The role of pneumococcal urinary antigen in CoViD-19 pneumonia: if you know it, you don't avoid it

ABSTRACT

Background: CoViD-19 pneumonia has a bacterial co-infection rate about 3-5% at the admission to hospital care. The aim of our study is to assess the utility of pneumococcal urinary antigen (Ag) test in the diagnosis of bacterial pulmonary co-infection in CoViD- 19 pneumonia and its support in the decision about antibiotic therapy. Materials and Methods: We searched in NIH and PubMed for a revision of literature about the characteristics of pneumococcal urinary Ag test and the respiratory co-infection rate in CoViD-19 pneumonia. We analyzed1268 cases of pneumonia admitted at the hospital 703 CoViD-19 pneumonia and 565 community-acquired pneumonia. We compared positivity test rate in these two groups, the presence of clinical features suggestive for bacterial co-infection and antibiotic treatment rates. Results: There was no statistical significative difference rate of positive test between the two groups (p-value=0,6) 703 CoViD- 19 pneumonia,10,8% (N=76) positive and 89,2% (n=627) negative;565 community-acquired pneumonia, 9,9% (n=56) positive and 90,1% (509) negative. Positive test wasn't always correlated with sign/symptoms of bacterial co-infection;the rate of antibiotic treatment was higher in community-acquired pneumonia group than in CoViD-19 pneumonia one. Conclusions: In conclusion, we support the use of pneumococcal Ag test in CoViD-19 pneumonia patients with sign/symptoms suggestive for bacterial co-infection. A positive test in this subgroup of patients must be considered as diagnostic for pneumococcal pneumonia and antibiotic treatment must be started.