Comparison of Clinical, Laboratory and Radiological Characteristics Between COVID-19 and Adenovirus Pneumonia: A Retrospective Study

Juan Jiang; Rongjun Wan; Pinhua Pan; Chengping Hu; Rihua Zhou; Yiping Yin; Ting Zhou; Hua Huang; Yuanyuan Li

doi:10.2147/IDR.S264132

Comparison of Clinical, Laboratory and Radiological Characteristics Between COVID-19 and Adenovirus Pneumonia: A Retrospective Study

Infect Drug Resist. 2020 Oct 2:13:3401-3408. doi: 10.2147/IDR.S264132. eCollection 2020.

Authors

Juan Jiang¹, Rongjun Wan¹, Pinhua Pan¹, Chengping Hu¹, Rihua Zhou², Yiping Yin², Ting Zhou², Hua Huang², Yuanyuan Li¹

Affiliations

¹ Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan Province, People's Republic of China.
² Medical Center of Tuberculosis, The Second People's Hospital of Chenzhou, Chenzhou, Hunan Province, People's Republic of China.

Abstract

Background: The pandemic of coronavirus disease 2019 (COVID-19) has become a global public health problem. It is important for clinical physicians to differentiate COVID-19 from other respiratory infectious diseases caused by viruses, such as human adenovirus.

Subjects and methods: This was a retrospective observational study. We analyzed and compared the clinical manifestations, laboratory findings and radiological features of two independent cohorts of patients diagnosed with either COVID-19 (n=36) or adenovirus pneumonia (n=18).

Results: COVID-19 did not show a preference in males or females, whereas 94.4% of patients with adenovirus pneumonia were males. Fever and cough were common in both COVID-19 and adenovirus pneumonia. But the median maximal body temperature of the adenovirus pneumonia cohort was significantly higher than in COVID-19 (P<0.001). Furthermore, 77.8% of patients with adenovirus pneumonia had a productive cough versus only 13.9% of COVID-19 patients (P<0.001). Compared with adenovirus pneumonia, constitutional symptoms were less common in COVID-19, including headache (16.7% vs 38.9%, P=0.072), sore throat (8.3% vs 27.8%, P=0.058), myalgia (8.3% vs 61.1%, P<0.001) and diarrhea (8.3% vs 44.4%, P=0.002). Furthermore, patients with COVID-19 were less likely to develop respiratory failure (8.3% vs 83.3%, P<0.001) and showed less prominent laboratory abnormalities, including lymphocytopenia (61.1% vs 88.9%, P=0.035), thrombocytopenia (2.8% vs 61.1%, P<0.001), elevated procalcitonin (2.8% vs 77.8%, P<0.001) and elevated C-reactive protein (36.1% vs 100%, P<0.001). Besides, a higher percentage of patients with adenovirus pneumonia showed elevated transaminase, myocardial enzymes, creatinine and D-dimer compared with COVID-19 patients. On chest CT, the COVID-19 cohort was characterized by peripherally distributed ground-glass opacity and patchy shadowing, while the adenovirus pneumonia cohort frequently presented with consolidation and pleural effusion.

Conclusion: There were many differences between patients diagnosed with COVID-19 and those with adenovirus pneumonia in their clinical, laboratory and radiological characteristics. Compared with adenovirus pneumonia, COVID-19 patients tended to show a lower severity of illness.

Keywords: adenovirus pneumonia; coronavirus disease 2019; differential diagnosis; human adenovirus; severe acute respiratory syndrome coronavirus 2.

Grants and funding

This work was supported in part by grants from the National Natural Science Foundation of China (8160025, 81873406), the Natural Science Foundation of Hunan Province (S2019JJQNJJ1970), the National Key Technology Research and Development Program of China (2015BAI12B00) and the National Key Research and Development Program of China (2018YFC1311900).