Table 4. Demographics, clinical characteristics, identity of pathogens, and outcomes of patients with severe pneumonia a , b .
| Total (n = 59) | Immunocompromised c(n = 43) | Non-immunocompromised(n = 16) | p | |
| Male, n (%) | 39 (66.1) | 28 (65.1) | 11 (68.8) | 0.793 |
| Mean age (SD), y | 59.3 (15.4) | 55.8 (14.7) | 68.6 (13.4) | 0.004 |
| Underlying disease, n (%) | ||||
| Hematologic malignancy | 27 (45.8) | 27 (62.8) | 0 | <0.001 |
| Structural lung disease | 14 (23.7) | 9 (20.9) | 5 (31.3) | 0.407 |
| Interstitial lung disease | 7 (11.9) | 7 (16.3) | 0 | 0.086 |
| Chronic obstructive pulmonary disease | 4 (6.8) | 1 (2.3) | 3 (18.8) | 0.026 |
| Tuberculous destroyed lung | 4 (6.8) | 1 (2.3) | 3 (18.8) | 0.026 |
| Diabetes mellitus | 13 (22.0) | 8 (18.6) | 5 (31.3) | 0.297 |
| Bone marrow transplantation | 10 (16.9) | 10 (23.3) | 0 | 0.034 |
| Solid organ transplantation | 6 (10.2) | 6 (14.0) | 0 | 0.115 |
| Solid cancer | 6 (10.2) | 3 (7.0) | 3 (18.8) | 0.183 |
| Cerebrovascular attack | 4 (6.8) | 2 (4.7) | 2 (12.5) | 0.286 |
| Chronic kidney disease d | 4 (6.8) | 0 | 4 (25.0) | 0.004 |
| Hospital stay prior to pneumonia, median (IQR), d | 20 (10–41) | 22 (11–42) | 17.5 (6.3–26.8) | 0.302 |
| Symptom duration before ICU admission, median (IQR), d | 3.0 (2.0–5.0) | 3.0 (2.0–5.0) | 3.5 (2.0–5.5) | 0.877 |
| Clinical manifestation | ||||
| Fever (≥38.0°C) | 44 (74.6) | 32 (74.4) | 12 (75.0) | 0.964 |
| Cough | 36 (61.0) | 28 (65.1) | 8 (50.0) | 0.290 |
| Sputum | 42 (71.2) | 30 (69.8) | 12 (75.0) | 0.693 |
| Dyspnea | 51 (86.4) | 36 (83.7) | 15 (93.8) | 0.317 |
| Altered mentality | 27 (45.8) | 17 (39.5) | 10 (62.5) | 0.115 |
| Shock | 20 (33.9) | 15 (34.9) | 5 (31.3) | 0.793 |
| APACHE2 score, mean (SD) | 25.6 (6.1) | 26.4 (5.5) | 23.1 (7.3) | 0.08 |
| SOFA score, mean (SD) | 10.6 (3.3) | 10.6 (3.4) | 10.5 (3.0) | 0.93 |
| Viral pathogens, n (%) | ||||
| Respiratory syncytial virus | 16 (27.1) | 13 (30.2) | 3 (18.8) | 0.378 |
| Parainfluenza virus | 16 (27.1) | 13 (30.2) | 3 (18.8) | 0.378 |
| Rhinovirus | 15 (25.4) | 10 (23.3) | 5 (31.3) | 0.531 |
| Influenza virus | 10 (16.9) | 5 (11.6) | 5 (31.3) | 0.074 |
| Cytomegalovirus | 5 (8.5) | 5 (11.6) | 0 | 0.154 |
| Human coronavirus | 4 (6.8) | 2 (4.7) | 2 (12.5) | 0.286 |
| Bocavirus | 2 (3.4) | 2 (4.7) | 0 | 0.380 |
| Human metapneumovirus | 2 (3.4) | 1 (2.3) | 1 (6.3) | 0.459 |
| Adenovirus | 1 (1.7) | 1 (2.3) | 0 | 0.538 |
| Twenty-eight day mortality, n (%) | 21 (35.6) | 18 (41.9) | 4 (25.0) | 0.234 |
ICU = intensive care unit; APACHE = Acute Physiology and Chronic Health Evaluation; SOFA = Sequential Organ Failure Assessment; IQR = interquartile range.
Categories of coinfection are not mutually exclusive. Some cases were associated with two or more pathogens.
Cases of coinfection with organisms other than bacteria/other virus (six with Aspergillus species, four with P. jirovecii) are not presented in the Table.
The immunocompromised state was verified if the patients: (i) had daily administration of corticosteroids (at least 5 mg per day of prednisolone or an equivalent drug), (ii) were solid organ or hematopoietic stem cell transplant recipients, (iii) had received treatment with chemotherapy for an underlying malignancy during the 6 months prior to ICU admission, and (iv) had an underlying acquired immune deficiency disorder.
Includes two patients with chronic renal failure and two patients with end-stage renal disease.