Table 2.
Mortality associated with Pneumocystis jirovecii pneumonia.
| Author | Year | Study design | Study period | Country | Level of care | Population description | No. of patients (n, %) | Mortality (type, n/N, %) |
|---|---|---|---|---|---|---|---|---|
| Báez-Saldaña et al. | 2015 | RCS SC | January 2010–December 2011 | Mexico | Tertiary | Adults with HIV-AIDS and infectious respiratory disease | Total: 308 PJP: 142 (46.1%) |
Inpatient ACM in PJP cases n = 17/54 (31.5%) |
| Chen et al. | 2020 | RCSSC | July 2015–December 2017 | Taiwan | Tertiary | Hospitalised patients aged ≥20 years with PJP | 170 | 60-day ACM n = 58/170 (34.1%) |
| Choi et al. | 2018 | RCS SC | January 2013–December 2015 | South Korea | Tertiary | HIV-negative patients with PJP admitted to ICU for respiratory failure | 81 | ACM n = 52/81 (64.2%) |
| Coyle et al. | 2012 | RCS MC | July 2008–July 2011 | Northern Ireland | Multiple | Patients with laboratory confirmed PJP | 53 | ACM n = 16/53 (30.2%) |
| Creemers-Schild et al. | 2016 | RCS SC | January 2003–July 2013 | Netherlands | Tertiary | Adult patients diagnosed with PJP and treated with TMP–SMX | 104 | 30-day ACM n = 14/104 (13.5%) |
| Evernden et al. | 2020 | RCSSC | January 2008–June 2017 | Canada | Tertiary | Adult allogenic HSCT patients receiving anti-thymocyte globulin for GVHD prophylaxis | Total: 649 PJP cases: 21 (32.4%) |
ACM in PJP cases n = 3/21 (14.3%) |
| Gaborit et al. | 2019 | PCSSC | January 2012–January 2017 | France | Tertiary | Patients with confirmed PJP | 107 | 90-day ACM n = 29/107 (27.1%) |
| Garg et al. | 2018 | CCSSC | January 1994–December 2016 | USA | Tertiary | Adult recipients of kidney or kidney-pancreas transplantation | Total: 112 Cases: 28 (25.0%) Controls: 84 (75.0%) |
3-month ACM–PJP cases n = 62.3% 2-year ACM – PJP cases n = 37.9% Raw numbers NS |
| Inoue and Fushimi | 2019 | RCS MC | April 2010–March 2016 | Japan | Tertiary | HIV-negative adults with PJP | 1299 | 60-day ACM in patients (PaO2 > 60 mmHg) n = 58/546 (10.6%) 60-day ACM in patients (PaO2 ≤ 60 mmHg) n = 189/732 (25.8%) |
| Kim et al. | 2014 | RCS MC | January 2004–July 2011 | South Korea | Tertiary | Immunocompromised HIV-negative patients with PJP | 173 | In-hospital ACM n = 62/173 (62%) Mortality attributable to PJP n = 56/173 (32.4%) |
| Kim et al. | 2015 | RCS SC | May 2007–January 2013 | South Korea | Tertiary | Hospitalised patients with laboratory confirmed PJP | 95 | Overall 30-day ACM n = 25/95 (26.3%) 30-day ACM: hospital-onset PJP n = 7/16 (43.8%) 30-day ACM: community-onset PJP n = 18/79 (22.8%) |
| Kim et al. | 2017 | PCS SC | January 2014–December 2015 | South Korea | Tertiary | HIV-negative adults with PJP with or without pulmonary CMV | Total: 76 With CMV: 34 (44.7%) Without CMV: 42 (55.3%) |
Overall 30-day ACM n = 8/76 (10.5%) 30-day ACM (CMV) n = 6/34 (17.7%) 30-day ACM (without CMV) n = 2/42 (47.6%) |
| Lee et al. | 2019 | RCS SC | February 2003–April 2017 | South Korea | Tertiary | Patients with laboratory-confirmed PJP with and without HIV-AIDS | Total: 424 HIV-negative: 362 (85.4%) HIV-AIDS: 62 (14.6%) |
30-day ACM (HIV-negative) n = 118/362 (32.6%) 90-day ACM (HIV-AIDS) n = 11/62 (17.7%) Authors used different definitions of mortality between cohorts |
| Lee et al. | 2021 | RCS SC | May 2004–January 2019 | South Korea | Tertiary | Adults with diffuse large B-cell lymphoma receiving R-CHOP who did or did not receive PJP prophylaxis | Total: 739 PJP prophylaxis: 137 (18.5%) No prophylaxis: 602 (81.5%) |
PJP-related mortality n = 8/49 (16.3%) |
| Lee et al. | 2020 | RCS SC | January 1997–March 2019 | South Korea | Tertiary | Kidney transplant recipients diagnosed with PJP | Total: 52 PJP only: 38 (73.1%) PJP and CMV: 14 (26.9%) |
ACM (PJP only) n = 8/38 (21.0%) ACM (PJP and CMV) n = 3/14 (21.4%) |
| Li et al. | 2020 | RCS MC | January 2013–December 2019 | China | Tertiary | Patients aged ≥16 years with pneumonia treated with glucocorticoids | Total: 716 PJP cases: 134 (18.7%) |
30-day ACM (PJP) n = 45/134 (33.6%) 90-day ACM (PJP) n = 51/134 (38.1%) |
| Li et al. | 2017 | RCS SC | November 2003–June 2014 | China | Tertiary | Patients with inflammatory or autoimmune disease receiving immunosuppressive therapy who had suspected PJP | Total: 123 Confirmed PJP: 52 (42.3%) Possible PJP: 22 (17.8%) Negative PJP: 49 (39.9%) |
28-day mortality n = 26/52 (50%) |
| Liu et al. | 2020 | RCS SC | December 2013–December 2018 | China | Tertiary | Patients with nephrotic syndrome who were diagnosed with PJP. | 57 | Mortality attributable to PJP n = 19/57 (33.3%) |
| Lopez-Sanchez et al. | 2015 | RCS SC | January 2000–December 2013 | Spain | Tertiary | Adult patients with HIV-AIDS diagnosed with PJP | 136 | In-hospital ACM n = 15/136 (11.0%) 5-year ACM in patients available for follow-up n = 20/121 (16.5%) |
| Matsumura et al. | 2014 | PCS SC | January 2008–July 2011 | Japan | Tertiary | Immunocompromised patients with suspected PJP | 190 | Overall 30-day ACM n = 41/190 (21.6%) 30-day ACM (treated for PJP) n = 17/85 (20.0%) 30-day ACM (untreated) n = 24/105 (22.9%) |
| Mundo et al. | 2020 | RCS SC | 1995–2019 | USA | Tertiary | Patients with laboratory confirmed PJP | Total: 71 HIV-negative: 28 (39.4%) HIV-AIDS: 43 (60.6%) |
Overall in-hospital ACM n = 27/71 (38.0%) In-hospital ACM (HIV-AIDS) n = 7/43 (16.3%) In-hospital ACM (HIV-negative) patients n = 20/28 (71.4%) 90-day ACM (HIV-AIDS) n = 3/(7.14%) 90-day ACM (HIV-negative) n = 16/(59.62%) 1-year ACM (HIV-AIDS) n = 3/(7.69%) 1-year ACM (HIV-negative) n = 19/(76.0%) |
| Neofytos et al. | 2018 | RCS MC | 2008–2016 | Switzerland | Multiple | All patients in the national SOT registry of Switzerland | Total: 2842 PJP: 41 |
12-week ACM (PJP cases) n = 2/41 (4.9%) 1-year ACM (PJP cases) n = 6/41 (14.6%) |
| Ohmura et al. | 2019 | RCS MC | January 2004–October 2017 | Japan | Tertiary | Patients with SRD diagnosed with PJP and treated with TMP–-SMX | 81 | 30-day ACM n = 3/81 (3.7%) |
| PERCH Study Group | 2019 | CCS MC | August 2011–January 2014 | Bangladesh, The Gambia, Kenya, Mali, South Africa, Thailand, Zambia | Multiple | Cases: children aged 1–59 months hospitalised with severe pneumonia. Controls: age-group-matched children randomly selected from local. |
Total: 9351 Cases: 4232 (45.3%) Controls: 5119 (54.7%) |
30-day ACM n = 292/4000 (7.3%) PJP specific data NS |
| Rego de Figueiredo et al. | 2019 | RCS SC | 2011–2016 | Portugal | Tertiary | Adult patients diagnosed with PJP | Total: 129 HIV-AIDS: 75 (58.1%) HIV-negative: 54 (41.9%) |
In-hospital ACM (HIV-AIDS) n = 10/75 (13.3%) In-hospital ACM (HIV-negative) n = 20/54 (37.0%) |
| Schmidt et al. | 2018 | RCS SC | January 2000–June 2017 | Germany | Tertiary | Patients with microbiological confirmation of PJP | 240 | In-hospital ACM n = 61/240 (25.4%) |
| Schoffelen et al. | 2013 | RCS MC | June 1996–January 2011 | The Netherlands | Multiple | Patients in a national HIV-AIDS registry who developed PJP | PJP: 1055 | ACM during follow-up n = 125/1055 (11.9%) |
| Shi et al. | 2020 | RCS SC | January 2014–December 2018 | China | Tertiary | Adults with SRD admitted to the ICU due to acute respiratory failure | Total: 259 Confirmed PJP: 103 (39.8%) |
ACM while in ICU (PJP cases) n = 69/103 (70.0%) |
| Singh et al. | 2019 | RCS SC | March 2014–March 2017 | India | Tertiary | Patients with HIV-AIDS and PJP | Total: 76 PCR and microscopy confirming PJP: 17 |
In-hospital mortality due to respiratory failure in patients with confirmed PJP n = 3/17 (17.7%) |
| Solodokin et al. | 2016 | RCS SC | January 2009–July 2014 | USA | Tertiary | Patients aged <22 years admitted to haematology or oncology who received ≥1 dose of IV pentamidine for PJP prophylaxis | 121 | ACM during follow-up n = 25/121 (20.6%) PJP-specific mortality NS |
| Wang et al. | 2019 | CCSSC | March 2014–July 2016 | China | Tertiary | Patients with HIV-AIDS diagnosed with PJP | 80 | ACM n = 14/80 (17.5%) |
| Wei et al. | 2018 | RCSMC | January 2006–December 2013 | Taiwan | Multiple | HIV-negative patients with non-Hodgkin's lymphoma | Total: 12 158 Treated with rituximab and developed PJP: 223/7554 (2.95%) Not treated with rituximab and developed PJP: 61/4604 (1.33%) |
30-day ACM (treated with rituximab and developed PJP) n = 27/223 (12.1%) 60-day ACM (treated with rituximab and developed PJP) n = 37/223 (16.6%) 90-day ACM (treated with rituximab and developed PJP) n = 48/223 (21.5%) |
| Yu et al. | 2017 | RCSSC | January 2009–January 2016 | China | Tertiary | HIV-negative patients diagnosed with PJP with or without CMV | Total: 70 CMV-positive: 38 (54.3%) CMV-negative: 32 (45.7%) |
Overall ACM n = 26/70 (37.1%) ACM (CMV-positive BAL) n = 17/38 (44.7%) ACM (CMV-negative BAL) n = 9/32 (28.2%) |
ACM, all-cause mortality; BAL, bronchioalveolar lavage; CCS, case control study; CMV, cytomegalovirus; GVHD, graft versus host disease; HSCT, haematopoietic stem cell transplant; ICU, intensive care unit; IV, intravenous; MC, multicentre; NS, not stated (by authors); PCS, prospective cohort study; PJP, Pneumocystis jirovecii pneumonia; R-CHOP, rituximab/cyclophosphamide/hydroxydaunorubicin/prednisone; RCS, retrospective cohort study; SC, single centre; SOT, solid organ transplant; SRD, systemic rheumatic disease; TMP–SMX, trimethoprim–sulfamethoxazole.
Data reported as it appears in the source papers.