Risk Factors for Pneumocystis jirovecii Pneumonia in Non-HIV Patients Hospitalized for COVID-19 : A Case-Control Study
BACKGROUND: Very few cases of Pneumocystis jirovecii pneumonia (PJP) have been reported in COVID-19 so far, and mostly in patients with concomitant HIV infection or in solid-organ transplant recipients. Despite COVID-19 being associated with lymphopenia and the use of steroids, there are no studies specifically aimed at investigating the risk factors for PJP in COVID-19.
METHODS: A retrospective case-control study was performed. We matched PJP cases with controls with a 1:2 ratio, based on age ± 10 years, solid-organ transplantation (SOT), hematological malignancies, and in the setting of PJP development (ICU vs. non-ICU). A direct immunofluorescence assay on bronchoalveolar lavage fluid was used to diagnose PJP.
RESULTS: We enrolled 54 patients. Among 18 cases of PJP, 16 were diagnosed as "proven". Seven of the eighteen cases were immunocompromised, while the other patients had no previous immunological impairment. Patients with PJP had significantly lower median lymphocyte values (p = 0.033), longer COVID-19 duration (p = 0.014), a higher dose of steroid received (p = 0.026), higher CRP values (p = 0.005), and a lower SARS-CoV-2 vaccination rate than the controls (p = 0.029). Cumulative steroid dose is the independent risk factor for PJP development (OR = 1.004, 95%CI = 1-1.008, p = 0.042).
CONCLUSIONS: PJP develops in COVID-19 patients regardless of immunosuppressive conditions and the severity of disease, and it is correlated to the corticosteroid dose received.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:9 |
|---|---|
| Enthalten in: |
Journal of fungi (Basel, Switzerland) - 9(2023), 8 vom: 11. Aug. |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Viceconte, Giulio [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
COVID-19 |
|---|
| Anmerkungen: |
Date Revised 29.08.2023 published: Electronic Citation Status PubMed-not-MEDLINE |
|---|
| doi: |
10.3390/jof9080838 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM361218575 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM361218575 | ||
| 003 | DE-627 | ||
| 005 | 20231226084657.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.3390/jof9080838 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1204.xml |
| 035 | |a (DE-627)NLM361218575 | ||
| 035 | |a (NLM)37623609 | ||
| 035 | |a (PII)838 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Viceconte, Giulio |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Risk Factors for Pneumocystis jirovecii Pneumonia in Non-HIV Patients Hospitalized for COVID-19 |b A Case-Control Study |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 29.08.2023 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a BACKGROUND: Very few cases of Pneumocystis jirovecii pneumonia (PJP) have been reported in COVID-19 so far, and mostly in patients with concomitant HIV infection or in solid-organ transplant recipients. Despite COVID-19 being associated with lymphopenia and the use of steroids, there are no studies specifically aimed at investigating the risk factors for PJP in COVID-19 | ||
| 520 | |a METHODS: A retrospective case-control study was performed. We matched PJP cases with controls with a 1:2 ratio, based on age ± 10 years, solid-organ transplantation (SOT), hematological malignancies, and in the setting of PJP development (ICU vs. non-ICU). A direct immunofluorescence assay on bronchoalveolar lavage fluid was used to diagnose PJP | ||
| 520 | |a RESULTS: We enrolled 54 patients. Among 18 cases of PJP, 16 were diagnosed as "proven". Seven of the eighteen cases were immunocompromised, while the other patients had no previous immunological impairment. Patients with PJP had significantly lower median lymphocyte values (p = 0.033), longer COVID-19 duration (p = 0.014), a higher dose of steroid received (p = 0.026), higher CRP values (p = 0.005), and a lower SARS-CoV-2 vaccination rate than the controls (p = 0.029). Cumulative steroid dose is the independent risk factor for PJP development (OR = 1.004, 95%CI = 1-1.008, p = 0.042) | ||
| 520 | |a CONCLUSIONS: PJP develops in COVID-19 patients regardless of immunosuppressive conditions and the severity of disease, and it is correlated to the corticosteroid dose received | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a Pneumocystis jirovecii | |
| 650 | 4 | |a SARS-CoV-2 | |
| 650 | 4 | |a immunocompromised | |
| 650 | 4 | |a pneumonia | |
| 700 | 1 | |a Buonomo, Antonio Riccardo |e verfasserin |4 aut | |
| 700 | 1 | |a D'Agostino, Alessia |e verfasserin |4 aut | |
| 700 | 1 | |a Foggia, Maria |e verfasserin |4 aut | |
| 700 | 1 | |a Di Fusco, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Pinchera, Biagio |e verfasserin |4 aut | |
| 700 | 1 | |a Scotto, Riccardo |e verfasserin |4 aut | |
| 700 | 1 | |a Iacovazzo, Carmine |e verfasserin |4 aut | |
| 700 | 1 | |a Fanasca, Luca |e verfasserin |4 aut | |
| 700 | 1 | |a Messina, Gaetana |e verfasserin |4 aut | |
| 700 | 1 | |a Cacciatore, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Salvatore, Paola |e verfasserin |4 aut | |
| 700 | 1 | |a Gentile, Ivan |e verfasserin |4 aut | |
| 700 | 1 | |a On Behalf Of The Federico Ii Covid Team |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Journal of fungi (Basel, Switzerland) |d 2014 |g 9(2023), 8 vom: 11. Aug. |w (DE-627)NLM25748468X |x 2309-608X |7 nnns |
| 773 | 1 | 8 | |g volume:9 |g year:2023 |g number:8 |g day:11 |g month:08 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.3390/jof9080838 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 9 |j 2023 |e 8 |b 11 |c 08 | ||