Differential Diagnosis

Version 1: 03-26-2020


1.  Other etiologies of a pulmonary infection

  • Viral

    • Influenza, Human metapneumovirus (HmPV), Parainfluenza, Adenovirus, Respiratory syncytial virus (RSV), Rhinovirus (common cold)

  • Bacterial

  • Fungal


2. Non-infectious respiratory disorders: 
 (e.g., vasculitis, dermatomyositis) [1]

3. Heart Failure 

4. Cancer

Murthy et al. in their recent article note: “Given the presence of a number of circulating respiratory viruses, differentiating COVID-19 from other pathogens, particularly influenza, is important and chiefly done using upper (nasopharyngeal) or lower (induced sputum, endotracheal aspirates, bronchoalveolar lavage) respiratory tract samples for reverse transcriptase–polymerase chain reaction and bacterial cultures. There are suggestive but nonspecific radiographic changes, such as ground-glass opacities on computed tomography. Rapid access to diagnostic testing results is a public health and clinical priority, allowing for efficient patient triage and implementation of infection control practices.” [2]

References

  1. Cascella M, Rajnik M, Cuomo A, et al. Features, Evaluation and Treatment Coronavirus (COVID-19) [Updated 2020 Mar 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www-ncbi-nlm-nih-gov.myaccess.library.utoronto.ca/books/NBK554776/

  2. Murthy, S., Gomersall, C. D. & Fowler, R. A. Care for Critically Ill Patients With COVID-19. JAMA (2020) doi:10.1001/jama.2020.3633.

 
More resources:


https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html
https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance
Wang  D, Hu B, Hu  C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China.  JAMA. Published online February 7, 2020. doi:10.1001/jama.2020.1585

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