Clinical profiles of patients admitted for rehabilitation after community-acquired pneumonia
https://doi.org/10.36604/1998-5029-2025-98-50-59
Abstract
Aim. To delineate clinical profiles among the patients recovering from community-acquired pneumonia (CAP) based on their clinical and functional characteristics, in order to justify the need for and personalize subsequent rehabilitation programs.
Materials and methods. The study enrolled 104 patients. Collected data included demographics, medical history (including smoking status and pack-year index, prior CAP episodes, and previous COVID-19), complaints, laboratory parameters, lung function and chest computed tomography (CT) findings at the moment of CAP diagnosis and at admission to rehabilitation.
Results. The mean age of the patients was 47.3 ± 17.9 years; 57% were women. Severe CAP was present in 25% and correlated with age (ρ = 0.22; p = 0.029). The median hospital stay was 10 [8–13] days and increased with age (ρ = 0.30; p = 0.001) and comorbidity (p = 0.039). On initial chest CT bilateral lung involvement was observed in 48.5%; the median number of involved segments was 3 [2–6], decreasing to 1 [0–3] by the onset of rehabilitation. Predominant complaints were dyspnea (90.3%) and fatigue (87.4%); productive cough was more frequent in smokers, whereas dry cough predominated in non-smokers. Erythrocyte sedimentation rate correlated with length of hospitalization (ρ = 0.28; p = 0.0075). Dyspnea was associated with lower FEV1, FEV1/FVC, and FEF50 (ρ = 0.36–0.42; p < 0.05). Cluster analysis identified two clinical profiles differing in symptom severity, residual CT abnormalities, and degree of pulmonary function impairment.
Conclusions. These findings support a personalized approach to rehabilitation and highlight the need for further prospective studies and profile-oriented programs.
About the Authors
E. G. Sheludko
Far Eastern Scientific Center of Physiology and Pathology of Respiration
Russian Federation
Russian Federation
Elizaveta G. Sheludko, MD, PhD (Med.), Senior Staff Scientist, Laboratory of Molecular and Translational Research
22 Kalinina Str., Blagoveshchensk, 675000
Yu. O. Semirech
Far Eastern Scientific Center of Physiology and Pathology of Respiration
Russian Federation
Russian Federation
Yuliya O. Semirech, MD, PhD (Med.), Head of Department of Medical Rehabilitation
22 Kalinina Str., Blagoveshchensk, 675000
V. V. Knyshova
Vladivostok Branch of Far Eastern Scientific Centre of Physiology and Pathology of Respiration – Research Institute of Medical Climatology and Rehabilitative Treatment
Russian Federation
Russian Federation
Vera V. Knyshova, MD, PhD (Med.), DSc (Med.), Senior Staff Scientist, Laboratory of Rehabilitation Treatment
73g Russkaya Str., Vladivostok, 690105
V. P. Kolosov
Far Eastern Scientific Center of Physiology and Pathology of Respiration
Russian Federation
Russian Federation
Victor P. Kolosov, MD, PhD (Med.), DSc (Med.), Academician of RAS, Professor, Scientific Director
22 Kalinina Str., Blagoveshchensk, 675000
References
1. World Health Organization. The top 10 causes of death. Fact sheet; 2024 Aug 7. Available at: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death (accessed 2025-10-22).
2. GBD 2021 Lower Respiratory Infections and Antimicrobial Resistance Collaborators. Global, regional, and national incidence and mortality burden of non-COVID-19 lower respiratory infections and aetiologies, 1990–2021: a systematic analysis from the Global Burden of Disease Study 2021. Lancet Infect. Dis. 2024; 24(9):974–1002. https://doi.org/10.1016/S1473-3099(24)00176-2
3. [Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor). State reports “On the sanitary and epidemiological well-being of the population in the Russian Federation,” 2011–2023]. Available at: https://rospotrebnadzor.ru (accessed 2025-10-22) (in Russian).
4. Polyanskaya E.V. [Analysis of demographic trends in the Far Eastern region (on the example of the Amur oblast)]. Problemy razvitiya territoriy 2023; 27(3):99–112 (in Russian). https://doi.org/10.15838/ptd.2023.3.125.7
5. Natykan Yu.A, Kurganova O.P., Trotsenko O.E. [Epidemiological features of community-acquired pneumonia morbidity in the Amur Region. In: Proceedings of the XI congress of pulmonologists of Siberia and the Russian Far East (with international participation]. Blagoveshchensk; 2025:201–207 (in Russian). ISBN: 978-5-905864-30-8. https://doi.org/10.36604/Congress-Pulmo-2025
6. Simonetti A.F., Garcia-Vidal C., Viasus D., Anton L., Dorca J., Gudiol F., Carratalà J. Declining mortality among hospitalized patients with community-acquired pneumonia. Clin. Microbiol. Infect. 2016; 22(6):567.e1–567.e7. https://doi.org/10.1016/j.cmi.2016.03.015
7. American lung association, epidemiology and statistics unit, research and health education division. Trends in pneumonia and influenza morbidity and mortality. Chicago (IL): American Lung Association; 2015. Available at: https://www.lung.org/getmedia/98f088b5-3fd7-4c43-a490-ba8f4747bd4d/pi-trend-report.pdf
8. Metlay J.P., Waterer G.W., Long A.C., Anzueto A., Brozek J., Crothers K., Cooley L. A., Dean N.C., Fine M. J., Flanders S.A., Griffin M.R., Metersky M.L., Musher D.M., Restrepo M.I., Whitney C.G. Diagnosis and treatment of adults with community-acquired pneumonia: an official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America. Am. J. Respir. Crit. Care. Med. 2019; 200(7):e45–e67. https://doi.org/10.1164/rccm.201908-1581ST
9. Eekholm S., Ahlström G., Kristensson J., Lindhardt T. Gaps between current clinical practice and evidence-based guidelines for treatment and care of older patients with community-acquired pneumonia: a descriptive cross-sectional study. BMC Infect. Dis. 2020; 20:73. https://doi.org/10.1186/s12879-019-4742-4
10. Pick H.J., Bolton C.E., Lim W.S., McKeever T.M. Patient-reported outcome measures in the recovery of adults hospitalized with community-acquired pneumonia: a systematic review. Eur. Respir. J. 2019; 53(3):1802165. https://doi.org/10.1183/13993003.02165-2018
11. Auld S.C., Sheshadri A., Alexander-Brett J., Bertelson N., Chang S.Y., Chupp G.L., Cormier S.A., Debley J.S., Drake K.M., Echevarria C., Fabre V., Gentile G., Hagan R.S., Kolls J.K., Lynch S.V., Martinez F.J., Boushey H.A. Postinfectious pulmonary complications: establishing research priorities to advance the field – an official American Thoracic Society workshop report. Ann. Am. Thorac. Soc. 2024; 21(9):1219–1237. https://doi.org/10.1513/AnnalsATS.202406-651ST
12. Fang Y.Y., Ni J.C., Wang Y., Yu J.H., Fu L.L. Risk factors for hospital readmissions in pneumonia patients: a systematic review and meta-analysis. World J. Clin. Cases 2022; 10(12):3787–3800. https://doi.org/10.12998/wjcc.v10.i12.3787
13. Kitaw T.A., Azmeraw M., Temesgen D., Haile R.N. Time to recovery from severe community-acquired pneumonia: a systematic review and meta-analysis. J. Glob. Health 2024; 14:04203. https://doi.org/10.7189/jogh.14.04203
14. Tsoumani E., Carter J.A., Salomonsson S., Stephens J.M., Bencina G. Clinical, economic, and humanistic burden of community acquired pneumonia in Europe: a systematic literature review. Expert Rev. Vaccines 2023; 22(1):876-884. https://doi.org/10.1080/14760584.2023.2261785
15. Safiri S., Mahmoodpoor A., Kolahi A.-A., Nejadghaderi S.A., Sullman M.J.M., Mansournia M.A., Ansarin K., Collins G.S., Kaufman J.S., Abdollahi M. Global burden of lower respiratory infections during the last three decades. Front. Public Health 2022; 10:1028525. https://doi.org/10.3389/fpubh.2022.1028525
16. Molina J., González-Gamarra A., Ginel L., Peláez M.E., Juez J.L., Artuñedo A., Aldana G., Quesada E., Cabré J.J., Gómez A., Linares M., Marín M.T., Sánchez P.Y., Núñez L., Gonzálvez J., Mascarós E., López J., Cano A., Herrero J., Serra M.C., Cimas E., Pedrol M., Alfaro J.V., Martinón-Torres F., Cifuentes I., Méndez C., Ocaña D. CAPPRIC study – characterization of community-acquired pneumonia in Spanish adults managed in primary care settings. Microorganisms 2021; 9(3):508. https://doi.org/10.3390/microorganisms9030508
17. Grijalva C.G., Johnson K.D., Resser J.J., Whitney C.G., Baughman A., Kio M., Traenkner J., Johnson J., Miller K.F., Rostad C.A., Salazar L.W., Tanios R., Smith V.E., Cornelison S.A., Zhu Y., Han J.H., Yildirim I., Weiss T., Roberts C.S., Rouphael N., Self W.H.; PNEUMO Investigators. All-cause and pneumococcal community-acquired pneumonia hospitalizations among adults in Tennessee and Georgia. JAMA Netw. Open 2025; 8(8):e2524783. https://doi.org/10.1001/jamanetworkopen.2025.24783
18. Marziano Y., Itzhak D., Halperin Y., Gershman V., Avraham A. S., Nirkis M., Klaiman E., Glam L., Segal G., Lerner R.K. Profound anemia in hospitalized community-acquired pneumonia patients is associated with increased mortality and is prevalent in all patients’ age groups: a retrospective analysis of 15,121 patients. BMC Infect. Dis. 2025; 25:1297. https://doi.org/10.1186/s12879-025-11744-2
19. Gonçalves-Pereira J., Araújo J.P., Malheiro L., Gonçalves-Pereira J., Froes F., Gonçalves Pereira F., Diniz A., Oliveira H., Mergulhão P. Community-acquired pneumonia mortality trends according to age and gender: 2009 to 2019. BMC Pulm. Med. 2025; 25:391. https://doi.org/10.1186/s12890-025-03875-8
20. Rünow E., Valeur F., Torisson G., Hansen K., Theilacker C., Riesbeck K., Ahl J. The incidence of radiologically verified community-acquired pneumonia requiring hospitalisation in adults living in southern Sweden, 2016–2018: a population-based study. BMC Infect. Dis. 2025; 25(1):80. https://doi.org/10.1186/s12879-025-10468-7
21. Lüthi-Corridori G., Boesing M., Roth A., Giezendanner S., Leuppi-Taegtmeyer A.B., Schuetz P. Predictors of length of stay, rehospitalization and mortality in community-acquired pneumonia patients: a retrospective cohort study. J. Clin. Med. 2023; 12(17):5601. https://doi.org/10.3390/jcm12175601
22. Rachina S.A., Kupryushina O.A., Strelkova D.A., Avdeev S.N., Vlasenko A.E., Yasneva A.S., Yudanova T.A., Trofimenko I.N., Antonov V.N., Agibalova M.N., Merzhoeva Z.M., Yatsyshina S.B., Tikhonova M.A., Elkina M.A., Ananicheva N.A., Burmistrova E.N., Sukhorukova M.V. [Etiology of community-acquired pneumonia in adults in Russian hospitals after the COVID-19 pandemic: results of a multicenter prospective study]. Kliniceskaa Mikrobiologia i Antimikrobnaa Himioterapia = Clinical Microbiology and Antimicrobial Chemotherapy 2024; 26(2):141–147 (in Russian). https://doi.org/10.36488/cmac.2024.2.141-147
23. Vijayakumar B., Tonkin J., Devaraj A., Philip K.E.J., Orton C.M., Desai S.R., Shah P.L. CT lung abnormalities after COVID-19 at 3 months and 1 year and their association with severity. Radiology 2022; 304(2):379–389. https://doi.org/10.1148/radiol.2021211746
24. Cha M.J., Solomon J.J., Lee J.E., Choi H., Chae K.J., Lee K.S., Lynch D.A. Chronic lung injury after COVID-19 pneumonia: imaging features and clinical implications. Radiology 2024; 311(3):e231643. https://doi.org/10.1148/radiol.231643
25. Brennan M., McDonnell M.J., Duignan N., Gargoum F., Rutherford R.M. The use of cough peak flow in the assessment of respiratory function in clinical practice: a narrative literature review. Respir. Med. 2022; 193:106740. https://doi.org/10.1016/j.rmed.2022.106740
26. Prasetyo A., Sadhana U., Budiman J. Nasal mucociliary clearance in smokers: a systematic review. Int. Arch. Otorhinolaryngol. 2021; 25(1):e160–e169. https://doi.org/10.1055/s-0040-1702965
Review
For citations:
Sheludko E.G., Semirech Yu.O., Knyshova V.V., Kolosov V.P. Clinical profiles of patients admitted for rehabilitation after community-acquired pneumonia. Bulletin Physiology and Pathology of Respiration. 2025;(98):50-59. (In Russ.) https://doi.org/10.36604/1998-5029-2025-98-50-59
Views:
14
Email this article 