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This work was supported by a grant from the "Fondo de Investigacion Sanitaria" (FIS) of the "Instituto de Salud Carlos III" (call 2015) for the "Accion Estrategica en Salud 2013-2016 del Programa Estatal de Investigacion Orientado a los Retos de la Sociedad", framing in the " Plan Estatal de Investigacion Cientifica y Tecnica y de Innovacion 2013-2016"; code file PI15/01230, cofinanced by the European Union through the "Fondo Europeo de Desarrollo Regional" (FEDER).

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Esteban-Julvez, LAuthorGomez-Bertomeu, FAuthor

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January 20, 2023
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Incidence and Risk of Pneumococcal Pneumonia in Adults with Distinct Underlying Medical Conditions: A Population-Based Study

Publicated to:Lung. 198 (3): 481-489 - 2020-06-01 198(3), DOI: 10.1007/s00408-020-00349-y

Authors: Vila-Corcoles, A; Ochoa-Gondar, O; Vila-Rovira, A; Aragon, M; Esteban-Julvez, L; Chamorro, N; Hospital, I; Satue, E; Blade, J; de Diego, C; Gomez-Bertomeu, F; Raga, X

Affiliations

Hosp Joan 23, Dept Lab & Microbiol, Tarragona, Spain - Author
Hosp Joan 23, Dept Pneumol, Tarragona, Spain - Author
Hosp Santa Tecla, Dept Lab & Microbiol, Tarragona, Spain - Author
Inst Catala Salut, Primary Hlth Care Serv Camp Tarragona, Rambla Nova 124,D 1 A, Tarragona 43001, Spain - Author
Inst Univ Invest Atencio Primaria Jordi Gol IDIAP, Unitat Suport Recerca Tarragona, Tarragona, Spain - Author
Univ Autonoma Barcelona, Primary Care Res Inst Jordi Gol, Informat Syst Improvement Res Primary Care SIDIAP, Barcelona, Spain - Author
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Abstract

Purpose This study investigated the incidence of pneumococcal pneumonia requiring hospitalisation among middle-aged and older adults with and without specific underlying medical conditions, evaluating the influence of these conditions in the risk of developing pneumonia. Methods Population-based prospective cohort study included 2,025,730 individuals >= 50 years around Catalonia, Spain. The Catalonian information system for the development of research in primary care (SIDIAP) was used to establish baseline characteristics of the cohort (comorbidities and underlying medical conditions). Hospitalisations from pneumococcal pneumonia occurred among cohort members between 01/01/2015 and 31/12/2015 were collected from hospital discharge codes of 68 reference Catalonian hospitals. Cox regression was used to estimate the association between baseline conditions and the risk of developing pneumonia. Results Global incidence rate (IR) of hospitalised pneumococcal pneumonia was 82.8 cases per 100,000 persons-year. Maximum IRs (per 100,000 persons-year) emerged among persons with haematological neoplasia (837.4), immunodeficiency (709.2), HIV infection (474.7), severe renal disease (407.5) and chronic pulmonary disease (305.7). In the multivariable analyses, apart from increasing age, HIV infection (hazard ratio [HR] 6.78), haematological neoplasia (HR 6.30), prior all-cause pneumonia (HR 5.27), immunodeficiency (HR 4.57) and chronic pulmonary disease (HR 2.89) were the conditions most strongly associated with an increasing risk. Pneumococcal vaccination did not emerge associated with a reduced risk in our study population (nor PPsV23 neither PCV13). Conclusion Old age, immunocompromising conditions and chronic pulmonary/respiratory disease are major risk factors for pneumococcal pneumonia in adults. Our data underline the need for better prevention strategies in these persons.

Keywords

AdultsBurdenCommunity-acquired pneumoniaDiseaseEuropeFemaleFollow-up studiesHospitalizationHumansImmunocompromised hostIncidenceMaleMiddle agedPneumococcal pneumoniaPneumonia, pneumococcalProspective studiesRisk factorsSpainStreptococcus pneumoniaStreptococcus pneumoniaeStreptococcus-pneumoniaeVaccine

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Lung due to its progression and the good impact it has achieved in recent years, according to the agency Scopus (SJR), it has become a reference in its field. In the year of publication of the work, 2020, it was in position , thus managing to position itself as a Q2 (Segundo Cuartil), in the category Pulmonary and Respiratory Medicine. Notably, the journal is positioned en el Cuartil Q3 for the agency WoS (JCR) in the category Respiratory System.

From a relative perspective, and based on the normalized impact indicator calculated from the Field Citation Ratio (FCR) of the Dimensions source, it yields a value of: 2.85, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: Dimensions Jul 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-07-19, the following number of citations:

  • WoS: 7
  • Scopus: 7
  • Europe PMC: 5

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-07-19:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 43.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 43 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 9.5.
  • The number of mentions on the social network X (formerly Twitter): 1 (Altmetric).
  • The number of mentions in news outlets: 1 (Altmetric).