Together with the word “coronavirus” we learned another new phrase: “community-acquired pneumonia”. What is it and why are there so many patients with this diagnosis?
Outside or inside
“Nosocomial pneumonia is pneumonia that occurs in a patient 48-72 hours after the patient’s admission to the hospital,” says Candidate of Medical Sciences, general practitioner, cardiologist of Atlas Medical Center Maria Kirillova. – Community-acquired pneumonia is one that has developed outside of the clinic. The symptoms in both pneumonias are the same (weakness, fever, cough, chest pain, shortness of breath). However, the pathogens that cause them are different.
Nosocomial pneumonia is caused by pathogens that are different in each hospital. Often, these pathogens are resistant to antibiotic therapy. Due to difficulties in selecting treatment for nosocomial pneumonia, 25 to 50% of patients die.
Since January 2020, the Federal State Statistics Service recorded a sharp increase in the number of community-acquired pneumonia (by 37% compared with January 2019). We certainly cannot say that it was already a coronavirus, because until April the patient was diagnosed with the “coronavirus” only after the presence of the virus confirms the analysis. Since PCR studies in a large percentage of cases give false-negative results, and the results had to wait 7-10 days, patients were diagnosed with community-acquired pneumonia. After all patients with characteristic symptoms underwent a CT scan and its conclusion (“frosted glass syndrome”, numerous sites combined with consolidation or a symptom of “cobblestone pavement” in the lungs) became the basis for the diagnosis, everything fell into place. ” .
Not pneumonia at all?
Later it turned out that the diagnosis of community-acquired pneumonia in patients with coronavirus infection is not entirely correct. Coronavirus causes chemical pneumonitis – a diffuse lesion of the membranes of the alveoli (cavities in the lungs in which oxygen and carbon dioxide are exchanged). As a result, hyaluronic acid is poured out of them (this is in the picture and looks like “frosted glass”).
What other pneumonia are there?
In addition to nosocomial and community-acquired, there is atypical pneumonia. So called lung damage caused by atypical pathogens. Atypical pneumonia is also called “Severe Acute Respiratory Syndrome ”(SARS) or SARS. The outbreak of this disease was recorded in 2002-2003 in the countries of Southeast Asia.
The causative agent of SARS also belongs to the coronavirus family. Bats turned out to be its distributor (the first outbreak was recorded in the Chinese province, where they were eaten).
–
Symptoms of SARS are similar to those of normal pneumonia (high fever, cough, shortness of breath), but are particularly severe. The disease often leads to the development of progressive severe respiratory failure, which is why SARS-associated SARS is considered to be a much more complex disease than other coronavirus infections.
Atypical pneumonia is a disease of the young. 70% of those infected in 2002-2003 are young healthy people who did not have chronic diseases or any health problems.
According to WHO statistics, 8436 cases of the disease were recorded in 30 countries of the world during the SARS epidemic, 900 people died. Mortality was 10%.
Unlike COVID-19, the SARS pathogen was transmitted only at very close contact (about 10 cm), and in the external environment it remained viable for no more than 3-6 hours.
Perhaps because of this, an outbreak of SARS was quickly taken under control. In 2003, the end of the epidemic was officially announced. SARS virus disappeared without a trace and since then has never reminded of itself. However, it is impossible to assume that the disease is a thing of the past. The virus still lives in animals, which means it can reappear.
– .
