Arif Doğan HABİLOĞLU, Serkan DEMİRCAN, Özlem ATAOĞLU, Filiz Mercan SARIDAŞ, Can ÇOLAKOĞLU, Mehmet Yasir PEKTEZEL

Toplum Kökenli Pnömoniyi COVID-19 Pnömonisinden Ayırmak Mümkün Mü?

Amaç: Koronavirüs hastalığı-2019 (COVID-19), yaklaşık 1 yıldır devam eden bir salgına neden oldu. Salgının ne kadar süreceği belirsizliğini korumaktadır. Pnömoni etiyolojisinin belirlenmesi tedavi yaklaşımı için en önemli noktadır. Bu çalışmada toplum kökenli pnömoninin (TKP) COVID-19 pnömonisinden ayrımında faydalı olabilecek parametrelerin belirlenmesi amaçlanmıştır. Gereç ve Yöntem: Ülkemizde 01.12.2019-30.01.2020 tarihleri arasında, TKP’nin insidansının arttığı ve influenzanın pik yaptığı dönemlerde enfeksiyon hastalıkları polikliniği ve göğüs hastalıkları polikliniğine başvuran ve pnömoni tanısı aldıktan sonra hastaneye yatırılan 53 kişi TKP grubunu oluşturdu. COVID-19 pnömoni grubuna, kombine nazal boğaz sürüntüsünden polimeraz zincir reaksiyonu ile pozitiflik saptanan ve bilgisayarlı tomografide COVID-19’a uyumlu lezyonları olan 37 hasta dahil edildi. Bulgular: TKP grubundaki hastalarda yaş, lökosit sayısı, nötrofil sayısı, monosit sayısı ve C-reaktif protein (CRP) anlamlı olarak daha yüksekti. İşlem Karakteristik Eğrisi analizinde, yaş CRP monosit sayısı formülünün pozitif prediktif değeri 0,83 ve negatif prediktif değeri 0,75 idi. Sonuç: Gruplar arası yaş farkı, pnömoni etiyolojisine yönelik farklı çalışmalarda kullanılmıştır. COVID-19 pnömonisinde postmortem çalışmalarda dokularda monosit tespit edilmesinin tüketime bağlı olabileceği düşünüldü. TKP’de COVID pnömonisine kıyasla daha yüksek CRP tespiti literatüre benzer bulunmuştur. Çalışmamız, istatistiksel olarak anlamlı derecede farklı olduğu tespit edilen monosit, CRP ve yaş faktörlerini içeren formülasyonun tanısal ayrımda kullanılmasının uygun olduğunu göstermiştir.

Is it Possible to Differentiate Community-Acquired Pneumonia from COVID-19 Pneumonia?

Objectives: Coronavirus disease-2019 (COVID-19) caused a pandemic, which has been going on for about 1 year. How long the pandemic will continue remains uncertain. Determining the etiology of pneumonia is the most important point for the treatment approach. In this study, it was aimed to determine the parameters that might be useful in the differentiation of community-acquired pneumonia (CAP) from COVID-19 pneumonia. Materials and Methods: CAP group consisted of 53 people who applied to the infectious diseases polyclinic and chest diseases polyclinic between 01.12.2019 and 30.01.2020 in our country, including the periods when the incidence of CAP increased and influenza peaked, and were hospitalized after being diagnosed with pneumonia. For the COVID-19 pneumonia group, 37 patients with Severe Acute Respiratory Syndrome-Coronavirus-2 detected by polymerase chain reaction from the combined nasal throat swab and with computed tomography showing lesions consistent with COVID-19 were included. Results: Age, leukocyte count, neutrophil count, monocyte count and C-reactive protein (CRP) were significantly higher in pneumonia patients in the CAP group. In receiver operating characteristic analysis, positive predictive value of age CRP monocyte count formula was 0.83 and negative predictive value was 0.75. Conclusion: The age difference between the groups was used in different studies on the etiology of pneumonia. It has been thought that the detection of monocytes in the tissues in postmortem studies in COVID-19 pneumonia may be due to consumption. Higher CRP detection in CAP compared to covid pneumonia was found to be similar to the literature. Our study has shown that the formulation containing monocytes, CRP and age factors, which were found to be statistically significantly different, is suitable for use in diagnostic differentiation.

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