{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T04:02:33Z","timestamp":1773288153886,"version":"3.50.1"},"reference-count":53,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2024,12,22]],"date-time":"2024-12-22T00:00:00Z","timestamp":1734825600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Bakground: The mortality rate from community-acquired pneumonia (CAP) or coronavirus disease 19 (COVID-19) is high, especially in hospitalized patients. This study aimed to assess the disturbances of glucose and lipid metabolism with in-hospital complications and short-term outcomes for patients with pneumonia with different etiologies. Methods: This observational study comprised 398 patients divided as follows: 155 with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia, 129 participants with viral CAP, and 114 with bacterial pneumonia. Results: Fasting plasma glucose (FPG) at admission and glycemic variation during hospitalization was linked with acute kidney injury (AKI) in bacterial CAP. Compared with a value &lt;110 mg\/dL for FPG at admission, levels between 110 and 126 mg\/dL are associated with mortality in both COVID-19 (OR = 3.462, 95% CI: 1.275\u20139.398, p = 0.015) and bacterial CAP participants (OR = 0.254; 95% CI: 0.069\u20130.935, p = 0.039), while a value \u2265126 mg\/dL was linked with mortality only in patients with SARS-CoV-2 (OR = 3.577, 95% CI: 1.166\u201310.976, p = 0.026). No relation between lipid biomarkers and complications or in-hospital outcomes was observed in all three participant groups. Conclusions: Patients with bacterial CAP are more prone to developing AKI due to increased FBG at admission and glycemic variations during hospitalization, while elevated FBG values at admission are associated with mortality in both COVID-19 and bacterial CAP.<\/jats:p>","DOI":"10.3390\/jcm13247832","type":"journal-article","created":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T10:58:55Z","timestamp":1734951535000},"page":"7832","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Metabolic Disturbances Associated with In-Hospital Complication and Mortality in Different Types of Pneumonia"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3718-8556","authenticated-orcid":false,"given":"Iulia","family":"F\u0103g\u0103r\u0103\u0219an","sequence":"first","affiliation":[{"name":"Department of Pneumology, \u201cIuliu Ha\u021bieganu\u201d University of Medicine and Pharmacy, 400332 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0977-8874","authenticated-orcid":false,"given":"Adriana","family":"Rusu","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Nutrition Diseases, \u201cIuliu Ha\u021bieganu\u201d University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hora\u021biu","family":"Com\u0219a","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Clinical Rehabilitation Hospital, \u201cIuliu Ha\u021bieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6401-7950","authenticated-orcid":false,"given":"Maria","family":"Cristea","sequence":"additional","affiliation":[{"name":"Faculty of Electrical Engineering, Technical University of Cluj-Napoca, 26-28 G. Bari\u021biu Street, 400027 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4017-5828","authenticated-orcid":false,"given":"Nicoleta-\u0218tefania","family":"Motoc","sequence":"additional","affiliation":[{"name":"Department of Pneumology, \u201cIuliu Ha\u021bieganu\u201d University of Medicine and Pharmacy, 400332 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ciprian","family":"Cristea","sequence":"additional","affiliation":[{"name":"Faculty of Electrical Engineering, Technical University of Cluj-Napoca, 26-28 G. Bari\u021biu Street, 400027 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7785-0121","authenticated-orcid":false,"given":"Corina Eugenia","family":"Budin","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of T\u00e2rgu Mure\u0219, 450142 T\u00e2rgu Mure\u0219, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0226-1733","authenticated-orcid":false,"given":"Ruxandra-Mioara","family":"R\u00e2jnoveanu","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine, \u201cIuliu Ha\u021bieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1306-2350","authenticated-orcid":false,"given":"Doina Adina","family":"Todea","sequence":"additional","affiliation":[{"name":"Department of Pneumology, \u201cIuliu Ha\u021bieganu\u201d University of Medicine and Pharmacy, 400332 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,22]]},"reference":[{"key":"ref_1","first-page":"n71","article-title":"Advances in the causes and management of community acquired pneumonia in adults","volume":"358","author":"Wunderink","year":"2017","journal-title":"BMJ"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1016\/S0140-6736(21)00630-9","article-title":"Community-acquired pneumonia","volume":"398","author":"Aliberti","year":"2021","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Morimura, A., Hamaguchi, S., Akeda, Y., and Tomono, K. (2021). Mechanisms Underlying Pneumococcal Transmission and Factors Influencing Host-Pneumococcus Interaction: A Review. Front. Cell. Infect. Microbiol., 11.","DOI":"10.3389\/fcimb.2021.639450"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1038\/s41579-018-0001-8","article-title":"Streptococcus pneumoniae: Transmission, colonization and invasion","volume":"16","author":"Weiser","year":"2018","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ccm.2016.11.012","article-title":"Epidemiology of Viral Pneumonia","volume":"38","author":"Jain","year":"2017","journal-title":"Clin. Chest Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1038\/s41579-020-00459-7","article-title":"Characteristics of SARS-CoV-2 and COVID-19","volume":"19","author":"Hu","year":"2021","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1708","DOI":"10.1056\/NEJMoa2002032","article-title":"Clinical Characteristics of Coronavirus Disease 2019 in China","volume":"382","author":"Guan","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1016\/S0140-6736(20)30566-3","article-title":"Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study","volume":"395","author":"Zhou","year":"2020","journal-title":"Lancet"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2255","DOI":"10.1056\/NEJMra2026131","article-title":"Cytokine Storm","volume":"383","author":"Fajgenbaum","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1798","DOI":"10.1016\/S0140-6736(09)60553-5","article-title":"Stress Hyperglycaemia","volume":"373","author":"Dungan","year":"2009","journal-title":"Lancet"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"810","DOI":"10.2337\/diacare.28.4.810","article-title":"The Relation Between Hyperglycemia and Outcomes in 2,471 Patients Admitted to the Hospital with Community-Acquired Pneumonia","volume":"28","author":"McAlister","year":"2005","journal-title":"Diabetes Care"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1097\/ACO.0000000000000706","article-title":"Glucose control in the ICU","volume":"32","author":"Gunst","year":"2019","journal-title":"Curr. Opin. Anaesthesiol."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Olariu, E., Pooley, N., Danel, A., Miret, M., and Preiser, J.C. (2018). A systematic scoping review on the consequences of stress-related hyperglycaemia. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0194952"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"R\u00e9a, R.R., Bernardelli, R.S., Kozesinski-Nakatani, A.C., Olandoski, M., Martins-Junior, M.J., Oliveira, M.C., and R\u00e9a-Neto, A. (2023). Dysglycemias in patients admitted to ICUs with severe acute respiratory syndrome due to COVID-19 versus other causes\u2014A cohort study. BMC Pulm. Med., 23.","DOI":"10.1186\/s12890-023-02439-y"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"4526","DOI":"10.1039\/C8AN01046C","article-title":"Lipid metabolism in inflammation-related diseases","volume":"143","author":"Zhang","year":"2018","journal-title":"Analyst"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"12543","DOI":"10.1128\/JVI.77.23.12543-12551.2003","article-title":"Role for Influenza Virus Envelope Cholesterol in Virus Entry and Infection","volume":"77","author":"Sun","year":"2003","journal-title":"J. Virol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2087","DOI":"10.3892\/mmr.2016.4781","article-title":"Native low-density lipoprotein promotes lipid raft formation in macrophages","volume":"13","author":"Song","year":"2016","journal-title":"Mol. Med. Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1091\/mbc.e03-06-0445","article-title":"Scavenger Receptor BI (SR-BI) Clustered on Microvillar Extensions Suggests that This Plasma Membrane Domain Is a Way Station for Cholesterol Trafficking between Cells and High-Density Lipoprotein","volume":"15","author":"Peng","year":"2004","journal-title":"Mol. Biol. Cell"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1418","DOI":"10.1164\/ajrccm\/148.5.1418","article-title":"Medical Section pf the American Lung Association: Guidelines for the Initial Management of Adults with Community-acquired Pneumonia: Diagnosis, Assessment of Severity, and Initial Antimicrobial Therapy","volume":"148","author":"Niederman","year":"2013","journal-title":"Am. Rev. Respir. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e241","DOI":"10.1017\/S0950268820002368","article-title":"CURB-65 may serve as a useful prognostic marker in COVID-19 patients within Wuhan, China: A retrospective cohort study","volume":"148","author":"Guo","year":"2020","journal-title":"Epidemiol. Infect."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1136\/thorax.58.5.377","article-title":"Defining community acquired pneumonia severity on presentation to hospital: An international derivation and validation study","volume":"58","author":"Lim","year":"2003","journal-title":"Thorax"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1159\/000339789","article-title":"KDIGO Clinical Practice Guideline for Acute Kidney Injury","volume":"120","author":"Khwaja","year":"2012","journal-title":"Nephron Clin. Pract."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1007\/s00134-020-05954-2","article-title":"Novel coronavirus infection during the 2019\u20132020 epidemic: Preparing intensive care units\u2014The experience in Sichuan Province, China","volume":"46","author":"Liao","year":"2020","journal-title":"Intensive Care Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1086\/511159","article-title":"Infectious Diseases Society of America\/American Thoracic Society Consensus Guidelines on the management of community-acquired pneumonia in adults","volume":"44","author":"Mandell","year":"2007","journal-title":"Clin. Infect. Dis."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/S2213-8587(18)30136-0","article-title":"Glycaemic variability in diabetes: Clinical and therapeutic implication","volume":"7","author":"Ceriello","year":"2019","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Gao, S., Liu, Q., Chen, H., Yu, M., and Li, H. (2021). Predictive value of stress hyperglycemia ratio for the occurrence of acute kidney injury in acute myocardial infarction patients with diabetes. BMC Cardiovasc. Disord., 21.","DOI":"10.1186\/s12872-021-01962-2"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Yao, M., Hao, Y., Wang, T., Xie, M., Li, H., Feng, J., and Ma, D. (2023). A review of stress-induced hyperglycaemia in the context of acute ischaemic stroke: Definition, underlying mechanisms, and the status of insulin therapy. Front. Neurol., 14.","DOI":"10.3389\/fneur.2023.1149671"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1681","DOI":"10.1001\/jama.295.14.1681","article-title":"Activation of Oxidative Stress by in Patients with Type 2 Diabetes","volume":"295","author":"Monnier","year":"2006","journal-title":"JAMA"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2004","DOI":"10.1093\/ndt\/gfu046","article-title":"Interaction between systemic inflammation and renal tubular epithelial cells","volume":"29","author":"Cantaluppi","year":"2014","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1186\/s13054-015-0908-7","article-title":"Time in blood glucose range 70 to 140 mg\/dl >80% is strongly associated with increased survival in non-diabetic critically ill adults","volume":"19","author":"Krinsley","year":"2015","journal-title":"Crit. Care"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1007\/s11892-018-0988-2","article-title":"Critical care management of stress-induced hyperglycemia","volume":"18","author":"Vanhorebeek","year":"2018","journal-title":"Curr. Diabetes Rep."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1097\/CCM.0b013e318283d124","article-title":"Stress hyperglycemia: An essential survival response","volume":"41","author":"Marik","year":"2013","journal-title":"Crit. Care Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1097\/SHK.0000000000000052","article-title":"A unified theory of sepsis- induced acute kidney injury: Inflammation, microcirculatory dysfunction, bioenergetics, and the tubular cell adaptation to injury","volume":"41","author":"Gomez","year":"2014","journal-title":"Shock"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1097\/CCM.0b013e3181cc4be9","article-title":"Glucose variability is associated with intensive care unit mortality","volume":"38","author":"Hermanides","year":"2010","journal-title":"Crit. Care Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1007\/s12020-016-0867-z","article-title":"Blood glucose fluctuation accelerates renal injury involved to inhibit the AKT signaling pathway in diabetic rats","volume":"53","author":"Ying","year":"2016","journal-title":"Endocrine"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"S171","DOI":"10.1007\/s00592-012-0398-x","article-title":"Acute and chronic fluctuations in blood glucose levels can increase oxidative stress in type 2 diabetes mellitus","volume":"49","author":"Chang","year":"2012","journal-title":"Acta Diabetol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1097\/MD.0000000000001251","article-title":"Cumulative cardiovascular polypharmacy is associated with the risk of acute kidney injury in elderly patients","volume":"94","author":"Chao","year":"2015","journal-title":"Medicine"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Clav\u00e9, S., Rousset-Rouvi\u00e8re, C., Daniel, L., and Tsimaratos, M. (2019). The invisible threat of non-steroidal anti-inflammatory drugs for kidneys. Front. Pediatr., 7.","DOI":"10.3389\/fped.2019.00520"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"177","DOI":"10.2147\/IJNRD.S212010","article-title":"NSAID associated bilateral renal infarctions: A case report","volume":"12","author":"Jeon","year":"2019","journal-title":"Int. J. Nephrol. Renov. Dis."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1177\/1932296820924469","article-title":"Glycemic Characteristics and Clinical Outcomes of COVID-19 Patients Hospitalized in the United States","volume":"14","author":"Bode","year":"2020","journal-title":"J. Diabetes Sci. Technol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2345","DOI":"10.2337\/dc20-1380","article-title":"Hyperglycemia at hospital admission is associated with severity of the prognosis in patients hospitalized for COVID-19: The Pisa COVID-19 study","volume":"43","author":"Coppelli","year":"2020","journal-title":"Diabetes Care"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2168","DOI":"10.1002\/jmv.26608","article-title":"Admission fasting plasma glucose is an independent risk factor for 28-day mortality in patients with COVID-19","volume":"93","author":"Yang","year":"2021","journal-title":"J. Med. Virol."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"F\u0103g\u0103r\u0103\u0219an, I., Rusu, A., Cristea, M., Bala, C.G., Vulturar, D.M., Cristea, C., and Todea, D.A. (2022). Predictors of New-Onset Diabetes in Hospitalized Patients with SARS-CoV-2 Infection. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph192013230"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1186\/s13054-021-03861-6","article-title":"Hyperglycemia and insulin resistance in COVID-19 versus non-COVID critical illness: Are they really different?","volume":"25","author":"Langouche","year":"2021","journal-title":"Crit. Care."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2128","DOI":"10.1016\/j.cgh.2020.04.040","article-title":"ACE2 Expression in Pancreas May Cause Pancreatic Damage After SARS-CoV-2 Infection","volume":"18","author":"Liu","year":"2020","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/S0749-0704(05)70154-8","article-title":"Stress-induced hyperglycemia","volume":"17","author":"McCowen","year":"2001","journal-title":"Crit. Care Clin."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1097\/00000542-200608000-00006","article-title":"Variability of blood glucose concentration and short-term mortality in critically ill patients","volume":"105","author":"Egi","year":"2006","journal-title":"Anesthesiology"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1007\/s11739-008-0206-3","article-title":"Glucose dysmetabolism and prognosis in critical illness","volume":"4","author":"Lazzeri","year":"2009","journal-title":"Intern. Emerg. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1093\/bja\/aeu187","article-title":"Metabolic response to the stress of critical illness","volume":"113","author":"Preiser","year":"2014","journal-title":"Br. J. Anaesth."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1586\/14787210.2013.825442","article-title":"Prediction of prognosis by markers in community-acquired pneumonia","volume":"11","author":"Viasus","year":"2013","journal-title":"Expert Rev. Anti-Infect. Ther."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1136\/thx.2008.105312","article-title":"Biomarkers improve mortality prediction by prognostic scales in community-acquired pneumonia","volume":"64","author":"Reyes","year":"2009","journal-title":"Thorax"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1111\/acem.13889","article-title":"Accuracy of Biomarkers for the Diagnosis of Adult Community-acquired Pneumonia: A Meta-analysis","volume":"27","author":"Ebell","year":"2020","journal-title":"Acad. Emerg. Med."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Nouvenne, A., Ticinesi, A., Folesani, G., Cerundolo, N., Prati, B., Morelli, I., Guida, L., Lauretani, F., Maggio, M., and Aloe, R. (2016). The association of serum procalcitonin and high-sensitivity C-reactive protein with pneumonia in elderly multimorbid patients with respiratory symptoms: Retrospective cohort study. BMC Geriatr., 16.","DOI":"10.1186\/s12877-016-0192-7"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/24\/7832\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:57:50Z","timestamp":1760115470000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/24\/7832"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,22]]},"references-count":53,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["jcm13247832"],"URL":"https:\/\/doi.org\/10.3390\/jcm13247832","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,22]]}}}