Mari C de la Torre1, Elisabet Palomera2, Mateu Serra-Prat3, Estel Güell4, Joan Carles Yébenes5, Jesús F Bermejo-Martín6, Jordi Almirall7. 1. Unidad Medicina Intensiva, Hospital de Mataró, Barcelona, Spain. Electronic address: mctorre@csdm.cat. 2. Unidad de Investigación, Hospital de Mataró, Barcelona, Spain. Electronic address: epalomera@csdm.cat. 3. Unidad de Investigación, Hospital de Mataró, Barcelona, Spain. Electronic address: mserra@csdm.cat. 4. Unidad Medicina Intensiva, Hospital de Mataró, Barcelona, Spain. Electronic address: eguell@csdm.cat. 5. Unidad Medicina Intensiva, Hospital de Mataró, Barcelona, Spain. Electronic address: jyebenes@csdm.cat. 6. Unidad de Investigación Médica en Infección e Inmunidad (IMI), Hospital Clínico Universitario de Valladolid SACYL/IECSCYL, Barcelona, Spain. Electronic address: jfbermejo@saludcastillayleon.es. 7. Unidad Medicina Intensiva, Hospital de Mataró, Barcelona, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain; Ciber Enfermedades Respiratorias (CIBERES), Barcelona, Spain. Electronic address: jalmirall@csdm.cat.
Abstract
BACKGROUND: Mortality in patients with community-acquired pneumonia (CAP) remains high despite improvements in treatment. OBJECTIVE: To determine immunoglobulin levels in patients with CAP and impact on disease severity and mortality. METHODOLOGY: Observational study. Hospitalized patients with CAP were followed up for 30 days. Levels of immunoglobulin G (IgG) and subclasses, immunoglobulin A (IgA) and immunoglobulin M (IgM) were measured in serum within 24 hours of CAP diagnosis. RESULTS: Three hundred sixty-two patients with CAP were enrolled -172 ward-treated and 190 intensive care unit-treated. Intensive care unit-treated patients had significantly lower values of IgG1, IgG2, IgG3 subclasses, and IgA than ward-treated patients. Thirty-eight patients died before 30 days. Levels of IgG2 were significantly lower in non-survivors than survivors (P=.004) and IgG2 <301 mg/dL was associated with poorer survival according to both the bivariate (hazard ratio 4.47; P<.001) and multivariate (HR 3.48; P=.003) analyses. CONCLUSIONS: Patients with CAP with IgG2 levels <301 mg/dL had a poorer prognosis and a higher risk of death. Our study suggests the usefulness of IgG2 to predict CAP evolution and to provide support measures or additional treatment.
BACKGROUND: Mortality in patients with community-acquired pneumonia (CAP) remains high despite improvements in treatment. OBJECTIVE: To determine immunoglobulin levels in patients with CAP and impact on disease severity and mortality. METHODOLOGY: Observational study. Hospitalized patients with CAP were followed up for 30 days. Levels of immunoglobulin G (IgG) and subclasses, immunoglobulin A (IgA) and immunoglobulin M (IgM) were measured in serum within 24 hours of CAP diagnosis. RESULTS: Three hundred sixty-two patients with CAP were enrolled -172 ward-treated and 190 intensive care unit-treated. Intensive care unit-treated patients had significantly lower values of IgG1, IgG2, IgG3 subclasses, and IgA than ward-treated patients. Thirty-eight patients died before 30 days. Levels of IgG2 were significantly lower in non-survivors than survivors (P=.004) and IgG2 <301 mg/dL was associated with poorer survival according to both the bivariate (hazard ratio 4.47; P<.001) and multivariate (HR 3.48; P=.003) analyses. CONCLUSIONS:Patients with CAP with IgG2 levels <301 mg/dL had a poorer prognosis and a higher risk of death. Our study suggests the usefulness of IgG2 to predict CAP evolution and to provide support measures or additional treatment.
Authors: Mari C de la Torre; Pere Torán; Mateu Serra-Prat; Elisabet Palomera; Estel Güell; Ester Vendrell; Joan Carles Yébenes; Antoni Torres; Jordi Almirall Journal: BMJ Open Respir Res Date: 2016-11-28
Authors: Aya Shnawa; Samuel Lee; Angelos Papatheodorou; Katie Gibbs; Adam Stein; Debra Morrison; Ona Bloom Journal: J Spinal Cord Med Date: 2021-01-14 Impact factor: 2.040