Prognostic analysis of concurrent Pneumocystis jirovecii pneumonia in patients with systemic lupus erythematosus: a retrospective study

• Published in: BMC infectious diseases 2024-08, Vol.24 (1), p.874-10, Article 874
• Main Authors: Shi, Yujie, Chen, Ruxuan, Sun, Hongli, Xu, Kai, Li, Zhiyi, Wang, Mengqi, Shao, Chi, Huang, Hui
• Format: Article
• Language: English
• Subjects: Adult; Autoimmune diseases; Bacteria; Bacterial diseases; C-reactive protein; CD4 antigen; Cell number; Chronic conditions; Comorbidity; Complement component C3; Complications and side effects; Cytomegalovirus; Diabetes mellitus; Erythrocyte sedimentation rate; Female; Ferritin; Hemoglobin; Humans; Hyperglycemia; IgG antibody; Immunoglobulin G; Infectious diseases; Kaplan-Meier Estimate; L-Lactate dehydrogenase; Lactate dehydrogenase; Leukocytes (neutrophilic); Lupus; Lupus Erythematosus, Systemic - complications; Lupus Erythematosus, Systemic - mortality; Lymphocytes; Lymphocytes T; Male; Medical records; Medical research; Medicine, Experimental; Middle Aged; Mortality; Multivariate analysis; Natural killer cells; Physiological aspects; Pneumocystis carinii - isolation & purification; Pneumocystis carinii pneumonia; Pneumocystis jirovecii; Pneumocystis jirovecii pneumonia; Pneumonia; Pneumonia, Pneumocystis - microbiology; Pneumonia, Pneumocystis - mortality; Prognosis; Regression analysis; Regression models; Retrospective Studies; Risk factors; Survival; Systemic lupus erythematosus; Thrombocytopenia; Urea; Ventilation
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-024-09757-4

Systemic lupus erythematosus (SLE) has been less deadly since the advent of corticosteroid-sparing medications. SLE patients still have a higher mortality rate than the general population. Infectious disease is reported as one of the major causes of death in patients with SLE. Although bacteria are the most often isolated pathogens from patients with SLE, Pneumocystis jirovecii pneumonia (PJP) is more deadly than bacterial infection. We retrospectively enrolled consecutive patients with SLE concurrent with PJP (SLE-PJP) in our center between January 2014 and December 2022. The participants were classified into two groups: survivors and non-survivors. Cox regression models and Kaplan‒Meier survival analyses were conducted to explore prognostic factors for survival. There were 57 patients with SLE (42.0 ± 15.8 years old, 78.9% female) complicated with PJP, 22 (38.6%) of whom died. Compared with the survival group, the non-survival group had more patients with hyperglycemia or diabetes mellitus, invasive ventilation (p