Association of Community-Acquired Pneumonia (Cap) With Inhaled Corticosteroids (Ics) Among Patients With Chronic Obstructive Pulmonary Disease

Abstract

Background: Chronic obstructive pulmonary disease has a significant morbidity burden and adversely affects patient quality of life. According to research, inhaling steroids may raise the chance of developing community-acquired pneumonia (CAP). Since no research had been done in our local community, this study was conducted to determine the relationship between pneumonia and COPD patients. To determine the association of community-acquired pneumonia with inhaled corticosteroids among patients with chronic obstructive pulmonary disease (COPD). Material and Methods: In a cross-sectional study carried out between October 15, 2020, to April 14, 2022 (18 months) at Nishtar Hospital Multan, 300 COPD patients from the Department of Medicine and Pulmonology were selected after permission from concerned authorities and the Institutional Review Board (IRB). Once registered, all patients underwent clinical examination and chest X-Ray to diagnose pneumonia. Results: Out of these 300 research cases, our study's patients had an average age of 56.63 ±3.4 years. Out of them, 190 (63.3%) were male patients and 110(27.7%) were female. One hundred and fifty-five (51%) were from metropolitan regions, while 145 (48.3%) were from rural areas. 123 (41.0 percent) of the subjects had diabetes, and 117 (39%) had hypertension. Of these 300 study cases, 200 (66.6 %) were smokers, while dyslipidemia was noted in 136 (45.3 %). Among 300 patients, 247 (82.3%) were on ICS. Community-acquired pneumonia was noted in 43 cases (14.3%). There was a statistically significant association between ICS usage and CAP (P<0.05). Post-stratification, CAP had a significant association (p-value ≤0.05) with older age (>55 years), urban population, diabetes, smoking, and COPD duration of >12 months. Conclusion: Our study noted a high CAP prevalence among COPD patients using ICS. Moreover, community-acquired pneumonia in patients with COPD using inhaled corticosteroids was strongly associated with old age, obesity, DM, smoking, and a long course of the illness. These may be considered as additional risk factors for CAP among ICS using subgroup. Keywords; Community-acquired pneumonia, CAP, Chronic obstructive pulmonary disease, COPD, Corticosteroids, ICS