Clinical Characteristics and Prognoses of Patients With Systemic Lupus Erythematosus Hospitalized for Pulmonary Infections

• Main Authors: Yanli Yang, Hui Jiang, Chuhan Wang, Nan Jiang, Chanyuan Wu, Shangzhu Zhang, Wei Jiang, Jinmin Peng, Li Weng, Jiuliang Zhao, Qian Wang, Mengtao Li, Bin Du, Yan Zhao, Xiaofeng Zeng
• Format: Article
• Language: English
• Published: Frontiers Media S.A. 2021-09-01
• Series: Frontiers in Medicine
• Subjects: systemic lupus erythematosus; pulmonary infection; mortality; risk factor; cardiopulmonary involvement; opportunistic infection
• Online Access: https://www.frontiersin.org/articles/10.3389/fmed.2021.732681/full

Objective: To identify factors associated with mortality in SLE patients who were hospitalized for pulmonary infections (PIs).Methods: This single-center retrospective study analyzed the characteristics and risk factors for mortality in 95 SLE patients hospitalized for PIs.Results: Ninety-five SLE patients had 97 episodes of hospitalization for PIs, and 33 of these episodes (34.02%) led to death. Death from PI was associated with a higher neutrophil count (6.30 vs. 4.201 × 109/L, p < 0.01), immunoglobulin G (6.20 vs. 9.82 g/L, p = 0.01), serum creatinine (126.00 vs. 73.00 μmol/L, p = 0.01), proteinuria (2.99 vs. 0.54 g/day, p < 0.01), cardiopulmonary involvement (57.58 vs. 34.38%, p < 0.05), SLE disease activity index (SLEDAI; 11.00 vs. 6.00, p < 0.05), and opportunistic infections (78.79 vs. 45.31%, p < 0.05). Demographic characteristics, antibody/complements, bacterial infection, and primary treatment before infection (including corticosteroid and immunosuppressants) had no effect. Multivariate analysis indicated cardiopulmonary involvement (HR: 2.077; 95%CI: 1.022–4.220; p = 0.043) and opportunistic infection (HR: 2.572; 95%CI: 1.104–5.993; p = 0.029) were independent risk factors for mortality. High-dose steroid pulse therapy (HR: 0.982; 95%CI: 0.410–2.350; p = 0.982) and first-line immunosuppressant therapy (HR: 1.635; 95%CI: 0.755–3.542, p = 0.212) had no effect on mortality.Conclusion: Cardiopulmonary involvement and opportunistic infection were independent risk factors for mortality for SLE patients hospitalized for PIs. Use of high-dose pulse steroids and or immunosuppressants before hospitalization had no significant effects.