Objective  To investigate the potential effect of glucocorticoids (referred to as 'hormones' here) on decreasing case fatality rate in patients with human immunodeficiency virus (HIV) negative Pneumocystis jirovecii pneumonia (PJP). Methods  The clinical data of a cohort of 93 patients that were diagnosed with HIV-negative PJP at Jiangxi Provincial People's Hospital between April 2019 and April 2022 were retrospectively analyzed. These patients were classified into two groups based on the partial pressure of oxygen in arterial blood (PaO₂), specifically PaO₂ ≥70 mm Hg and PaO₂ <70 mm Hg. The association between case fatality rate and various factors such as underlying diseases, hormone use, mechanical ventilation, and others was examined. Results  Over a period of three years, 93 cases of HIV-negative PJP were identified. The most prevalent underlying diseases were solid organ transplantation (n=34, 36.6%), rheumatic system diseases (n=26, 28.0%), and malignant tumors (n=15, 16.1%). 51 cases had arterial PaO₂ levels ≥70 mm Hg, while 42 cases had levels <70 mm Hg. Moreover, 19 patients required invasive ventilation, 39 patients were treated with non-invasive ventilation, while 50 patients received oxygenation using a nasal cannula. Out of the 93 patients, 31 died from the disease, resulting in an overall case fatality rate of 33.3%. Meanwhile, 62 patients survived. In patients with arterial PaO₂ levels ≥70 mm Hg, the administration of hormones did not significantly affect the case fatality rate (P > 0.05); In patients with arterial PaO₂ level <70 mm Hg, the administration of hormones did not significantly affect the case fatality rate (P > 0.05). Conclusion  Hormone use did not contribute to improved survival rates in HIV-negative PJP patients, regardless of arterial PaO₂ level.

Citation： OUYANG Guoquan, XIAO Zuke. Glucocorticoids do not improve the survival rate of human immunodeficiency virus negative Pneumocystis jirovecii pneumonia. Chinese Journal of Respiratory and Critical Care Medicine, 2023, 22(7): 476-479. doi: 10.7507/1671-6205.202209020 Copy