AUTHOR=Yang Yanli , Jiang Hui , Wang Chuhan , Jiang Nan , Wu Chanyuan , Zhang Shangzhu , Jiang Wei , Peng Jinmin , Weng Li , Zhao Jiuliang , Wang Qian , Li Mengtao , Du Bin , Zhao Yan , Zeng Xiaofeng 

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

JOURNAL=Frontiers in Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.732681

DOI=10.3389/fmed.2021.732681

ISSN=2296-858X

ABSTRACT=<p><bold>Objective:</bold> To identify factors associated with mortality in SLE patients who were hospitalized for pulmonary infections (PIs).</p><p><bold>Methods:</bold> This single-center retrospective study analyzed the characteristics and risk factors for mortality in 95 SLE patients hospitalized for PIs.</p><p><bold>Results:</bold> 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 × 10<sup>9</sup>/L, <italic>p</italic> &lt; 0.01), immunoglobulin G (6.20 vs. 9.82 g/L, <italic>p</italic> = 0.01), serum creatinine (126.00 vs. 73.00 μmol/L, <italic>p</italic> = 0.01), proteinuria (2.99 vs. 0.54 g/day, <italic>p</italic> &lt; 0.01), cardiopulmonary involvement (57.58 vs. 34.38%, <italic>p</italic> &lt; 0.05), SLE disease activity index (SLEDAI; 11.00 vs. 6.00, <italic>p</italic> &lt; 0.05), and opportunistic infections (78.79 vs. 45.31%, <italic>p</italic> &lt; 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; <italic>p</italic> = 0.043) and opportunistic infection (HR: 2.572; 95%CI: 1.104–5.993; <italic>p</italic> = 0.029) were independent risk factors for mortality. High-dose steroid pulse therapy (HR: 0.982; 95%CI: 0.410–2.350; <italic>p</italic> = 0.982) and first-line immunosuppressant therapy (HR: 1.635; 95%CI: 0.755–3.542, <italic>p</italic> = 0.212) had no effect on mortality.</p><p><bold>Conclusion:</bold> 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.</p>