SARS-CoV-2 vs Streptococcus pneumoniae: a comparison of clinical features, laboratory findings, and clinical outcomes in patients hospitalized at Alessandria’s General Hospital

Abstract

Aims: the aim of the present study was to compare the clinical, anamnestic, and laboratory features and outcomes of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pneumonia and pneumonia caused by Streptococcus pneumoniae in hospitalized patients at the General Hospital of Alessandria, Italy. Materials and Methods: radiological diagnosis of pneumonia by chest X-ray and/or chest Computed Tomography (CT); microbiological diagnosis of SARS-CoV-2 infection by nasopharyngeal swab Reverse Transcriptase - Polymerase Chain Reaction (RT-PCR), etiological diagnosis of S. pneumoniae pneumonia by positive urinary antigen detection and/or isolation of S. pneumoniae from respiratory and/or blood cultures. Results: 222 patients were included, 171 with SARS-CoV-2 pneumonia and 51 with S. pneumoniae. SARS-CoV-2 group most frequently treated with antiviral drugs: 139/171 (81.3%) vs 1/51 (2.1%); p<0.001; they often needed oxygen therapy: 142/171 (83%) vs 27/51 (56.3%); p<0,001; and non-invasive mechanical ventilation: 59/171 (34.5%) vs 7/51 (14.6%); p=0.004. Mortality was higher in SARS-CoV-2 pneumonia patients: 46/171 (26.9%) than in pneumococcal pneumonia patients 5/51 (9.8%); p=0.011. Conclusions: the study showed the increased prevalence of pneumonia caused by SARS-CoV-2 and S. pneumoniae in males than in females. Moreover, patients with SARS-CoV-2 pneumonia represent higher risk group for complications and death than S. pneumoniae.