Clinical and radiological diagnosis of non–SARS‐CoV‐2 viruses in the era of COVID‐19 pandemic

• Published in: Journal of medical virology Vol. 93; no. 2; pp. 1119 - 1125
• Main Authors: Alpaydin, Aylin O., Gezer, Naciye S., Simsek, Gokçen O., Tertemiz, Kemal C., Kutsoylu, Oya O. E., Zeka, Arzu N., Guzel, Irmak, Soyturk, Mujde, Sayiner, Ayca A., Oguz, Vildan A.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01-02-2021; John Wiley and Sons Inc
• Subjects: Adult; Aged; Coinfection - diagnosis; Coinfection - virology; Confidence intervals; Coronaviridae; Coronaviruses; COVID-19; COVID-19 - epidemiology; Cross-Sectional Studies; Diagnosis; Diagnosis, Differential; Differential diagnosis; Hospitalization; Humans; Laboratories; Leukocytes; Lymphocytes; Middle Aged; Nasopharynx - virology; non–SARS‐CoV‐2 viruses; Opacity; Pandemics; Pathogens; Pneumonia, Viral - diagnosis; Pneumonia, Viral - epidemiology; Respiratory diseases; SARS‐CoV‐2; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Sputum; Sputum - virology; Thrombocytes; Tomography, X-Ray Computed; Turkey - epidemiology; Viral diseases; viral pneumonia; Virology; Virus Diseases - diagnosis; Virus Diseases - epidemiology; Viruses; Viruses - classification; Viruses - genetics; Viruses - isolation & purification; Turkey; COVID-19; SARS-CoV-2; non-SARS-CoV-2 viruses; viral pneumonia
• ISSN: 0146-6615; 1096-9071
• DOI: 10.1002/jmv.26410

Following the announcement of the first coronavirus disease 2019 (COVID‐19) case on 11 March 2020 in Turkey, we aimed to report the coinfection rates, and the clinical, laboratory, radiological distinctive features of viral pneumonia caused by viruses other than severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). A cross‐sectional study was conducted between 18 and 31 March 2020. COVID‐19 suspected cases admitted to pandemic policlinic, who had nasopharyngeal swab specimens tested for both SARS‐CoV‐2 and other respiratory viral pathogens, were included. Among 112 patients, SARS‐CoV‐2 was detected in 34 patients (30%). Among the non–SARS‐CoV‐2 viruses (n = 25, 22%), metapneumovirus (n = 10) was the most frequent agent. There were two coinfections with SARS‐CoV‐2. Sputum was less in the SARS‐CoV‐2 group (P = .003). The leukocyte, lymphocyte, and thrombocyte count and C‐reactive protein levels were the lowest in the SARS‐CoV‐2 group (P < .001, P = .04, P < .001, P = .007, respectively). Peripheral involvement (80% vs 20%; P ≤ .001), pure ground‐glass opacity (65% vs 33%; P = .04), apicobasal gradient (60% vs 40%; P = .08), involvement of greater than or equal to three lobes (80% vs 40%; odds ratio: 6.0; 95% confidence interval: 1.33‐27.05; P = .02), and consolidation with accompanying ground‐glass opacity (4% vs 33%; P = .031) were more common in SARS‐CoV‐2 group. Some clinical, laboratory, and radiological findings may help in the differential diagnosis of non–SARS‐CoV‐2 viruses from COVID‐19. However, coinfections may occur, and a non–SARS‐CoV‐2 pathogen positivity does not exclude accompanying COVID‐19.
Highlights
Non SARS‐CoV‐2 viruses have some clinical, laboratory and radiological distinctive parameters from SARS CoV‐2. However, it should always be considered that co‐infections may develop in the clinical course of COVID‐19.