{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T02:40:51Z","timestamp":1790995251886,"version":"4.1.0"},"reference-count":57,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T00:00:00Z","timestamp":1734480000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      A considerable knowledge gap exists in predicting severe\n                      <jats:italic>Pneumocystis<\/jats:italic>\n                      pneumonia (PCP) outcomes following PCP diagnosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective cohort, we studied immunocompromised patients with PCP admitted to 5 University Health Network centers in Canada (2011\u20132022). The study outcome included severe PCP, a composite of 21\u2010day ICU admission or 28\u2010day all\u2010cause mortality. Adjusted odds ratios (aOR) estimated the association between severe PCP and comorbidities as well as clinical and laboratory variables at diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 44 out of 182 (24.2%) immunocompromised patients (19 [10.4%] HIV\u2010infected, 55 [30.2%] hematologic malignancies, 32 [17.6%] hematopoietic stem cell transplants, 32 [17.6% solid tumors, 26 solid organ transplants [14.3%], 12 (6.6%) autoimmune diseases, and 6 (3.3%) other immunosuppressive conditions) developed composite outcomes (40 ICU admissions [21.9%], 18 deaths [9.9%]). Patients with composite outcomes more often had acute\u2010onset PCP (&lt; 7 days) (18\/34 [52.9%] vs. 38\/126 [30.1%],\n                      <jats:italic>p<\/jats:italic>\n                      = 0.013), shortness of breath (39\/44 [88.6%] vs. 96\/136 [70.6%],\n                      <jats:italic>p<\/jats:italic>\n                      = 0.002), chronic liver disease (15\/44 [34.1%] vs. 9\/138 [6.5%],\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), hypoalbuminemia (median [IQR] albumin (g\/L): 27 [25\u201331] vs. 32 [29\u201335],\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), elevated lactate dehydrogenase (median [IQR] LDH (U\/L): 537 [324\u2013809] vs. 340 [237\u2013475],\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), lymphopenia (median [IQR] absolute lymphocyte count [(10*9\/L),]: 0.4 [0.2\u20130.6] vs. 0.7 [0.3\u20131.2],\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), or required supplemental oxygen (39\/44 [88.6%] vs. 60\/136 [44.1%],\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001) than those without composite outcomes. In multivariable analysis, chronic liver disease (aOR: 11.6, 95% CI: 2.2\u201361.3) and requiring supplemental oxygen on admission (aOR: 19.7, 95% CI: 3.0\u2013128.5) were significantly associated with severe PCP.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Alongside hypoxemia upon admission, chronic liver disease appears to significantly predict severe PCP in immunocompromised patients. This biologically plausible finding warrants further investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tid.14417","type":"journal-article","created":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T09:35:17Z","timestamp":1734514517000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Critical Insights: Severe Outcomes of\n                    <i>Pneumocystis<\/i>\n                    Pneumonia: A 10\u2010year Retrospective Cohort Study"],"prefix":"10.1111","volume":"27","author":[{"given":"Poramed","family":"Winichakoon","sequence":"first","affiliation":[{"name":"Transplant Infectious Diseases and Ajmera Transplant Centre University Health Network University of Toronto  Toronto Canada"},{"name":"Division of Infectious Diseases and Tropical Medicine Department of Medicine Faculty of Medicine Chiang Mai University  Chiang Mai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier Tomas","family":"Solera Rallo","sequence":"additional","affiliation":[{"name":"Transplant Infectious Diseases and Ajmera Transplant Centre University Health Network University of Toronto  Toronto Canada"},{"name":"Infectious Diseases Unit Quir\u00f3nsalud University Hospital Pozuelo de Alarc\u00f3n  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanan","family":"Albasata","sequence":"additional","affiliation":[{"name":"Transplant Infectious Diseases and Ajmera Transplant Centre University Health Network University of Toronto  Toronto Canada"},{"name":"Infectious Diseases Department Rashid Hospital Dubai Academic Health Corporation  Dubai UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan Marie","family":"Poutanen","sequence":"additional","affiliation":[{"name":"Departments of Microbiology and Medicine University Health Network and Sinai Health University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7979-2458","authenticated-orcid":false,"given":"Seyed M","family":"Hosseini\u2010Moghaddam","sequence":"additional","affiliation":[{"name":"Transplant Infectious Diseases and Ajmera Transplant Centre University Health Network University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,18]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2020.00224"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32833a3967"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/1060028016650107"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2022.100400"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/S00134\u2010024\u201007489\u20102"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.medmal.2014.01.007"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1164\/RCCM.201807\u20101358ED\/SUPPL_FILE\/DISCLOSURES.PDF"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkw156"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/EJH.14133"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/MR\/ROAC088"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/IJMS24087399"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.14108"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy682"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1378\/CHEST.07\u20100223"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/S12885\u2010021\u201008727\u20102\/TABLES\/3"},{"key":"e_1_2_11_17_1","unstructured":"UHN.Princess Margaret Cancer Centre \u2010 Annual Report 2021. 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