Abstract
In the non-AIDS group, several underlying conditions and immune defects could lead to different PCP presentations. This study compared PCP presentation and outcome according to the underlying disease. A secondary analysis of a previously published prospective observational study including 544 PCP patients was done. Only non-AIDS patients were included. Underlying disease was defined as chronic lymphocytic leukemia (CLL), organ transplantation, solid cancer, allogeneic hematopoietic stem cell transplant (AHSCT), other hematological diseases, and immunosuppressive treatment. Clinical characteristics and outcomes were compared between groups. Multiple correspondent analyses compared clinical characteristics at diagnosis. Day 30 mortality was analyzed. Three hundred and twenty-one patients were included in the study. The underlying diseases were hematological malignancy (n = 75), AHSCT (n = 14), CLL (n = 19), solid organ transplant (n = 94), solid tumor (n = 39), and immunosuppressive treatment (n = 57). Compared with other underlying diseases, PCP related to CLL was closer to PCP related to AIDS presentation (long duration of symptoms before diagnosis, high level of dyspnea, and low oxygen saturation at diagnosis). Day 30 mortality was associated with underlying disease, oxygen flow, and shock at ICU admission. PCP presentations may vary according to the underlying reason for immunosuppression. Response to treatment and adjuvant steroid therapy should be analyzed regarding this result.
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Data are available on reasonable request required because of observational study.
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The initial cohort was supported by a grant from the French ministry of health.
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GB, LB, EA, and VL designed the study, performed analysis, and wrote the manuscript. AR, SV, FRG, SH, DM, AD, SLG, FD, ML, DT, CP, APB, JB, AB, XI, IDJ, DM, DP, CH, and EM included patients, and reviewed and approved the manuscript.
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Antoine Roux, MD,; Sandrine Valade, MD; Florence Gangneux-Robert, PharmD, PhD; Samia Hamane, MD; Daniele Maubon, MD, PhD; Anne Debourgogne, PhD, MPH; Solène Le Gal, DVM, PhD; Frederic Dalle, PharmD, PhD; Marion Leterrier, PharmD; Dominique Toubas, MD, PhD; Christelle Pomares, MD, PhD; Anne Pauline Bellanger, PharmD, PhD; Julie Bonhomme, MD, PhD; Xavier Iriart, PhD; Isabelle Durand-Joly, PhD; Denis Magne, PhD; Denis Pons, Pharmacien Biologiste; and Eric Maury, MD, PhD, have disclosed no relevant financial relationships. Christophe Hennequin, MD, PhD, has disclosed the following relevant financial relationships: served as an advisor or consultant for Gilead Sciences, Inc., Merck Sharp & Dohme Corp; Pfizer Inc. Elie Azoulay, MD, PhD, has disclosed the following relevant financial relationships: Gilead Sciences, Pfizer, Astellas, Alexion, Fisher-Paykel. Dr. Lemiale has disclosed being memeber of a research group which received grant from Pfizer, Fisher-Paykel, Gilead, Alexion, Astellas.
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Burghi, G., Biard, L., Roux, A. et al. Characteristics and outcome according to underlying disease in non-AIDS patients with acute respiratory failure due to Pneumocystis pneumonia. Eur J Clin Microbiol Infect Dis 40, 1191–1198 (2021). https://doi.org/10.1007/s10096-020-04118-w
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DOI: https://doi.org/10.1007/s10096-020-04118-w