Table 1.
Clinical characteristics and disease course of patients.
| CAP-other* | CAP-strep | CAP-flu | COVID-19 | p-value | |
|---|---|---|---|---|---|
| (n = 177) | (n = 27) | (n = 22) | (n = 39) | ||
| DEMOGRAPHICS | |||||
| Age, years | 67·8 (16·6) | 64·4 (13·3) | 65·8 (15·8) | 60·5 (11·4) | 0·06 |
| Sex, male | 99 (55·9) | 17 (63·0) | 12 (54·5) | 20 (51·3) | 0·82 |
| Body mass index | 25·8 (5·5) | 24·2 (5·5) | 26·1 (5·4) | 30·3 (6·9)↑ | <0·01 |
| CHRONIC COMORBIDITIES | |||||
| Immune deficiency | 36 (20·3) | 4 (14·8) | 2 (9·1) | 2 (5·1) | 0·09 |
| Immunosuppressives | 29 | 2 | 1 | 2 | |
| Solid organ transplant | 19 | 0 | 2 | 2 | |
| Haematological malignancy | 12 | 1 | 1 | 0 | |
| Chemotherapy <6 months | 6 | 0 | 0 | 0 | |
| COPD | 52 (29·4) | 10 (37·0) | 7 (31·8) | 2 (5·1)↓ | <0·01 |
| Asthma | 15 (8·5) | 3 (11·1) | 2 (9·1) | 3 (7·7) | 0·92 |
| Congestive heart failure | 17 (9·6) | 2 (7·4) | 0 (0·0) | 1 (2·6) | 0·31 |
| Myocardial infarction | 30 (16·9) | 4 (14·8) | 3 (13·6) | 2 (5·1) | 0·29 |
| History of stroke | 21 (11·9) | 0 (0·0) | 0 (0·0) | 3 (7·7) | 0·09 |
| Diabetes mellitus | 49 (27·7) | 6 (22·2) | 3 (13·6) | 10 (25·6) | 0·56 |
| Chronic kidney disease | 23 (13·0) | 1 (3·7) | 2 (9·1) | 2 (5·1) | 0·37 |
| LABORATORY TESTS† | |||||
| Leukocytes, x109/L | 11·8 [8·9, 14·7]↑ | 13·7 [8·8, 19·2] | 9·9 [5·3, 13·8] | 6·9 [5·7, 9·0]↓ | <0·01 |
| Neutrophils, x109/L | 9·1 [6·1, 12·2]↑ | 12·2 [8·9, 16·3]↑ | 8·8 [4·8, 11·2] | 5·1 [3·9, 6·9]↓ | <0·01 |
| Lymphocytes, x109/L | 0·94 [0·62, 1·52] | 0·86 [0·60, 1·20] | 1·08 [0·56, 1·23] | 0·97 [0·72, 1·40] | 0·93 |
| Platelets, x109/L | 252 (117) | 243 (127) | 206 (96) | 261 (108) | 0·31 |
| Creatinine, µmol/L | 89 [66, 124] | 88 [72, 115] | 85 [70, 110] | 88 [71, 102] | 0·90 |
| VITAL SIGNS AND DISEASE EVERITY† | |||||
| Temperature,°C | 38·2 (1·2) | 38·4 (1·0) | 38·1 (1·0) | 37·7 (1·2)↓ | 0·03 |
| Respiratory rate, bpm | 22 [16, 26] | 22 [19, 30] | 23 [20, 25] | 23 [20, 27] | 0·12 |
| Heart rate, bpm | 98 [84, 110] | 103 [91, 121] | 90 [80, 100] | 94 [80, 108] | 0·03 |
| MAP, mmHg | 97·3 (16·8) | 88·3 (13·8) | 91·2 (18·8) | 96·4 (15·4) | 0·03 |
| MEWS | 3 [2, 4] | 4 [2, 5] | 3 [3, 4] | 3 [2, 4] | 0·14 |
| PSI | 4 [3, 4] | 4 [3, 4] | 4 [2, 4] | 3 [2, 3]↓ | <0·01 |
| CURB-65 | 2 [1, 2] | 2 [1, 3] | 1 [0, 3] | 1 [0, 2]↓ | 0·01 |
| qSOFA | 1 [0, 1] | 1 [0, 1] | 0 [0, 1] | 1 [0, 1] | 0·21 |
| DISEASE COURSE | |||||
| Symptoms to admission, days | 3 [2, 7]↓,‡ | 4 [3, 7]‡ | 4 [2, 6]‡ | 8 [5, 10]↑ | <0·01 |
| Increase of corticosteroids upon admission | 28 (15·8) | 5 (18·5) | 7 (31·8) | 2 (5·1) | 0.05 |
| ICU admission (at any point during admission) | 15 (8·5) | 4 (14·8) | 1 (4·5) | 6 (15·4) | 0·36 |
| Time to clinical stability¶ or discharge, days | 3 [2, 6] | 3 [2, 6] | 3 [2, 5] | 4 [3, 7] | 0·22 |
| Hospital LOS, days | 5 [3, 9] | 4 [3, 9] | 3 [2, 4] | 4 [3, 8] | 0·11 |
| 28-day mortality | 11 (6·2) | 0 (0·0) | 1 (4·5) | 5 (12·8) | 0·20 |
CAP = community-acquired pneumonia; COPD = chronic obstructive pulmonary disease; bpm = breaths/beats per minute; MAP = mean arterial pressure; CURB-65 = confusion, blood urea nitrogen, respiratory rate, blood pressure, age 65 or older; MEWS= modified early warning score; PSI= pneumonia severity index; qSOFA = quick sequential organ failure assessment score; LOS= length of stay.
Continuous data are presented as mean (standard deviation) or median [interquartile range], and compared using a two-sided ANOVA or two-sided Kruskal-Wallis test, respectively. Categorical data are presented as count (percentage) and compared using Fisher's exact test.
Microbiological results in this group: no pathogen identified (n=120), Haemophilus influenzae (n=15), Pseudomonas aeruginosa (n=8), Rhinovirus (n=7), Human metapneumovirus (n=5), Coronavirus (n=4), Staphylococcus aureus (n=4), Klebsiella pneumoniae (n=2), Respiratory syncytial virus (n=2), Pneumocystis jirovecii (n=2), Parainfluenza virus 1-4 (n=2), Aspergillus spp. (n=1), Legionella (n=1), Mycobacterium tuberculosis (n=1), Escherichia coli (n=1), Mycoplasma pneumoniae (n=1), Rothia dentocariosa (n=1).
Measured upon presentation to the emergency department
Missing values in 50/177 (28·2%), 3/27 (11·1%), and 7/22 (31·8%) of patients; date of start of symptoms was not available in the OPTIMACT study
Defined as the modified Halm's criteria: temperature ≤37·2°C, heart rate ≤100 bpm, systolic blood pressure ≤90 mmHg, respiratory rate ≤ 24 bpm, and oxygen saturation ≥90% for the entire day
Significantly higher than grand mean of other groups, corrected for multiple testing by Holm's method.
Significantly lower than grand mean of other groups, corrected for multiple testing by Holm's method.