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Respiratory infection risk in primary Sjögren’s syndrome complicated with interstitial lung disease: a retrospective study

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A LETTER TO THE EDITOR to this article was published on 23 February 2024

A LETTER TO THE EDITOR to this article was published on 23 February 2024

Abstract

Objectives

To explore clinical and laboratory characteristics of primary Sjögren’s syndrome (pSS) complicated with interstitial lung disease (ILD) and investigate the risk factors for respiratory infections in pSS-ILD.

Methods

A cohort of 162 pSS-ILD patients in Peking University People’s Hospital from 2015 to 2020 were included, and all medical records were completely collected. We screened 53 patients suffering from respiratory infections as study cases, compared with 109 age- and sex-matched controls. Differences between infection group and control group were compared. Univariate and multivariate binary logistic regression tests were conducted to identify potential risk factors for respiratory infections in pSS-ILD patients.

Results

Among 162 pSS-ILD patients, 32.72% (53/162) suffered from respiratory infections. The most frequent type of ILD was nonspecific interstitial pneumonia (32.08%, 51/159), and the most common type of pathogen was bacteria (64.25%, 34/53). Infection group showed higher levels of ESSDAI (P < 0.001), CRP (P < 0.001), ESR (P = 0.003), and C3 (P = 0.020) but lower level of DLCO-SB (P = 0.015). Univariate logistic model revealed that PAH and the use of glucocorticoid increased infection risk in pSS-ILD patients. On multivariate logistic regression analysis, PAH (OR = 3.993, 95% CI = 1.192–13.373, P = 0.025) and severe reduction of DLCO (DLCO-SB < 40%, OR = 4.625, 95% CI = 1.281–16.702, P = 0.019) were significantly associated with increased risk of respiratory infections in pSS-ILD patients.

Conclusion

Among pSS-ILD patients, the most frequent type of ILD was nonspecific interstitial pneumonia. In patients with infection, bacteria were the most common pathogen. Higher levels of ESSDAI, CRP, ESR, and C3 may be correlated with increased infection risk. PAH and reduction of DLCO were identified as independent risk factors.

Key Points

• ILD and infectious diseases severely affect pSS patient conditions.

• Higher levels of ESSDAI, CRP, ESR, and C3 may be correlated with increased infection risks in pSS-ILD.

• PAH and reduction of DLCO were identified as independent risk factors for lower respiratory infection.

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Data availability

The data underlying this article will be shared on reasonable request to the corresponding author.

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Funding

This study was supported by the National Natural Science Foundation of China and by the Beijing Sci-Tech Program [Z191100006619114], NSFC (Natural Science Foundation of China) Grant [81701607], and Peking University People’s Hospital Scientific Research Development Funds [RDZH2022-03].

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Authors and Affiliations

  1. Department of Rheumatology and Immunology, Beijing Key Laboratory for Rheumatism Mechanism and Immune Diagnosis, Peking University People’s Hospital, 11 Xizhimen South St, Beijing, 100044, China

    Xingyu Zhou, Hao Li, Naidi Wang, Yuebo Jin & Jing He

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  1. Xingyu Zhou
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  2. Hao Li
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  3. Naidi Wang
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  4. Yuebo Jin
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  5. Jing He
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Contributions

XZ and HL drafted the manuscript and performed most of the data collection. JH and YJ conceived the study and participated in its design and coordination, and interpreted the data. All authors read and approved the final manuscript.

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Correspondence to Yuebo Jin or Jing He.

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Zhou, X., Li, H., Wang, N. et al. Respiratory infection risk in primary Sjögren’s syndrome complicated with interstitial lung disease: a retrospective study. Clin Rheumatol 43, 707–715 (2024). https://doi.org/10.1007/s10067-023-06803-5

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  • DOI: https://doi.org/10.1007/s10067-023-06803-5

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