Identifying Community-Acquired Pneumonia During the COVID-19 Pandemic

ABSTRACT

* Pneumonia is an infection of the alveoli characterized by fever, cough, and pulmonary infiltrate. * Prior to COVID-19, the most common pathogens found in adults hospitalized with pneumonia were rhinovirus, influenza, and Streptococcus pneumoniae. * The identification of a pathogen is increased in severe cases of pneumonia and when multiple detection techniques are used. * Blood cultures are not recommended for routine cases of pneumonia. * SARS-CoV-2 and influenza testing is recommended when either is prevalent in the community. * Healthy patients with suspected bacterial community-acquired pneumonia and who are otherwise suitable for discharge can be treated with a course of oral antibiotics for five to seven days. * Patients with comorbidities who are appropriate for discharge should be treated with either an amoxicillin/clavulanic acid or a cephalosporin in addition to treatment with a macrolide or doxycycline for seven days. * The concept of healthcare-associated pneumonia is not useful to identify patients at increased risk for infection from drug-resistant organisms. * Scoring tools can be used to support clinical judgment in determining patients with a low mortality risk who may be appropriate for outpatient treatment. * The effectiveness of monoclonal antibodies and antivirals is subject to change because of the potential development of resistance to newer variants.