Long-term survival and factors associated with mortality in patients with Community-Acquired Pneumonia and COVID-19: A retrospective cohort study

Introduction: Community-acquired pneumonia (CAP) is a leading cause of infectious deaths globally (1). In the United States, the estimated incidence of CAP ranges from 106 cases to 164 cases per 10,000 inhabitants. The main objective of this study was to evaluate the survival rates and factors associated with mortality in patients diagnosed with Community-Acquired Pneumonia (CAP) and Coronavirus Disease 2019 (COVID-19) following their hospitalization in Colombia. Materials and methods: A retrospective cohort study was conducted to assess 12-month survival in patients with CAP and COVID-19 using the Kaplan-Meier method. Stratifications were performed according to age, sex, comorbidities, and disease severity. Additionally, a multivariate analysis using Cox regression was conducted to investigate the risk factors that may have influenced 12-month survival. Results: A total of 4697 patients were included, with 52.5% having CAP (2464/4697), 32.5% having COVID-19 (1528/4697), and 15% having neither CAP nor COVID-19 (705/4697). The 12-month survival rate was 46.2% for patients with CAP, 74.9% for patients with COVID-19, and 64.4% for patients with neither condition. Cox regression analysis revealed that being male (HR:1.142;95%CI:1.042-1.252;p=0.004), age > 65 years (HR:2.622;95%CI:2.324-2.959;p<0.001), Charlson Comorbidity Index ≥3 (HR:1.770;95%CI:1.604-1.954;p<0.001), CURB-65 ≥2 (HR:2.081;95%CI:1.874-2.313;p<0.001), and a history of CAP (HR:1.569; 95%CI:1.420-1.735;p<0.001) were associated with increased mortality at 12 months. Discussion: Survival among patients with CAP at 12 months of follow-up was lower, with identified factors associated with increased mortality, including being male, over 65 years of age, comorbidities, and disease severity as measured by CURB-65.