A simplified triage approach for viral pneumonitis: hospitalization versus home management on the context of coronavirus disease pandemic

Background
Viral pneumonitis poses a significant public health challenge, particularly when complicated by acute respiratory distress syndrome, as seen during the coronavirus disease 2019 pandemic. Early identification of patients requiring hospitalization is critical for effective triage and resource allocation.


Objective
This retrospective study aimed to identify clinical, laboratory, and radiological predictors of hospitalization among patients with viral pneumonitis, facilitating differentiation between cases manageable at home and that require inpatient care.


Patients and methods
We analyzed data from 97 patients diagnosed with viral pneumonitis. Of these, 63 were hospitalized at Ahmed Maher Teaching Hospital, and 34 were managed at home. Baseline characteristics, comorbidities, clinical symptoms, laboratory markers, and high-resolution computed tomography findings were evaluated.


Results
The mean age was 56.0 ± 14.3 years (range: 19–90). Diabetes mellitus (52.3%) and hypertension (50.8%) were significantly more prevalent among hospitalized patients, while chronic obstructive pulmonary disease was more common in home-managed cases (17.6%). The presence of diabetes mellitus, hypertension, or both was independent predictors of hospitalization. Clinical symptoms such as vomiting, chest pain, taste loss, and anosmia were significantly associated with inpatient care, with chest pain emerging as an independent predictor. High-resolution computed tomography abnormalities were more frequent and severe in hospitalized patients (97.9 vs. 88.3%). Laboratory markers including oxygen saturation, total leukocyte count, neutrophil/lymphocyte ratio, serum ferritin, and C-reactive protein were significant independent predictors of hospitalization.