Pneumonia最新文献

{"title":"Back to the future: the novel art of digital auscultation applied in a prospective observational study of critically ill Covid-19 patients.","authors":"Evangelos Kaimakamis, Serafeim Kotoulas, Myrto Tzimou, Christos Karachristos, Chrysavgi Giannaki, Vassileios Kilintzis, Leandros Stefanopoulos, Evangelos Chatzis, Nikolaos Beredimas, Bruno Rocha, Diogo Pessoa, Rui Pedro Paiva, Nicos Maglaveras, Militsa Bitzani","doi":"10.1186/s41479-024-00131-1","DOIUrl":"10.1186/s41479-024-00131-1","url":null,"abstract":"<p><strong>Background: </strong>The Covid-19 pandemic has caused immense pressure on Intensive Care Units (ICU). In patients with severe ARDS due to Covid-19, respiratory mechanics are important for determining the severity of lung damage. Lung auscultation could not be used during the pandemic despite its merit. The main objective of this study was to investigate associations between lung auscultatory sound features and lung mechanical properties, length of stay (LOS) and survival, in adults with severe Covid-19 ARDS.</p><p><strong>Methods: </strong>Consecutive patients admitted to a large ICU between 2020 and 2021 (n = 173) were included. Digital stethoscopes obtained auscultatory sounds and stored them in an on-line database for replay and further processing using advanced AI techniques. Correlation and regression analysis explored relationships between digital auscultation findings and lung mechanics or the ICU outcome. The resulting annotated lung sounds database is also publicly available as supplementary material.</p><p><strong>Results: </strong>The presence of squawks was associated with the ICU LOS, outcome and 90-day mortality. Other features (age, SOFA score & oxygenation index upon admission, minimum crackle entropy) had significant impact on outcome. Additional features affecting the 90-d survival were age and mean crackle entropy. Multivariate logistic regression showed that survival was affected by age, baseline SOFA, baseline oxygenation index and minimum crackle entropy.</p><p><strong>Conclusions: </strong>Respiratory mechanics were associated with various adventitious sounds, whereas the lung sound analytics and the presence of certain adventitious sounds correlated with the ICU outcome and the 90-d survival. Spectral features of crackles sounds can serve as prognostic factors for survival, highlighting the importance of digital auscultation.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"16 1","pages":"9"},"PeriodicalIF":6.8,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11151547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Invasive pulmonary aspergillosis among patients with severe community-acquired pneumonia and influenza in ICUs: a retrospective cohort study.","authors":"Wei-Chun Lee, Che-Chia Chang, Meng-Chin Ho, Chieh-Mo Lin, Shaw-Woei Leu, Chin-Kuo Lin, Yu-Hung Fang, Shu-Yi Huang, Yu-Ching Lin, Min-Chun Chuang, Tsung-Ming Yang, Ming-Szu Hung, Yen-Li Chou, Ying-Huang Tsai, Meng-Jer Hsieh","doi":"10.1186/s41479-024-00129-9","DOIUrl":"10.1186/s41479-024-00129-9","url":null,"abstract":"<p><strong>Rationale: </strong>The prevalence, clinical characteristics, and outcomes of invasive pulmonary aspergillosis in patients with severe community-acquired pneumonia (CAP) in intensive care units remain underestimated because of the lack of a disease-recognition scheme and the inadequacy of diagnostic tests.</p><p><strong>Objectives: </strong>To identify the prevalence, risk factors, and outcomes of severe CAP complicated with invasive pulmonary aspergillosis (IPA) in intensive care units (ICUs).</p><p><strong>Methods: </strong>We conducted a retrospective cohort study including recruited 311 ICU-hospitalized patients with severe CAP without influenza or with influenza. Bronchoalveolar lavage fluid (BALF) samples were from all patients and subjected to mycological testing. Patients were categorized as having proven or probable Aspergillus infection using a modified form of the AspICU algorithm comprising clinical, radiological, and mycological criteria.</p><p><strong>Measurements and main results: </strong>Of the 252 patients with severe CAP and 59 influenza patients evaluated, 24 met the diagnostic criteria for proven or probable Aspergillus infection in the CAP group and 9 patients in the influenza group, giving estimated prevalence values of 9.5% and 15.3%, respectively. COPD and the use of inhaled corticosteroids were independent risk factors for IPA. IPA in patients with severe CAP was significantly associated with the duration of mechanical support, the length of ICU stay, and the 28-day mortality.</p><p><strong>Conclusions: </strong>An aggressive diagnostic approach for IPA patients with severe CAP and not only influenza or COVID-19 should be pursued. Further randomized controlled trials need to evaluate the timing, safety, and efficacy of antifungal therapy in reducing IPA incidence and improving clinical outcomes.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"16 1","pages":"10"},"PeriodicalIF":6.8,"publicationDate":"2024-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11127357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141094531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of the recording of pneumonia events in English electronic healthcare record data in patients with chronic obstructive pulmonary disease.","authors":"Alexander J Adamson, Constantinos Kallis, Ian Douglas, Jennifer K Quint","doi":"10.1186/s41479-024-00130-2","DOIUrl":"https://doi.org/10.1186/s41479-024-00130-2","url":null,"abstract":"<p><strong>Background: </strong>In primary care, identifying pneumonia events in people with chronic obstructive pulmonary disease (COPD) may be challenging due to similarities in symptoms with COPD exacerbations and lack of diagnostic testing. This study explored the accuracy of pneumonia diagnosis coded in primary care by comparing diagnosis in primary care with diagnosis in hospital.</p><p><strong>Methods: </strong>A study population of people with COPD in England was created using the Clinical Practice Research Datalink Aurum database linked with Hospital Episode Statistics inpatient data. Pneumonia codes only, and pneumonia code with associated clinical and/or treatment codes (chest x-ray, symptoms, antibiotics, sputum and blood culture) were used to determine pneumonia events in primary care. Events that were followed by hospitalisation within 7 days were used to estimate the positive predictive value (PPV) of pneumonia coding in primary care, using primary diagnosis of pneumonia in secondary care as the gold standard. The PPV of primary care recording of hospitalised pneumonia was also calculated.</p><p><strong>Results: </strong>Two hundred seventy-four thousand one hundred fifty-six COPD patients were eligible for inclusion, of whom 7,560 had an eligible pneumonia event in primary care diagnosed between 2015-2019 which was not 'hospital-acquired' and was diagnosed and entered on the same day. Of the 2,094 events which were followed by hospitalisation within 7 days, 1,208 had a primary diagnosis of pneumonia in hospital, representing a PPV of pneumonia coding in primary care of 57.7% (95% CI 55.6%-59.8%). Another 284 (13.6%) were diagnosed as a COPD exacerbation and 114 (5.4%) were diagnosed as another respiratory disease. Use of additional pneumonia clinical and treatment codes had a modest effect on the PPV but substantially lowered the number of events. Of the 33,603 eligible pneumonia events identified in secondary care, only 11,445 were recorded in primary care within 42 days, representing a sensitivity of 34.1% (95% CI 33.6%-34.6%).</p><p><strong>Conclusions: </strong>Use of primary care pneumonia codes and associated clinical and treatment codes to determine pneumonia is not recommended due to significant levels of misdiagnosis and many hospitalised events failing to be recorded in primary care.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"16 1","pages":"8"},"PeriodicalIF":6.8,"publicationDate":"2024-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11070075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-dependent vulnerability for Wistar rats model following intranasal instillation with Klebsiella pneumoniae ATCC 43816 causing lobar pneumonia.","authors":"Patrick Hervé Diboue Betote, Esther Del Florence Ndedi Moni, Sonia Raïssa Gayap Matchuenkam, Sandrine Suzanne Bayengue Beack, Rodrigue Fifen, Raogo Ouedraogo, Gabriel A Agbor, Rasmané Semde, Nga Nnanga, Maximilienne Ascension Nyegue","doi":"10.1186/s41479-024-00126-y","DOIUrl":"10.1186/s41479-024-00126-y","url":null,"abstract":"<p><strong>Background: </strong>Klebsiella pneumoniae has become one of the major threats to public health as it causes nosocomial and community-acquired infections like lobar pneumonia. This infection causes acute inflammation in the lung, characterized by the recruitment of polymorphonuclear cells, generating free radicals, and decreasing the endogenous antioxidant balance system. Many experimental studies have focused on the induction, progression and resolution of infection up to its peak, but these documented processes remain highly random and their sex dependence un-elicited. These fluctuations of physiopathological parameters would impact disease progression depending on the animal's model and bacterial strain used. The present study investigated the sex-dependent vulnerability of Wistar rats to K. pneumoniae ATCC 43816 lobar pneumonia induced by the intranasal instillation method.</p><p><strong>Methods: </strong>Experimental pneumonia was induced by K. pneumoniae ATCC 43816 in male and female Wistar rats following intranasal instillation. The physiopathogenesis of the disease was studied by bacteriological and histopathological exams, histomorphometric analysis of the blood and/or lung tissue, and body weight loss in infected animals. In addition, the overall severity of lesions was determined by the total score obtained by averaging the individual scores from the same group of animals.</p><p><strong>Results: </strong>The K. pneumoniae ATCC 43816 strain showed inoculation dose-, incubation time of the disease- and sex-dependent- differences in its ability to induce lobar pneumonia. Evaluation of different parameters showed that the disease peaked on day 15 post-inoculation, with more pathogenic effects on female rats. This observed sex-dependence difference in Wistar rats was mainly highlighted by the determined lethal dose 50 (LD₅₀), bacterial load count in whole blood and lung tissues, body weight loss, inflammatory granulomas forming and diffuse alveolar damages. The pathogenicity was confirmed by scoring the severity of pathologic lesions of lung tissues.</p><p><strong>Conclusions: </strong>The results obtained highlighted the gender-dependency in the physiopathogenesis processes of K. pneumoniae ATCC 43816 induced-lobar pneumonia, in Wistar rats. Female Wistar rats' susceptibility is useful in studying pathology and in preclinical trial investigations of new treatments for infectious pneumonia.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"16 1","pages":"5"},"PeriodicalIF":6.8,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10962189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140207803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combination of a multiplex pneumonia panel and Gram staining for antimicrobial selection to treat lower respiratory tract infection.","authors":"Hiroshi Matsuura, Koudai Arimoto, Yoshihito Takahashi, Masafumi Kishimoto","doi":"10.1186/s41479-024-00125-z","DOIUrl":"10.1186/s41479-024-00125-z","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to examine the utility of simultaneously performed the Film Array pneumonia panels (pneumonia panels) and Gram staining with the same specimens and evaluate their effect on antimicrobial selection.</p><p><strong>Methods: </strong>This prospective study, conducted from April 2022 to January 2023, enrolled adult patients with pneumonia, including those with ventilator-associated pneumonia (VAP). Specimens obtained at the time of sputum culture were tested using Gram staining and the pneumonia panel. The patients' characteristics and pneumonia panel results were assessed. We also evaluated the selection of antimicrobial agents for drug-resistant bacteria detected by the pneumonia panel.</p><p><strong>Results: </strong>This study comprised 39 patients: 25 patients (64.1%) underwent intubation, including 7 (17.9%) patients with VAP. Most tests were performed at the time of admission, while some were performed during hospitalization. Good quality sputum was obtained from intubated patients. The pneumonia panel detected drug-resistant bacteria in 12 cases. Six patients required antimicrobial escalation, while the antimicrobial regimen remained unchanged for 2 patients in whom Pseudomonas aeruginosa was detected and had already received meropenem. The attending physician did not change the antimicrobials, considering the results of Gram staining and the patient's general condition in 4 patients.</p><p><strong>Conclusions: </strong>The pneumonia panel might be useful for detecting drug-resistant organisms at an early stage. It may be important to take the Gram staining results and the patient's condition into account with pneumonia panel for appropriate antibiotic prescription.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"16 1","pages":"4"},"PeriodicalIF":6.8,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10913398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140029143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of favipiravir in COVID-19 patients with pneumonia. A randomized, double-blind, placebo-controlled study (FAVID).","authors":"Juan P Horcajada, Rebeca Aldonza, Mónica Real, Silvia Castañeda-Espinosa, Elena Sendra, Joan Gomez-Junyent, Inmaculada López-Montesinos, Silvia Gómez-Zorrilla, Silvia Briansó, Montserrat Duran-Taberna, Andrés Fernández, Cristina Tarragó, Teresa Auguet-Quintillá","doi":"10.1186/s41479-023-00124-6","DOIUrl":"10.1186/s41479-023-00124-6","url":null,"abstract":"<p><strong>Purpose: </strong>To design a randomized clinical trial to assess the efficacy and safety of favipiravir in patients with COVID-19 disease with pneumonia.</p><p><strong>Methods: </strong>A randomized, double blind, placebo-controlled clinical trial of favipiravir in patients with COVID-19 pneumonia was conducted in three Spanish sites. Randomization 1:1 to favipiravir or placebo (in both groups added to the Standard of Care) was performed to treat the patients with COVID-19 pneumonia. The primary endpoint was \"time to clinical improvement,\" measured as an improvement for ≥ two categories on a 7-point WHO ordinal scale in an up to 28 days' time frame.</p><p><strong>Results: </strong>Forty-four patients were randomized (23 in the favipiravir group and 21 in the placebo group). The median time to clinical improvement was not different between the favipiravir and the placebo arms (10 days for both groups) and none of the secondary endpoints showed significant differences between arms. The proportion of adverse events (both serious and non-serious) was statistically different between the favipiravir group (68.29%) and the placebo group (31.7%) (p = 0.019), but there was insufficient statistical evidence to correlate the degree of severity of the events with the treatment group.</p><p><strong>Conclusions: </strong>Favipiravir administered for ten days to patients with COVID-19 and pneumonia did not improve outcomes compared with placebo. Although this is an underpowered negative study, efficacy results align with other randomized trials. However, in the present study, the non-serious adverse events were more frequent in the favipiravir group.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"16 1","pages":"3"},"PeriodicalIF":6.8,"publicationDate":"2024-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10894471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139944536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effectiveness of glucocorticoid treatment in post-COVID-19 pulmonary involvement.","authors":"Jan Mizera, Samuel Genzor, Milan Sova, Ladislav Stanke, Radim Burget, Petr Jakubec, Martin Vykopal, Pavol Pobeha, Jana Zapletalová","doi":"10.1186/s41479-023-00123-7","DOIUrl":"10.1186/s41479-023-00123-7","url":null,"abstract":"<p><strong>Rationale: </strong>Persistent respiratory symptoms following Coronavirus Disease 2019 (COVID-19) are associated with residual radiological changes in lung parenchyma, with a risk of development into lung fibrosis, and with impaired pulmonary function. Previous studies hinted at the possible efficacy of corticosteroids (CS) in facilitating the resolution of post-COVID residual changes in the lungs, but the available data is limited.</p><p><strong>Aim: </strong>To evaluate the effects of CS treatment in post-COVID respiratory syndrome patients.</p><p><strong>Patients and methods: </strong>Post-COVID patients were recruited into a prospective single-center observational study and scheduled for an initial (V1) and follow-up visit (V2) at the Department of Respiratory Medicine and Tuberculosis, University Hospital Olomouc, comprising of pulmonary function testing, chest x-ray, and complex clinical examination. The decision to administer CS or maintain watchful waiting (WW) was in line with Czech national guidelines.</p><p><strong>Results: </strong>The study involved 2729 COVID-19 survivors (45.7% male; mean age: 54.6). From 2026 patients with complete V1 data, 131 patients were indicated for CS therapy. These patients showed significantly worse radiological and functional impairment at V1. Mean initial dose was 27.6 mg (SD ± 10,64), and the mean duration of CS therapy was 13.3 weeks (SD ± 10,06). Following therapy, significantly better improvement of static lung volumes and transfer factor for carbon monoxide (DLCO), and significantly better rates of good or complete radiological and subjective improvement were observed in the CS group compared to controls with available follow-up data (n = 894).</p><p><strong>Conclusion: </strong>Better improvement of pulmonary function, radiological findings and subjective symptoms were observed in patients CS compared to watchful waiting. Our findings suggest that glucocorticoid therapy could benefit selected patients with persistent dyspnea, significant radiological changes, and decreased DLCO.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"16 1","pages":"2"},"PeriodicalIF":6.8,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10840187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139681729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum soluble toll-like receptor 4 and risk for clinical severity in COVID-19 patients.","authors":"Maha E Houssen, Marwa O Elmaria, Dina Badr, Rasha El-Mahdy, Mayada A Ghannam, Shaimaa El-Ashwah, May Denewer, Metwaly Ibrahim Mortada","doi":"10.1186/s41479-023-00121-9","DOIUrl":"10.1186/s41479-023-00121-9","url":null,"abstract":"<p><p>Toll-like receptor 4 (TLR4) signaling mediates sustained systemic inflammation in(COVID)-19 patients. We aimed to assess the serum levels of sTLR4 and sCD14 as negative regulators of Toll like receptor signaling and their association with laboratory markers and clinical severity in covid 19 patients. Ninety-eight patients with COVID-19 (70 severe and 28 non-severe) were enrolled in the study. Serum sCD14 andsTLR4were determined by ELISA. A significant increase in serum sTLR4 and sCD14 levels was detected in severe compared to non severe COVID19 patients.Receiver operating characteristic curve (ROC) analysis revealed significant diagnostic potential of serum sTLR4 and sCD14 in covid19 patients.We conclude that Serum sTLR4 and sCD14 may be promising clinical severity markers for COVID19 patients.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"16 1","pages":"1"},"PeriodicalIF":6.8,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10768148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139098919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Host genetic variants associated with susceptibility and severity of pneumococcal pneumonia in adult patients.","authors":"Lucía Boix-Palop, María J Arranz, Anna Sangil, Beatriz Dietl, Mariona Xercavins, Josefa Pérez, Esther Calbo","doi":"10.1186/s41479-023-00120-w","DOIUrl":"10.1186/s41479-023-00120-w","url":null,"abstract":"<p><strong>Background: </strong>Pneumococcal community-acquired pneumonia (P-CAP) is a major cause of morbidity and hospitalization. Several host genetics factors influencing risk of pneumococcal disease have been identified, with less information about its association with P-CAP. The aim of the study was to assess the influence of single nucleotide polymorphisms (SNP) within key genes involved in the innate immune response on the susceptibility to P-CAP and to study whether these polymorphic variants were associated with the severity and outcome of the episodes in a cohort of adult Caucasian patients.</p><p><strong>Methods: </strong>Seventeen SNPs from 7 genes (IL-R1, IL-4, IL-10, IL-12B, NFKBIA, NFKBIE, NFKBIZ) were analyzed. For susceptibility, a case-control study including a cohort of 57 adult with P-CAP, and 280 ethnically matched controls was performed. Genetic influence on clinical severity and outcome was evaluated in a prospective observational study including all consecutive adult P-CAP patients from November 2015 to May 2017.</p><p><strong>Results: </strong>The NFKBIA polymorphism rs696 and a haplotype combination were associated with susceptibility to P-CAP (OR = 0.62, p = 0.005 and OR = 0.63, p = 0.008, respectively). The SNP IL4 rs2227284 was associated with severe P-CAP (OR = 2.17, p = 0.04). IL-R1 (rs3917267) and IL-10 (rs3024509) variants were related with respiratory failure (OR = 3.31, p = 0.001 and OR = 0.18, p = 0.003, respectively) as well as several haplotype combinations in NFKBIA, NFKBIZ, IL-R1 and IL-10 (p = 0,02, p = 0,01, p = 0,001, p = 0,03, respectively). CURB-65 values were associated with the IL-10 rs3024509 variant (beta = - 0.4, p = 0.04), and with haplotype combinations of NFKBIZ and IL-10 (p = 0.05, p = 0.04, respectively). Genetic variants in IL-10 (rs3024509) and in IL-12B (rs730691) were associated with PSI values (beta = - 0.54, p = 0.01, and beta = - 0.28, p = 0.04, respectively), as were allelic combinations in IL-R1 (p = 0.02) and IL-10 (p = 0.01). Finally, several polymorphisms in the IL-R1 gene (rs13020778, rs2160227, & rs3917267) were associated with the time elapsed until clinical stability (beta = - 0.83, p = 0.03; beta = - 1, p = 0.02 and beta = 1.07, p = 0.008, respectively).</p><p><strong>Conclusions: </strong>A genetic variant in NFKBIA was associated with susceptibility to P-CAP in adult Caucasian patients and genetic variants from key cytokines of the innate immune response (Il-4, IL-10, IL-R1 and IL-12B) and NF-κB inhibitors were associated with different phenotypes of severe P-CAP. If validated, these SNPs may help to identify people at risk of P-CAP or severe P-CAP on which preventive measures could be applied.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"15 1","pages":"18"},"PeriodicalIF":6.8,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10749500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139032702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time to recovery and its determinant factors among patients with COVID-19 in Assosa COVID-19 treatment center, Western Ethiopia.","authors":"Maru Zewdu Kassie,&nbsp;Molalign Gualu Gobena,&nbsp;Yihenew Mitiku Alemu,&nbsp;Awoke Seyoum Tegegne","doi":"10.1186/s41479-023-00119-3","DOIUrl":"https://doi.org/10.1186/s41479-023-00119-3","url":null,"abstract":"<p><strong>Background: </strong>The Novel Coronavirus disease (COVID-19) pandemic has become a global threat. Determining the time to recovery from COVID-19 is intended to assist healthcare professionals in providing better care, and planning logistics. So, the study aimed to identify the factors that affect the time to recovery from COVID-19 for patients treated at Assosa COVID-19 treatment center, Benishangul Gumuz Regional State, Western Ethiopia.</p><p><strong>Methods: </strong>A retrospective study design was conducted on 334 randomly selected COVID-19 patients at Assosa COVID-19 treatment center from February 2021 to July 2021. The median survival time, Kaplan-Meier survival estimate, and Log-Rank test were used to describe the data and compare the survival time between groups. The study used the Cox PH model to analyze the time to the first recovery of COVID-19 patients, where hazard ratio, p-value, and 95% CI for hazard ratio were used for testing significance. Schoenfeld and Cox-Snell residuals were used for checking the model assumption.</p><p><strong>Results: </strong>The overall incidence rate was 13.79 per 100 (95% CI: 10.04, 18.95) person-days observations. The median time to recovery was 16 days. At the end of the follow-up, 77.2% of the patients had developed an event of recovery, and the rest 22.8% were censored. The mean age of patients was 45.22 years. Severe COVID-19 patients (AHR = 0.7876, 95% CI: 0.7090, 0.8748), presence of symptoms (AHR = 0.2814, 95% CI: 0.1340, 0.5914), comorbidity (AHR = 0.1627, 95% CI: 0.1396, 0.1897), ≥ 90 oxygen saturation (AHR = 3.2370, 95% CI: 2.161, 4.848), and being older age (AHR = 0.9840, 95% CI: 0.971, 0.9973) were found to have statistically significant association with the time to recovery from COVID-19.</p><p><strong>Conclusion: </strong>The study concludes that severe COVID-19 patients, male patients, patients having comorbidity, older age, and patients having symptoms as poor prognostic factors of COVID-19 disease and also prolonged recovery time. Therefore, health providers in treatment centers should give strict follow-up and priority to older patients, severe COVID-19 patients, and patients having another co-morbid illness by focusing on respiratory difficulties and underlying pre-existing medical conditions to manage the disease severity and recover quickly.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"15 1","pages":"17"},"PeriodicalIF":6.8,"publicationDate":"2023-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10625712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71487215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}