{
  "abstract": "Background Pneumocystis jirovecii pneumonia (PJP) is a significant opportunistic infection in immunocompromised patients. This study explores whether steroid use or underlying immunosuppression influences the likelihood of developing PJP and affects clinical outcomes, particularly morbidity and mortality.Methods A 5-year retrospective analysis was conducted of patients diagnosed with PJP between 2019–2024. Data collected included age, comorbidities (Charlson Comorbidity Index), lymphocyte count, steroid use and duration, immunosuppression status, number of hospitalisations, and total days spent in hospital. Mortality data were recorded. Binary variables were derived for immunosuppression and oral corticosteroid (OCS) exposure. Correlation analysis was performed to explore associations with clinical outcomes.Results 73 patients were diagnosed with PJP pneumonia in the time period and the mean age was 65 years. 58% (n=42) died during or after their admission with PCP. 35% (n=25) were oncology patients. 62% of patients received a form of immunosuppressive therapy, and 66% received OCS specifically. Immunosuppression and steroid use showed a moderate correlation (r = 0.30). A weak correlation was observed between immunosuppression and mortality (r = 0.10), with negligible correlation between steroid use and mortality (r = 0.02). No strong linear relationship was observed between steroid duration and hospital stay or mortality. moderate positive correlation (r = 0.34) was found between Charlson Comorbidity Index and mortality, suggesting that higher comorbidity may increase mortality risk. Neither steroid use nor immunosuppression was significantly associated with mortality in logistic regression (p > 0.05). Predictive modelling (random forest) indicated that age and comorbidity index were the strongest predictors of mortality.Conclusion In patients with PJP, neither immunosuppressive therapy or OCS showed a strong linear association with mortality or morbidity. Comorbidity index and age were identified as stronger predictors of mortality. These findings suggest that comorbid conditions may be more critical in predicting poor outcomes in PJP than steroid therapy or immunosuppression alone. Further multivariable modelling is needed to identify independent risk factors for poor outcomes in this population.",
  "authors": [
    {
      "affiliations": [
        "Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK"
      ],
      "name": "C Dominic"
    },
    {
      "affiliations": [
        "Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK"
      ],
      "name": "E Kakouri"
    },
    {
      "affiliations": [
        "Wythenshawe Hospital, Manchester NHS Foundation Trust, Manchester, UK"
      ],
      "name": "V Nanda"
    },
    {
      "affiliations": [
        "Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK"
      ],
      "name": "S Drazich-Taylor"
    },
    {
      "affiliations": [
        "Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK"
      ],
      "name": "S Dervisevic"
    },
    {
      "affiliations": [
        "Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK"
      ],
      "name": "A Kamath"
    }
  ],
  "title": "P180 The impact of steroids & immunosuppression on outcomes in patients with pneumocystis jirovecii pneumonia (PJP): a retrospective analysis at a large tertiary centre",
  "uid": "82dd43a2-d81a-5968-a047-080b59e68f0f"
}