Longitudinal assessment of immunoglobulin response and disease progression in critically ill patients with community acquired pneumonia
Authors' conclusion
In critically ill patients with CAP, IgG and IgM dynamics in the first week of ICU stay are not associated with clinically relevant changes in disease course, regardless of the causative pathogen.
Study context
- Population
- Consecutive critically ill patients with CAP and PaO2/FiO2-ratio < 200 with or without septic shock82 (32%) S
- Participants
- 255 patients
- Exposure
- Serial IgG and IgM levels and disease course
- Outcome
- Association between IgG and IgM (days 1, 3 and 7) and disease course (SOFA score on days 2, 4 and 8)
Methodological detailsconsecutive patients, existing biorepository, generalized linear mixed models
- Consecutive patients
- Existing biorepository
- Generalized linear mixed models
Main finding
As reported in the abstract
Lower IgG-level and Sequential Organ Failure Assessment (SOFA) score at admission (β per 1 g/L IgG; p = 0.029)
- 0.07
IgG-level decline over time and SOFA score increase, not associated (β; p = 0.564)
- 0.04
Observational data: associations, not effects.
Further findings
Prevalence of low immunoglobulin (Ig)-levels · admission
- Low IgG (< 7.0 g/L): 151 patients
- 59%
- Low IgM (< 0.4 g/L): 77 patients
- 30%
- Both low: 56 patients
- 22%
Original publication
Longitudinal assessment of immunoglobulin response and disease progression in critically ill patients with community acquired pneumonia. Crit Care. Published 5 December 2024. doi:10.
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