Abstract
Introduction: The objective of this study was to clarify the clinical differences between nursing and healthcare-associated pneumonia (NHCAP) and community-acquired pneumonia (CAP) due to COVID-19. We also investigated the clinical characteristics to determine whether there is a difference between the variant and non-variant strain in patients with NHCAP due to COVID-19. In addition, we analyzed the clinical outcomes in NHCAP patients with mental disorders who were hospitalized in a medical institution for treatment of mental illness.
Methods: This study was conducted at five institutions and assessed a total of 836 patients with COVID-19 pneumonia (154 cases were classified as NHCAP and 335 had lineage B.1.1.7.).
Results: No differences in patient background, clinical findings, disease severity, or outcomes were observed in patients with NHCAP between the non-B.1.1.7 group and B.1.1.7 group. The median age, frequency of comorbid illness, rates of intensive care unit stay, and mortality rate were significantly higher in patients with NHCAP than in those with CAP. Among the patients with NHCAP, the mortality rate was highest at 37.5% in patients with recent cancer treatment, followed by elderly or disabled patients receiving nursing care (24.3%), residents of care facilities (23.0%), patients receiving dialysis (13.6%), and patients in mental hospitals (9.4%).
Conclusions: Our results demonstrated that there were many differences in the clinical characteristics between NHCAP patients and CAP patients due to COVID-19. It is necessary to consider the prevention and treatment content depending on the presence or absence of applicable criteria for NHCAP.
Keywords: COVID-19; Community-acquired pneumonia; Elderly person; Mental disorder; Nursing and healthcare-associated pneumonia; SARS-CoV-2.
【저자키워드】 COVID-19, SARS-CoV-2., Mental disorder, community-acquired pneumonia, Elderly person, Nursing and healthcare-associated pneumonia, 【초록키워드】 Treatment, SARS-CoV-2, COVID-19 pneumonia, Hospitalized, intensive care, Clinical characteristics, Pneumonia, disease severity, elderly, variant, intensive care unit, outcome, Mental Disorders, clinical outcomes, dialysis, Clinical outcome, Mental disorder, Clinical findings, B.1.1.7, Patient, Disabled, Lineage, Nursing, mortality rate, Care, cancer treatment, community-acquired pneumonia, Frequency, criteria, followed by, presence or absence, nursing care, median age, no differences, mental illness, FIVE, highest, analyzed, the patient, addition, investigated, conducted, receiving, determine, absence, demonstrated, significantly higher, mental hospital, patients with COVID-19, 【제목키워드】 Pneumonia, clinical, feature,