Signs and symptoms of community-acquired pneumonia

Added June 2, 2020

Citation: Marchello CS, Ebell MH, Dale AP, et al. Signs and symptoms that rule out community-acquired pneumonia in outpatient adults: a systematic review and meta-analysis. The Journal of the American Board of Family Medicine. 2019 Mar 1;32(2):234-47.

What is this? Some patients with COVID-19 will develop pneumonia, which can become a serious and life-threatening illness. Existing research on the signs and symptoms of community-acquired pneumonia may provide useful information for health professionals and policy makers.

In this systematic review, the authors searched for prospective studies that reported clinical decision rules for diagnosing, predicting, or ruling out community-acquired pneumonia (CAP) in the outpatient setting. They restricted their searches to prospective studies that recruited adults or adolescents in an outpatient setting and reported chest radiography and computed tomography findings. They did not restrict their searches by date, or language of publication and did the search in January 2017. They included 12 prospective studies conducted in the US (5), Norway (1), The Netherlands (1), Denmark (1), Chile (1), Switzerland (1), 12 European countries (1), and Iran (1). 6 of the included studies were conducted in an emergency department setting and 6 conducted in a primary care setting.

What works: The presence of normal vital signs (temperature, respiratory rate, and heart rate) and normal pulmonary examination greatly reduces the likelihood of CAP in adults with acute cough illness.

Clinicians can use this simple heuristic to confidently identify patients with acute cough who do not require chest radiography, in the absence of other factors such as signs of malignancy or prolonged symptoms.

What doesn’t work: Nothing reported.

What’s uncertain: Nothing noted.


Disclaimer: This summary has been written by staff and volunteers of Evidence Aid in order to make the content of the original document accessible to decision makers who are searching for the available evidence on the coronavirus (COVID-19) but may not have the time, initially, to read the original report in full. This summary is not intended as a substitute for the medical advice of physicians, other health workers, professional associations, guideline developers, or national governments and international agencies. If readers of this summary think that the evidence that is presented within it is relevant to their decision-making they should refer to the content and details of the original article, and the advice and guidelines offered by other sources of expertise, before making decisions. Evidence Aid cannot be held responsible for any decisions made about the coronavirus (COVID-19) on the basis of this summary alone.