Assessment of the pneumonia severity score in community-acquired and nursing and healthcare-associated pneumonia due to COVID-19

• Published in: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 2023-05, Vol.29 (5), p.437-442
• Main Authors: Miyashita, Naoyuki, Nakamori, Yasushi, Ogata, Makoto, Fukuda, Naoki, Yamura, Akihisa, Ishiura, Yoshihisa
• Format: Article
• Language: English
• Subjects: A-DROP; Community-Acquired Infections - drug therapy; Community-acquired pneumonia; COVID-19; Cross Infection - drug therapy; Healthcare-Associated Pneumonia; Humans; Nursing and healthcare-associated pneumonia; Pneumonia - diagnosis; Pneumonia severity; Retrospective Studies; SARS-CoV-2; Severity of Illness Index
• ISSN: 1341-321X; 1437-7780
• DOI: 10.1016/j.jiac.2022.12.007

The Japanese Respiratory Society (JRS) pneumonia guidelines recommend simple predictive rules, the A-DROP scoring system, for assessment of the severity of community-acquired pneumonia (CAP) and nursing and healthcare-associated pneumonia (NHCAP). We evaluated whether the A-DROP system can be adapted for assessment of the severity of coronavirus disease 2019 (COVID-19) pneumonia. Data from 1141 patients with COVID-19 pneumonia were analyzed, comprising 502 patients observed in the 1st to 3rd wave period, 338 patients in the 4th wave and 301 patients in the 5th wave in Japan. The mortality rate and mechanical ventilation rate were 0% and 1.4% in patients classified with mild disease (A-DROP score, 0 point), 3.2% and 46.7% in those with moderate disease (1 or 2 points), 20.8% and 78.3% with severe disease (3 points), and 55.0% and 100% with extremely severe disease (4 or 5 points), indicating an increase in the mortality and mechanical ventilation rates in accordance with severity (Cochran–Armitage trend test; p =