Comorbidome and community-acquired pneumonia: Analysis by age, sex, and intensive care unit admission

Objective: To evaluate the influence of age, sex, and the need for intensive care unit admission on the clinical outcomes of patients with community-acquired pneumonia (CAP), considering the impact of comorbidities such as cardiovascular diseases, chronic kidney disease, and oncological conditions on the risk of complications and mortality. Methodology: A multicenter retrospective cohort study was conducted in patients with CAP admitted to two tertiary-level institutions in Colombia between January 2010 and December 2020. A comorbidity map (comorbidome) was developed to reflect the prevalence of these conditions according to intensive care unit (ICU) stay, sex, and age. Results: In a cohort of 3370 patients, the most frequent comorbidities were arterial hypertension (50.1%), anemia (31.8%), and chronic pulmonary disease (27.8%). Functional dependency showed the strongest association with mortality (OR 7.17; 95% CI 5.6–9.17), with significant differences in distribution and strength of association according to age, sex, and need for ICU admission. Conclusion: This study demonstrated the high prevalence of comorbidities in patients with CAP in Colombia, highlighting arterial hypertension, anemia, and chronic pulmonary disease as the most common. The distribution of these comorbidities varied according to age and sex, although a very similar clinical profile was observed regarding the need for ICU admission.