Risk Factors for Secondary Organizing Pneumonia and Acute Fibrinous and Organizing Pneumonia in Patients with COVID-19 Pneumonia

Overview

Journal Infect Drug Resist

Publisher Dove Medical Press

Date 2024 Nov 18

PMID 39554470

Authors

Alisa Aikwanich

Dararat Eksombatchai

Tananchai Petnak

Tanapat Tassaneeyasin

Viboon Boonsarngsuk

Affiliations

Soon will be listed here.

Abstract

Purpose: Secondary organizing pneumonia (OP) and acute fibrinous and organizing pneumonia (AFOP) are frequently observed in cases of COVID-19 pneumonia. Nevertheless, the identification of risk factors related to OP/AFOP and their impact on patient outcomes remain inadequately elucidated.

Patients And Methods: This retrospective study aimed to identify risk factors associated with OP/AFOP in patients with COVID-19 pneumonia and to compare clinical outcomes between patients with and without OP/AFOP. The study included hospitalized patients with COVID-19 pneumonia admitted between July 1 and September 30, 2021. Factors associated with OP/AFOP were identified using multivariable regression analysis. Additionally, a multivariable Cox proportional hazard model was used to evaluate the association of OP/AFOP with 90-day mortality.

Results: Among the 666 hospitalized patients with COVID-19 pneumonia, 53 (8%) developed OP/AFOP during their admission. When compared to patients younger than 50 years old, those aged 50-70 and over 70 years old exhibited an increased risk of developing OP/AFOP, with adjusted odds ratios (aOR) of 3.87 (95% CI, 1.24-12.11; P=0.02) and 5.74 (95% CI, 1.80-18.27; P=0.003), respectively. Other factors associated with OP/AFOP included a history of diabetes mellitus (aOR 2.37; 95% CI, 1.27-4.44; P=0.01) and patients with oxygen saturation at admission below 88% (aOR 4.52; 95% CI, 1.22-16.67; P=0.02). Furthermore, the presence of OP/AFOP was correlated with an increased risk of various complications, such as respiratory failure, acute kidney injury, secondary infections, pneumothorax, pneumomediastinum, and pulmonary embolism. Lastly, patients with OP/AFOP exhibited significantly higher 90-day mortality (adjusted hazard ratio 3.40; 95% CI, 1.68-6.92; P=0.001) compared to those without OP/AFOP.

Conclusion: We identified factors associated with an increased risk of OP/AFOP in patients with COVID-19 pneumonia, which included age ≥50 years, a history of DM, and hypoxemia on admission (SpO2 <88%). Furthermore, our study revealed that OP/AFOP was significantly linked to higher 90-day mortality.

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