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Comparison of Clinical, Laboratory and Radiological Characteristics Between COVID-19 and Adenovirus Pneumonia: A Retrospective Study

Authors Jiang J, Wan R, Pan P, Hu C, Zhou R, Yin Y, Zhou T, Huang H, Li Y

Received 23 May 2020

Accepted for publication 20 August 2020

Published 2 October 2020 Volume 2020:13 Pages 3401—3408


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Suresh Antony

Juan Jiang,1 Rongjun Wan,1 Pinhua Pan,1 Chengping Hu,1 Rihua Zhou,2 Yiping Yin,2 Ting Zhou,2 Hua Huang,2 Yuanyuan Li1

1Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China; 2Medical Center of Tuberculosis, The Second People’s Hospital of Chenzhou, Chenzhou, Hunan Province, People’s Republic of China

Correspondence: Yuanyuan Li
Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha 410008, People’s Republic of China
Tel +86 13975806790
Email [email protected]
Hua Huang
Medical Center of Tuberculosis, The Second People’s Hospital of Chenzhou, Chenzhou 423000, People’s Republic of China
Tel +86 18673561888
Email [email protected]

Background: The pandemic of coronavirus disease 2019 (COVID-19) has become a global public health problem. It is important for clinical physicians to differentiate COVID-19 from other respiratory infectious diseases caused by viruses, such as human adenovirus.
Subjects and Methods: This was a retrospective observational study. We analyzed and compared the clinical manifestations, laboratory findings and radiological features of two independent cohorts of patients diagnosed with either COVID-19 (n=36) or adenovirus pneumonia (n=18).
Results: COVID-19 did not show a preference in males or females, whereas 94.4% of patients with adenovirus pneumonia were males. Fever and cough were common in both COVID-19 and adenovirus pneumonia. But the median maximal body temperature of the adenovirus pneumonia cohort was significantly higher than in COVID-19 (P< 0.001). Furthermore, 77.8% of patients with adenovirus pneumonia had a productive cough versus only 13.9% of COVID-19 patients (P< 0.001). Compared with adenovirus pneumonia, constitutional symptoms were less common in COVID-19, including headache (16.7% vs 38.9%, P=0.072), sore throat (8.3% vs 27.8%, P=0.058), myalgia (8.3% vs 61.1%, P< 0.001) and diarrhea (8.3% vs 44.4%, P=0.002). Furthermore, patients with COVID-19 were less likely to develop respiratory failure (8.3% vs 83.3%, P< 0.001) and showed less prominent laboratory abnormalities, including lymphocytopenia (61.1% vs 88.9%, P=0.035), thrombocytopenia (2.8% vs 61.1%, P< 0.001), elevated procalcitonin (2.8% vs 77.8%, P< 0.001) and elevated C-reactive protein (36.1% vs 100%, P< 0.001). Besides, a higher percentage of patients with adenovirus pneumonia showed elevated transaminase, myocardial enzymes, creatinine and D-dimer compared with COVID-19 patients. On chest CT, the COVID-19 cohort was characterized by peripherally distributed ground-glass opacity and patchy shadowing, while the adenovirus pneumonia cohort frequently presented with consolidation and pleural effusion.
Conclusion: There were many differences between patients diagnosed with COVID-19 and those with adenovirus pneumonia in their clinical, laboratory and radiological characteristics. Compared with adenovirus pneumonia, COVID-19 patients tended to show a lower severity of illness.

Keywords: coronavirus disease 2019, severe acute respiratory syndrome coronavirus 2, human adenovirus, adenovirus pneumonia, differential diagnosis

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