key: cord-0771026-z9u7wx9w authors: Fernández, Leyre Serrano; Iturriaga, Luis Alberto Ruiz; Yandiola, Pedro Pablo España; Ocaña, Raúl Méndez; Fernández, Silvia Pérez; Huget, Eva Tabernero; Echeverria, Ane Uranga; Jimenez, Paula Gonzalez; Hontoria, Patricia García; Martí, Antoni Torres; Villanueva, Rosario Menendez; Jorge, Rafael Zalacain title: BACTERAEMIC PNEUMOCOCCAL PNEUMONIA AND SARS-CoV-2 PNEUMONIA: DIFFERENCES AND SIMILARITIES date: 2021-11-18 journal: Int J Infect Dis DOI: 10.1016/j.ijid.2021.11.023 sha: adf969ac33b31b671b9b3ddecfff3a1a8f00429e doc_id: 771026 cord_uid: z9u7wx9w Objective Analyse differences in clinical presentation and outcome between bacteraemic pneumococcal community-acquired pneumonia (B-PCAP), and SARS-CoV-2 pneumonia. Methods Observational multicenter study conducted on patients hospitalized for B-PCAP between 2000-2020 and SARS-CoV-2 pneumonia during 2020. We compared 30-day survival, predictors of mortality and intensive care unit (ICU) admission. Results We included 663 B-PCAP and 1561 SARS-CoV-2 pneumonia. B-PCAP patients had higher severity, ICU admission and more complications. SARS-CoV-2 pneumonia patients had higher in-hospital mortality (10.8%vs6.8%, p 0.004). Among ICU patients, need for invasive mechanical ventilation (69.7%vs36.2%, p<0.001) and mortality were higher in SARS-CoV-2 pneumonia. In B-PCAP, our predictive model related mortality to systemic complications (hyponatremia, septic shock, neurological complications), lower respiratory reserve or tachypnoea; whereas chest pain and purulent sputum were protective. In SARS-CoV-2, mortality was related to previous liver and cardiac disease, advanced age, altered mental status, tachypnoea, hypoxemia, bilateral involvement, pleural effusion, septic shock, neutrophilia, and high blood urea nitrogen; in contrast, ≥7 days of symptoms was a protective factor. In-hospital mortality occurred earlier in B-PCAP. Conclusions Although B-PCAP was associated with higher severity and ICU rate, SARS-CoV-2 pneumonia-related mortality was higher and occurred later. New prognostic scales and more effective treatments are needed for SARS-CoV-2 pneumonia. The aim of our study was to analyse the differences and similarities in clinical presentation, host inflammatory response and outcome between what has previously been the most common and invasive pneumonia (B-PCAP),and the pneumonia caused by the current pandemic virus which is threatening global public health (SARS-CoV-2 pneumonia). We have compared factors associated with intensive care unit (ICU) admission and in-hospital mortality and assessed survival after hospitalization in both types of pneumonia. This is an observational multicenter study based on the analysis of a prospective registry We recorded patients' clinical and demographic characteristics, as well as physical examination, laboratory and radiological findings on admission. 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