The frequency and associated factors of pulmonary fibrosis by the twelfth month after community-acquired pneumonia

Year 2024, , 248 - 254, 29.07.2024

Mustafa İlteriş Bardakçı , Gülhan Albayrak , Müfide Arzu Özkarafakılı , Remzi Gediz

https://doi.org/10.38053/acmj.1471586

Abstract

Aims: Community-acquired pneumonia (CAP) is a term used to describe an acute lung infection that develops outside of a hospital setting. Radiological sequelae may remain in a certain part of these patients that may affect their lives. We aimed to investigate the frequency of sequelae parenchymal lesions and influencing factors in patients with community-acquired pneumonia.
Methods: This retrospective study included patients diagnosed with CAP. First, patients who were admitted to the chest diseases outpatient clinic for any reason and who were treated with the diagnosis of CAP in the emergency department 12 months ago at the earliest were selected. Among these patients, patients with thorax computed tomography (chest-CT) under the control of the chest diseases outpatient clinic were included in the study. Chest-CT results, demographic data and laboratory data were evaluated.
Results: A total of 80 patients, 32 (40%) female and 48 (60%) male, diagnosed with CAP were included. The mean age of our patients was 56.83±13.41 (min-max: 18-71). Twenty-three (28.75%) of the patients did not have pathology in the control chest-CT, while 57 (71.25%) patients had various levels of sequelae changes. Of the sequelae observed in 57 patients, 34 (42.5%) had single linear atelectasis or single band formation or ectasia in a single bronchus, while fibrotic structure was detected in 23 (28.75%). Five (6.25%) patients had pulmonary fibrosis. Age and smoking have a statistically significant effect on the presence of fibrosis in patients with CAP.
Conclusion: Mild to severe fibrotic changes were observed in one-third of our patients one year after CAP treatment. In our study, fibrotic changes were found to be highly correlated with age and smoking.

Keywords

Pneumonia, Fibrosis, Age, Smoking

Ethical Statement

The study was carried out with the permission of Health Sciences University Şişli Hamidiye Etfal Training and Research Hospital Ethics Committee (Date: 10.10.2023, Decision No:2464).

Supporting Institution

NO

Thanks

We thank the participants of this research.

References

• Sayıner A, Azap A, Yalçı A, et al. Türk toraks derneği erişkinlerde toplumda gelişen pnömoniler tanı ve tedavi uzlaşı raporu. 2021.
• Wunderink RG. Community-acquired pneumonia. infectious diseases (Fourth Edition). Neth J Med. 2017;1:251-257.
• Ramirez JA, Wiemken TL, Peyrani P, et al. Adults hospitalized with pneumonia in the united states: incidence, epidemiology, and mortality. Clin Infect Dis. 2017;65(11):1806-1812.
• Shoar S, Musher DM. Etiology of community-acquired pneumonia in adults: a systematic review. Pneumonia. 2020;12:11.
• Özlü T, Bülbül Y, Özsu S. Ulusal Verilerle Toplumda gelişen pnömoniler. Tüberk Toraks Derg. 2007;55:191-212.
• Brown JS. Community-acquired pneumonia. Clinical Medicine. 2012;12(6):538-543.
• Baskaran, V, Murray RL, Hunter A, et al. Effect of tobacco smoking on the risk of developing community acquired pneumonia: A systematic review and meta-analysis. PloSone. 2019;14(7):0220204.
• McLaughlin JM, Khan FL, Thoburn EA, et al. Rates of hospitalization for community-acquired pneumonia among US adults: a systematic review. Vaccine. 2020;38(4):741-751.
• Aliberti S, Cruz CSD, Amati F, et al. Community-acquired pneumonia. Lancet. 2021;398(10303):906-919.
• Houck PM, Bratzler DW, Nsa W, et al. Timing of antibiotic administration and outcomes for Medicare patients hospitalized with community-acquired pneumonia. Arch Intern Med. 2004; 164:637-644.
• Cesur S. Covid-19 pandemisi döneminde tanı konan bir toplum kaynaklı pnömonisi olgusu. Tüberk Toraks Derg. 2021;1:116-119.
• Gao J, Chu W, Duan J, et al. Six-month outcomes of post-ARDS pulmonary fibrosis in patients with H1N1 pneumonia. Front Mol Biosci. 2021;8:640763.
• Huang WJ, Tang XX. Virus infection induced pulmonary fibrosis. J Trans Med. 2021;19(1):496.
• Sheng G, Chen P, Wei Y, et al. Viral infection increases the risk of idiopathic pulmonary fibrosis: a meta-analysis. Chest. 2020;157;1175-1187.
• Richter AG, Stockley RA, Harper L, Thickett DR. Pulmonary infection in wegener granulomatosis and idiopathic pulmonary fibrosis. Thorax. 2009;64(8):692-697.
• Molyneaux PL, Maher TM. The role of infection in the pathogenesis of idiopathic pulmonary fibrosis. Eur Respir Rev. 2013;22:376-381.
• Raghu G, Collard HR, Egan JJ, et al. An official ats/ers/ jrs/alat statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management. Am J Respir Crit Care Med. 2011;183:788-824.
• File TM. Community-acquired pneumonia. Lancet. 2003; 362: 1991-2001. doi: 10.1016/S0140-6736(03)15021-0
• Nuorti JC, Farley MM, Harrison LH, et al. Cigarette smoking and invasive pneumococcal disease. N Eng J Med. 2000;342:681-689.
• Wilson MS, Wynn TA. Pulmonary fibrosis: pathogenesis, etiology and regulation. Mucosal Immunol. 2009;2:103-121.
• Molyneaux PL, Cox MJ, Saffron AG, et al. The role of bacteria in the pathogenesis and progression of idiopathic pulmonary fibrosis. Am J Respir Crit Care Med. 2014;190:906-913.
• Selman M, Buendia-Roldan I, Pardo A. Aging and pulmonary fibrosis. Rev Invest Clin. 2016;68(2):75-83.
• Pardo A, Selman M. Lung fibroblasts, aging, and idiopathic pulmonary fibrosis. Ann Am Thorac Soc. 2016;13:417-421.
• Leung J, Cho Y, Lockey RF, Kolliputi N. The role of aging in idiopathic pulmonary fibrosis. Lung. 2015;193(4):605-610.
• Stout-Delgado HW, Cho SJ, Chu SG, et al. Age-dependent susceptibility to pulmonary fibrosis is associated with NLRP3 inflammasome activation. Am J Respir Cell Mol Biol. 2016;55:252-263.
• Lopez Ramirez C, Valdivia LS, Portal JAR. Causes of pulmonary fibrosis in the elderly. Med Sci. 2018;6:58.
• Oh CK, Murray LA, Molfino NA. Smoking and idiopathic pulmonary fibrosis. Pulm Med. 2012;20:808260.
• Bellou V, Belbasis L, Evangelou E. Tobacco smoking and risk for pulmonary fibrosis: a prospective cohort study from the UK Biobank. Chest. 2021;160:983-993.
• Park Y, Ahn C, Kim TH. Occupational and environmental risk factors of idiopathic pulmonary fibrosis: a systematic review and meta-analyses. Sci Rep. 2021;11:43182021.
• Sousa C, Rodrigues M, Carvalho A, et al. Diffuse smoking-related lung diseases: insights from a radiologic-pathologic correlation. Insights Imaging. 2019;10:73.