{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T12:39:18Z","timestamp":1764333558524,"version":"3.40.5"},"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:00:00Z","timestamp":1747353600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NOVA National School of Public Health"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Community-acquired pneumonia (CAP) is a major cause of hospitalization that leads to substantial morbidity, mortality, and costs. Evaluating CAP trends over time is important to understand patterns and the impact of public health interventions. This study aims to describe the characteristics and trends in the incidence of adults hospitalized with CAP in Portugal between 2010 and 2018. In this study, we included hospitalization data, prevalence of comorbidities, and population data. CAP hospitalizations of adults (\u226518y) living in mainland Portugal discharged from public hospitals were identified using ICD-9-CM or ICD-10-CM codes. Based on previous CAP studies, we selected nine relevant comorbidities. We described the frequency and incidence of CAP hospitalizations per sex, age group, comorbidity, and year of discharge. Trends were explored using Joinpoint regression. We observed 470,545 CAP hospitalizations falling into the 2010\u201318 period. The majority were males (54.8%) and aged \u226575 years (65.3%). Most often recorded comorbidities were congestive heart failure (26.4%), diabetes (25.5%), and chronic pulmonary disease (19.2%). The Joinpoint regression identified a gradual decline in the incidence rates of CAP hospitalizations for both sexes and all age groups. Of the nine comorbidities selected, seven showed a progressive increase in incidence rates followed by a subsequent decline (all except HIV\/AIDS and chronic renal disease). Our findings offer valuable insights for selecting priority groups for public health interventions and design strategies to mitigate the burden of CAP.<\/jats:p>","DOI":"10.1371\/journal.pone.0322623","type":"journal-article","created":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T20:06:33Z","timestamp":1747425993000},"page":"e0322623","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Characteristics and incidence trends of adults hospitalized with community-acquired pneumonia in Portugal, pre-pandemic"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8140-5004","authenticated-orcid":true,"given":"Joana","family":"Carneiro","sequence":"first","affiliation":[]},{"given":"Rita","family":"Teixeira","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0843-0630","authenticated-orcid":true,"given":"Andreia","family":"Leite","sequence":"additional","affiliation":[]},{"given":"Maria","family":"Lahuerta","sequence":"additional","affiliation":[]},{"given":"Julie","family":"Catusse","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1410-388X","authenticated-orcid":true,"given":"Mohammad","family":"Ali","sequence":"additional","affiliation":[]},{"given":"S\u00edlvia","family":"Lopes","sequence":"additional","affiliation":[]}],"member":"340","published-online":{"date-parts":[[2025,5,16]]},"reference":[{"issue":"9998","key":"pone.0322623.ref001","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1016\/S0140-6736(15)60733-4","article-title":"Community-acquired pneumonia","volume":"386","author":"E Prina","year":"2015","journal-title":"Lancet"},{"key":"pone.0322623.ref002","author":"World Health Organization","year":"2024"},{"key":"pone.0322623.ref003","doi-asserted-by":"crossref","DOI":"10.1787\/82129230-en","volume-title":"Health at a Glance: Europe 2020: State of Health Cycle","author":"OECD","year":"2020"},{"key":"pone.0322623.ref004","volume-title":"Health at a Glance: Europe 2018","author":"OECD","year":"2018"},{"issue":"6","key":"pone.0322623.ref005","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1080\/00325481.2015.1074030","article-title":"Community-acquired pneumonia: An overview","volume":"127","author":"LA Mandell","year":"2015","journal-title":"Postgrad Med"},{"issue":"6","key":"pone.0322623.ref006","doi-asserted-by":"crossref","first-page":"2140","DOI":"10.1378\/chest.125.6.2140","article-title":"Treatment costs of community-acquired pneumonia in an employed population","volume":"125","author":"GL Colice","year":"2004","journal-title":"Chest"},{"issue":"1","key":"pone.0322623.ref007","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1136\/thx.2009.129502","article-title":"Clinical and economic burden of community-acquired pneumonia among adults in Europe","volume":"67","author":"T Welte","year":"2012","journal-title":"Thorax"},{"key":"pone.0322623.ref008","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.rmed.2018.02.007","article-title":"Burden of pneumococcal community-acquired pneumonia in adults across Europe: A literature review","volume":"137","author":"A Torres","year":"2018","journal-title":"Respir Med"},{"issue":"1","key":"pone.0322623.ref009","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/s12890-019-1045-x","article-title":"Factors associated with in-hospital mortality from community-acquired pneumonia in Portugal: 2000-2014","volume":"20","author":"E Pessoa","year":"2020","journal-title":"BMC Pulm Med"},{"issue":"1","key":"pone.0322623.ref010","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1186\/s12913-020-05620-9","article-title":"Defining ambulatory care sensitive conditions for adults in Portugal","volume":"20","author":"J Sarmento","year":"2020","journal-title":"BMC Health Serv Res"},{"issue":"2","key":"pone.0322623.ref011","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1164\/rccm.201801-0139WS","article-title":"Future research directions in pneumonia. 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