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Effects of age and comorbidities on serum levels of inflammatory markers in community‐acquired pneumonia
Author(s) -
Viasus Diego,
Simonetti Antonella F.,
EstupiñanBohórquez Andrés F.,
Carratalà Jordi
Publication year - 2021
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.13480
Subject(s) - pneumonia , community acquired pneumonia , medicine , comorbidity , immunology , intensive care medicine
Studies have suggested that an inappropriate inflammatory response is a major cause of treatment failure and mortality in patients with community‐acquired pneumonia (CAP). We aimed to determine the effect of age and comorbidities on serum inflammatory markers in CAP. Methods We performed a prospective cohort study of adults hospitalized with CAP. For the purposes of this study, we compared patients according to comorbidities and age. Inflammatory markers were measured at hospital admission, focusing on acute phase proteins, cytokines and monocyte human leucocyte antigen DR (mHLA‐DR) expression. Results In patients with chronic pulmonary disease (COPD), serum cytokines had significantly decreased levels of tumour necrosis factor (TNF)‐α, interleukin (IL)‐6 and mHLA‐DR expression, as well as the C‐reactive protein (CRP), compared with patients who had no comorbidities. Similarly, patients with chronic heart disease had a significantly reduced CRP levels and mHLA‐DR expression, whereas patients with chronic kidney disease had significantly higher serum levels of procalcitonin and TNF‐α. Lower procalcitonin, IL‐6 and IL‐10 levels, as well as mHLA‐DR expression, were documented in older patients, but with no significant differences compared to younger patients. Multimorbidity in older patients was associated with significant lower levels of CRP and mHLA‐DR expression. Conclusions The circulating inflammatory markers to CAP have profiles that differ with age and underlying comorbidities. Multimorbidity in the elderly is also associated with lower serum levels of some inflammatory markers. Our findings suggest that inflammatory markers in CAP should be interpreted after considering age and comorbid conditions.