Clinical and radiological findings of adult hospitalized patients with community-acquired pneumonia from SARS-CoV-2 and endemic human coronaviruses

PLoS One. 2021 Jan 14;16(1):e0245547. doi: 10.1371/journal.pone.0245547. eCollection 2021.

Abstract

Endemic human coronaviruses (HCoVs) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are members of the family Coronaviridae. Comparing the findings of the infections caused by these viruses would help reveal the novel characteristics of SARS-CoV-2 and provide insight into the unique pathogenesis of SARS-CoV-2 infection. This study aimed to compare the clinical and radiological characteristics of SARS-CoV-2 and endemic HCoVs infection in adult hospitalized patients with community-acquired pneumonia (CAP). This study was performed at a university-affiliated tertiary hospital in the Republic of Korea, between January 1, 2015, and July 31, 2020. A total of 109 consecutive patients who were over 18 years of age with confirmed SARS-CoV-2 and endemic HCoVs were enrolled. Finally, 19 patients with SARS-CoV-2 CAP were compared to 40 patients with endemic HCoV CAP. Flu-like symptoms such as cough, sore throat, headache, myalgia, and prolonged fever were more common in SARS-CoV-2 CAP, whereas clinical findings suggestive of bacterial pneumonia such as dyspnea, leukocytosis with left shift, and increased C-reactive protein were more common in endemic HCoV CAP. Bilateral peripherally distributed ground-glass opacities (GGOs) were typical radiologic findings in SARS-CoV-2 CAP, whereas mixed patterns of GGOs, consolidations, micronodules, and pleural effusion were observed in endemic HCoV CAP. Coinfection was not observed in patients with SARS-CoV-2 CAP, but was observed in more than half of the patients with endemic HCoV CAP. There were distinctive differences in the clinical and radiologic findings between SARS-CoV-2 and endemic HCoV CAP. Further investigations are required to elucidate the mechanism underlying this difference. Follow-up observations are needed to determine if the presentation of SARS-CoV-2 CAP changes with repeated infection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • COVID-19 / diagnostic imaging*
  • COVID-19 / epidemiology
  • COVID-19 / pathology
  • COVID-19 / virology
  • Cohort Studies
  • Coinfection / diagnostic imaging
  • Coinfection / epidemiology
  • Coinfection / pathology
  • Coinfection / virology
  • Community-Acquired Infections
  • Coronavirus / isolation & purification
  • Endemic Diseases
  • Female
  • Humans
  • Lung / diagnostic imaging
  • Male
  • Middle Aged
  • Middle East Respiratory Syndrome Coronavirus / isolation & purification
  • Pandemics
  • Pneumonia, Viral / diagnostic imaging*
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / pathology
  • Pneumonia, Viral / virology
  • Radiography, Thoracic / methods
  • Republic of Korea / epidemiology
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2 / isolation & purification
  • Thorax / diagnostic imaging

Grants and funding

Seong-Ho Choi was supported by the National Research Foundation of Korea grant funded by the Korea Government (MSIP) (2019R1C1C1006417). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.