Evidence map›Paper›PMID 37794443›Full record

ArticlePneumonia (Nathan Qld.)2023

Risk of subsequent lower respiratory tract infection (LRTI) after hospitalization for COVID-19 LRTI and non-COVID-19 LRTI: a retrospective cohort study.

Katia J Bruxvoort, Heidi Fischer, Joseph A Lewnard, Vennis X Hong, Magdalena Pomichowski, Lindsay R Grant, Luis Jódar, Bradford D Gessner, Sara Y Tartof

Open access · goldAbstract read
In one paragraph

Article in Pneumonia (Nathan Qld.), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.9field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 4 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Katia J BruxvoortDepartment of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA. kbruxvoort@uab.edu.
Heidi FischerDepartment of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.
Joseph A LewnardDivision of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA.
Vennis X HongDepartment of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.
Magdalena PomichowskiDepartment of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.
Lindsay R GrantPfizer Vaccines, Collegeville, PA, USA.
Luis JódarPfizer Vaccines, Collegeville, PA, USA.
Bradford D GessnerPfizer Vaccines, Collegeville, PA, USA.
Sara Y TartofDepartment of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.
Kaiser Permanente · USPfizer (United States) · USBerkeley Public Health Division · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRespiratory pathogens, including SARS-CoV-2, can cause pulmonary structural damage and physiologic impairment, which may increase the risk of subsequent lower respiratory tract infections (LRTI). Prior hospitalization for any reason is a risk factor for LRTI, but data on the risk of subsequent new-onset LRTI following hospitalization for COVID-19 LRTI or non-COVID-19 LRTI are needed to inform strategies for immunizations targeting respiratory pathogens.

methodsWe conducted a retrospective cohort study at Kaiser Permanente Southern California (KPSC) among adults hospitalized from 3/1/2020 to 5/31/2022, excluding labor and delivery. We categorized individuals into 3 mutually exclusive baseline exposure groups: those hospitalized for COVID-19 LRTI, those hospitalized for non-COVID-19 LRTI, and those hospitalized for all other causes without LRTI or COVID-19 ("non-LRTI"). Following hospital discharge, patients were followed up for new-onset LRTI, beginning 30 antibiotic-free days after hospital discharge until 8/31/2022. We used multivariable cause-specific Cox regression with time-varying covariates to estimate hazard ratios (HR) of new-onset LRTI comparing those hospitalized for COVID-19 LRTI or non-COVID-19 LRTI to those hospitalized for non-LRTI, adjusting for demographic and clinical characteristics.

resultsThe study included 22,417 individuals hospitalized for COVID-19 LRTI, 12,795 individuals hospitalized for non-COVID-19 LRTI, and 176,788 individuals hospitalized for non-LRTI. Individuals hospitalized for non-COVID-19 LRTI were older and had more comorbidities than those hospitalized for COVID-19 LRTI or non-LRTI. Incidence rates per 1,000 person-years (95% CI) of new-onset LRTI were 52.5 (51.4-53.6) among individuals hospitalized for COVID-19 LRTI, 253.5 (243.7-263.6) among those hospitalized for non-COVID-19 LRTI, and 52.5 (51.4-53.6) among those hospitalized for non-LRTI. The adjusted hazard of new-onset LRTI during follow-up was 20% higher among individuals hospitalized for COVID-19 LRTI (HR 1.20 [95% CI: 1.12-1.28]) and 301% higher among individuals hospitalized for non-COVID-19 LRTI (HR 3.01 [95% CI: 2.87-3.15]) compared to those hospitalized for non-LRTI.

conclusionThe risk of new-onset LRTI following hospital discharge was high, particularly among those hospitalized for non-COVID-19 LRTI, but also for COVID-19 LRTI. These data suggest that immunizations targeting respiratory pathogens, including COVID-19, should be considered for adults hospitalized for LRTI prior to hospital discharge.

Indexed as

COVID-19HospitalizationLower respiratory tract infectionPneumonia

Identifiers

PMID37794443
PMCPMC10552217
OpenAlexW4387345465

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.