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introduction:The patients with Community-Acquired Pneumonia(CAP) could have a higher risk of acute and severe respiratory illness than those without CAP in acute exacerbations of COPD(AECOPD).consequently,early identification of pneumonia in AECOPD is quite important. metholds:62 subjects with AECOPD+CAP and 107 subjects with AECOPD were enrolled from two clinical centers. Clinical parameters and the values of osteopontin (OPN),soluble triggering receptor expressed on myeloid cells-1 (sTrem-1), C-reactive protein (CRP),procalcitonin (PCT),and neutrophil counts (NEU) were measured and compared in AECOPD and AECOPD+CAP on the first day of admission. results:patients with AECOPD+CAP has increased presence of fever, sputum volume,sputum purulence,diabetes mellitus,lower blood pressure, and higher carbon dioxide partial pressure than AECOPD patients(p<0.05).At day1,AECOPD+CAP patients had higher values of NEU,CRP,PCT and OPN,while serum sTREM-1 levels were similar in the two groups. CRP fares best at predicting acute exacerbation of COPD with pneumonia with an area under the curve (AUC) of 0.78, while OPN had similar accuracy with Neu and PCT.the AUC value of OPN,Neu and PCT was 0.61(95% CI 0.53-0.68) , 0.63(95% CI 0.55-0.70) and 0.68(95% CI 0.60-0.75) respectively(p<0.05 for the test of difference). In multivariate analysis, plasma levels of CRP≥15.8 mg/dL at day 1 and sputum purulence were promising predictors of pneumonia in AECOPD. Conclusions:Patients with CAP in AECOPD patients present more clinical parameters and increased biomarker levels but similar short-term outcomes. Combined with plasma CRP level and the clinical characteristic of purulent sputum can be used to predict COPD complicated with pneumonia.

Mingjin Yang

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Background: As of March 31, 2020, about 82,545 COVID-19-infected patients in China have been confirmed. Several observational studies have reported clinical characteristics of pneumonia caused by COVID-19 in China. But there are doubts about the clinical significance of differences reported in the different studies. The objective of this paper is to meta-analyze all available data from observational studies in China to enable an objective reappraisal of the clinical characteristics. Methods: PubMed, CNKI, EMBASE, and Cochrane Library were searched. Observational studies were included if they reported information on clinical characteristics of COVID-19-infected pneumonia. Statistical heterogeneity was assessed using the I2 test, with a value ≥ 50% indicating a substantial level of heterogeneity. Results: Pooled results exhibited that the proportion of male (58%) was higher in patients with COVID-19-infected pneumonia. Fever (89%), cough (74%), fatigue (44%), and shortness of breath (31%) were the common clinical manifestations. Cardiovascular disease (8%), endocrine system disease (9%), and digestive system disease (5%) were the common comorbidities. Moreover, hypertension (29%), endocrine system disease (16%), and cardiovascular disease (8%) were the most common comorbidities in severe patients. Acute cardiac injury (5%), ARDS (11%), shock (3%), and AKI (2%) were the common complications. Conclusions: Men may be more susceptible to COVID-19. The people with hypertension and endocrine system disease are more likely to develop severe pneumonia. The most common symptoms are fever and cough. The heart and kidneys may be also important organs for the COVID-19 to attack in addition to the lungs. Most patients have bilateral imaging abnormalities.