Abstract Background Community-acquired pneumonia (CAP) is a leading cause of hospitalization and mortality. Increasing evidence suggests that CAP may contribute to long-term morbidity through the development of non-communicable diseases (NCDs). We evaluate the risk for new NCDs following hospitalization for CAP. Methods This was a retrospective matched cohort study of adults hospitalized between June 1, 2015, and May 31, 2016, using the Epic Cosmos database, with five years follow-up. Adults hospitalized with CAP were matched 1:3 by age, sex and race with adults hospitalized for non-CAP medical reasons. NCDs were identified using International Classification of Diseases, Tenth Revision (ICD-10) codes. For each NCD category (cardiovascular, pulmonary, central nervous system, metabolic, renal, and neoplastic), analyses were restricted to patients without a prior history of that specific NCD, thereby defining separate at-risk populations for each outcome. Absolute and population-based measures of risk were calculated. Exploratory analysis estimating the national excess of NCDs attributable to CAP was performed. Results Among 207,848 CAP patients and 623,544 matched controls, CAP hospitalization was associated with significantly increased risk of new NCDs over five years. Pulmonary disease showed the greatest absolute burden with a number needed to harm of 14 (95% CI: 13-15). The estimated national excess of NCDs attributable to CAP in one year was 146,542 (95% CI: 132,677-161,716) , driven primarily by pulmonary, cardiovascular and renal diseases. Conclusions CAP hospitalization is associated with a substantial and sustained increase in risk for new NCDs, supporting CAP as an acute infection that may trigger long-term multimorbidity.
Ramirez et al. (Tue,) studied this question.