To characterize the etiological spectrum of pneumonia and identify clinical and laboratory factors associated with in-hospital and post-discharge mortality in a cohort of patients treated during the COVID-19 era at a tertiary care hospital.
Approach:
Study Design: Retrospective cohort study conducted at Saint John of God Hospital in Linz, Austria.
Study Population: Included adult patients (≥ 18 years) admitted with pneumonia from January 1, 2020, to January 7, 2024.
Data Collection: Data extracted from electronic medical records included demographics, comorbidities, clinical presentation, laboratory findings, and outcomes.
Microbiological Analysis: Pathogen detection performed using standard laboratory procedures, including blood cultures and RT-PCR for SARS-CoV-2.
Statistical Analysis: Descriptive statistics, Cox proportional hazards regression for survival analysis, with statistical significance set at p < 0.05.
Key Findings:
The study cohort comprised 1,848 patients with a mean age of 75.3 years, predominantly male (93.8%).
Common comorbidities included arterial hypertension (53.9%), diabetes mellitus type 2 (29.2%), chronic heart failure (27.5%), and chronic kidney disease (20.5%).
Etiological agents were identified in 487 patients (26.4% of the cohort), with 73.6% of cases remaining without pathogen identification.
SARS-CoV-2 was the most frequently detected pathogen (8.7% of all cases).
Interpretation:
The study highlights the challenges in pathogen identification in pneumonia cases during the COVID-19 pandemic and the demographic characteristics of affected patients.
Limitations:
Retrospective design limits the ability to establish causality.
High percentage of cases without identified pathogens complicates the understanding of pneumonia etiology.
Ethnic and racial data were not recorded, limiting generalizability.
Conclusion:
The study provides insights into pneumonia causes and risk factors during the COVID-19 pandemic, emphasizing the need for improved diagnostic methods.
