naicker S, Yang CW, Hwang SJ, Liu BC, Chen JH, Jha V. The novel coronavirus 2019 epidemic and kidneys. Kidney Int. 2020 Mar;97(5):824–8. 10.1016/j.kint.2020.03.001
12. Puelles VG, Lütgehetmann M, Lindenmeyer MT, Sperhake JP, Wong MN, Allweiss L, et al. Multiorgan and renal tropism of SARS-CoV-2. N Engl J Med. 2020 Aug;383:590–2. 10.1056/NEJMc2011400
13. Su H, Yang M, Wan C, Yi LX, Tang F, Zhu HY, et al. Renal histopathological analysis of 26 postmortem findings of patients with COVID-19 in China. Kidney Int. 2020 Apr;98 (1):219–27. 10.1016/j.kint.2020.04.003
14. Hirsch JS, Ng JH, Ross DW, Sharma P, Shah HH, Barnett R, et al. Acute kidney injury in patients hospitalized with COVID-19. Kidney Int. 2020 Jul;98(1):209–18. 10.1016/j.kint.2020.05.006
15. Raina R, Mahajan ZA, Vasistha P, Chakraborty R, Mukunda K, Tibrewal A, et al. Incidence and outcomes of acute kidney injury in COVID-19: Asystematic review. Blood Purif. 2021 Jun. pp. 1–14. 10.1159/000514940
16. Tian J, Xu Q, Liu S, Mao L, Wang M. Comparison of clinical characteristics between coronavirus disease 2019 pneumonia and community-acquired pneumonia. Curr Med Res Opin. 2020 Nov;36 (11):1747–52. 10.1080/03007995.2020.1830050
17. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020 Apr;382(18):1708–20. 10.1056/NEJMoa2002032
18. Wunderink RG, Waterer G. Advances in the causes and management of community acquired pneumonia in adults. BMJ. 2017 Jul;358:j2471. 10.1136/bmj.j2471
19. Prina E, Ranzani OT, Torres A. Community-acquired pneumonia. Lancet. 2015 Aug;386:1097–108. 10.1016/S0140-6736(15)60733-4
20. Rey JR, Caro-Codón J, Rosillo SO, Iniesta ÁM, Castrejón-Castrejón S, Marco-Clement I, et al. Heart failure in COVID-19 patients: prevalence, incidence and prognostic implications. Eur J Heart Fail. 2020 Dec;22:2205–15. 10.1002/ejhf.1990
21. Tomasoni D, Inciardi RM, Lombardi CM, Tedino C, Agostoni P, Ameri P, et al. Impact of heart failure on the clinical course and outcomes of patients hospitalized for COVID-19. Results of the Cardio-COVID-Italy multicentre study. Eur J Heart Fail. 2020 Dec;22:2238–47. 10.1002/ejhf.2052
22. Alvarez-Garcia J, Jaladanki S, Rivas-Lasarte M, Cagliostro M, Gupta A, Joshi A, et al. New heart failure diagnoses among patients hospitalized for COVID-19. J Am Coll Cardiol. 2021 May;77:2260–2. 10.1016/j.jacc.2021.03.006
23. Sellars C, Bowie L, Bagg J, Sweeney MP, Miller H, Tilston J, et al. Risk factors for chest infection in acute stroke: A prospective cohort study. Stroke. 2007 Aug;38(8):2284–91. 10.1161/STROKEAHA.106.478156
24. Pranata R, Huang I, Lim MA, Wahjoepramono EJ, July J. Impact of cerebrovascular and cardiovascular diseases on mortality and severity of COVID-19 —Systematic review, meta-analysis, and meta-regression. J Stroke Cerebrovasc Dis. 2020 Aug;29:104949. 10.1016/j.jstrokecerebrovasdis.2020.104949.
25. Aggarwal G, Lippi G, Henry BM. Cerebrovascular disease is associated with an increased disease severity inpatients with coronavirus disease 2019 (COVID-19): A pooled analysis of published literature. Int J Stroke. 2020 Jun;15:385–9. 10.1177/1747493020921664
26. Beyrouti R, Adams ME, Benjamin L, Cohen H, Farmer SF, Goh YY, et al. Characteristics of ischemic stroke associated with COVID-19. J Neurol Neurosurg Psychiatry. 2020 Aug; 91:889–91. 10.1136/jnnp-2020-323586
27. Dogra S, Jain R, Cao M, Bilaloglu S, Zagzag D, Hochman S, Lewis A, et al. Hemorrhagic stroke and anticoagulation in COVID-19. J Stroke Cerebrovasc Dis. 2020 Aug;29:104984. 10.1016/j.jstrokecerebrovasdis.2020.104984
28. Nannoni S, de Groot R, Bell S, Markus HS. Stroke in COVID-19: A systematic review and meta-analysis. Int J Stroke. 2021 Feb;16(2):137–49. 10.1177/1747493020972922
29. Cheng Y, Luo R, Wang K, Zhang M, Wang Z, Dong L, et al. Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney Int. 2020 May;97(5): 829–38. 10.1016/j.kint.2020.03.005
30. Taher A, Alalwan AA, Naser N, Alsegai O, Alaradi A. Acute kidney injury in COVID-19 pneumonia: A single-center experience in Bahrain. Cureus. 2020 Aug;12:e9693. 10.7759/cureus.9693
31. Murugan R, Karajala-Subramanyam V, Lee M, Yende S, Kong L, Carter M, et al. Acute kidney injury in non-severe pneumonia is associated with an increased immune response and lower survival. Kidney Int. 2010 Mar;77 (6):527–35. 10.1038/ki.2009.502
32. Abate SM, Ahmed Ali S, Mantfardo B, Basu B. Rate of intensive care unit admission and outcomes among patients with coronavirus: A systematic review and meta-analysis. PloS One. 2020 Jul;15(7):e0235653. 10.1371/journal.pone.0235653
33. Cillóniz C, Liapikou A, Martin-Loeches I, García-Vidal C, Gabarrús A, Ceccato A, et al. Twenty-year trend in mortality among hospitalized patients with pneumococcal community-acquired pneumonia. PloS One. 2018 Jul;13(7):e0200504. 10.1371/journal.pone.0200504
34. Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020 Apr;8(4):420–2. 10.1016/S2213-2600(20)30076-X
35. Barton LM, Duval EJ, Stroberg E, Ghosh S, Mukhopadhyay S. Covid-19 autopsies, Oklahoma, USA. Am J Clin Pathol. 2020 May;153(6):725–33. 10.1093/ajcp/aqaa062.
36. Akram AR, Singanayagam A, Choudhury G, Mandal P, Chalmers JD, Hill AT. Incidence and prognostic implications of acute kidney injury on admission in patients with community-acquired pneumonia. Chest. 2010 Oct;138(4):825–32. 10.1378/chest.09-3071
37. Mohamed MM, Lukitsch I, Torres-Ortiz AE, Walker JB, Varghese V, Hernandez-Arroyo CF, et al. Acute kidney injury associated with coronavirus disease 2019 in urban New Orleans. Kidney 360. 2020 Jul;1(7):614–22. 10.34067/KID.0002652020
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Jan 7, 2022
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Outcome of Hospitalized Pneumonia Patients with and without COVID-19: A Retrospective Cohort Study. (2022). Journal of Renal and Hepatic Disorders, 6(1), 17-23. https://doi.org/10.15586/jrenhep.v6i1.132
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