ArticleScientific reports2025
Time series modeling shows early lymphocyte decline predicts inflammatory rise and mortality in older adults with community acquired pneumonia.
Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Community-acquired pneumonia (CAP) remains a leading cause of death in older adults, largely because immunosenescence and inflamm-aging obscure early clinical deterioration. We explored the short-term temporal interplay between immune and inflammatory biomarkers and assessed how age, malnutrition, and diabetes modify these dynamics and their prognostic value. A retrospective cohort study was conducted on 418 elderly CAP patients (≥ 65 years). Lymphocyte counts, C-reactive protein (CRP), and procalcitonin (PCT) were recorded at admission (T0) and 24 h intervals (T1, T2). Biomarker trends were analyzed using auto-regressive integrated moving average (ARIMA) models, while cross-correlation functions (CCF) quantified lagged relationships, and time-varying Cox models and time-dependent receiver-operating-characteristic (td-ROC) curves evaluated 28 day mortality. Overall mortality was 18.4% (77/418). Lymphocyte counts were consistently lower in non-survivors (p < 0.001). Falls in lymphocytes preceded rises in CRP and PCT by 24-48 h. ARIMA projections mirrored observed trends and identified sustained lymphopenia and escalating PCT in non-survivors. In time-varying Cox analysis, lymphocyte count was the strongest protective factor (HR per 1 × 10
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