Differentiating patients with COVID-19 from those with bacterial pneumonia is important for patient placement, testing, and treatment. Kettering Health Network has an algorithm (click here to view) to assist with this decision, and we ask that ED and admitting providers use this and/or seek assistance from Infectious Diseases or Pulmonary specialists.
The following criteria (adapted from Nebraska Medicine) can also be used to make this differentiation. Patients presenting with findings of bacterial pneumonia do not need testing for COVID-19 nor admission to the COVID-19 designated units.
| COVID-19 | Bacterial Pneumonia | |
| Symptoms | Fever, cough, SOB, viral prodrome (myalgia/HA/vomiting/diarrhea) | Fever, cough, SOB, purulent sputum |
| Lab Abnormalities | Normal WBC often with lymphopenia, mild transaminitis | Leukocytosis with bandemia |
| Procalcitonin | Usually low | Elevated |
| Imaging | Multifocal ground glass opacities, usually bilateral, no effusion | Lobar infiltrate with or without effusion |
| Isolation | Droplet with contact, Airborne if intubated or undergoing aerosol-generating procedures | As appropriate for organism |