Mortality due to respiratory infections: an alert study before COVID-19 pandemic

Pathologica. 2022 Apr;114(2):146-151. doi: 10.32074/1591-951X-306.

Abstract

Objective: Respiratory tract infections remain a common problem in clinical practice with high morbidity and mortality worldwide. In Portugal, pneumonia was the third leading death cause in 2018. Due to COVID-19 pandemic, there is a growing concern about the burden of respiratory diseases and preventable risk factors. The present study started before the pandemic and its aim was to determine the occurrence of pneumonia/bronchopneumonia in a postmortem series and to characterize its circumstantial context.

Methods: A retrospective anatomopathological study was performed on cases with acute pneumonia/bronchopneumonia at the Medicolegal Portuguese Institute (2011-2017).

Results: In an autopsy series of 737 patients, 521 were male and 675 presented comorbidities. The mean age was 63.87 ± 19.8 years. The most common acquisition site was community (65.1%), as natural death (65.5%). Concerning the manner of death, most cases (48.0%) were sudden deaths, followed by accidents (29.2%). A statistically significant association was observed between the medicolegal etiology and the place of infection acquisition, with higher prevalence of natural obitus (91.0%) in community-acquired pneumonia/bronchopneumonia versus higher prevalence of violent obitus in hospital-acquired pneumonia/bronchopneumonia (82.1%) (p < 0.001).

Conclusions: Forensic anatomopathological postmortem data may contribute to better understand community and hospital pulmonary infections.

Keywords: bronchopneumonia; pneumonia; postmortem study.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bronchopneumonia* / epidemiology
  • COVID-19* / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia* / epidemiology
  • Respiratory Tract Infections* / epidemiology
  • Retrospective Studies