Characterizing the timing and causes of death in community-acquired pneumonia

Fatimah Al-Zergani; Alessandra Meddis; Clara Lundetoft Clausen; Pernille Ravn; Marcus Sebastian Roldgaard; Lilian Kolte; Hacer Sarac; Markus Fally; Simone Bastrup Israelsen; Thomas Benfield

doi:10.1016/j.cmi.2026.03.016

Characterizing the timing and causes of death in community-acquired pneumonia

Fatimah Al-Zergani^*
, Alessandra Meddis
, Clara Lundetoft Clausen
, Pernille Ravn
, Marcus Sebastian Roldgaard
, Lilian Kolte
, Hacer Sarac
, Markus Fally
, Simone Bastrup Israelsen
, Thomas Benfield

^*Corresponding author for this work

Abstract

OBJECTIVE: We assessed the timing and causes of death in subjects hospitalised with community-acquired pneumonia (CAP).

METHODS: A cohort of 2,918 immunocompetent adults hospitalised with CAP followed for 90 days between 2017-2020. Each immediate and underlying cause of death was independently assessed by two physicians.

RESULTS: Overall, 19% (562/2918) of patients died within 90 days. Pneumonia-related deaths (243/562 [43%]) primarily occurred within the first two weeks of admission, and respiratory failure was the most common cause of death overall (272/562 [48%]). Later deaths were either unrelated to pneumonia (159/562 [28%]) or unknown (160/562 [28%]), if they occurred out of hospital. Of deceased patients 314/562 (56%) transitioned to palliative care within the last 7 days of life.

CONCLUSION: In a contemporary cohort, CAP-related mortality occurred early while later deaths were driven by comorbidities and increased frailty. Understanding the burden of CAP through specific cause-of death assessment is critical to evaluate treatment effects, and to improve outcomes for increasingly frail patient populations.

Original language	English
Journal	Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
ISSN	1198-743X
DOIs	https://doi.org/10.1016/j.cmi.2026.03.016
Publication status	E-pub ahead of print - 14 Mar 2026

Keywords

CAP
Causes of death
Community-acquired pneumonia
Hospitalization
Mortality

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Al-Zergani, F., Meddis, A., Clausen, C. L., Ravn, P., Roldgaard, M. S., Kolte, L., Sarac, H., Fally, M., Israelsen, S. B., & Benfield, T. (2026). Characterizing the timing and causes of death in community-acquired pneumonia. Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases. Advance online publication. https://doi.org/10.1016/j.cmi.2026.03.016

Characterizing the timing and causes of death in community-acquired pneumonia. / Al-Zergani, Fatimah; Meddis, Alessandra; Clausen, Clara Lundetoft et al.
In: Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 14.03.2026.

Research output: Contribution to journal › Journal article › Research › peer-review

Al-Zergani, F, Meddis, A, Clausen, CL , Ravn, P , Roldgaard, MS , Kolte, L, Sarac, H, Fally, M, Israelsen, SB & Benfield, T 2026, 'Characterizing the timing and causes of death in community-acquired pneumonia', Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases. https://doi.org/10.1016/j.cmi.2026.03.016

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title = "Characterizing the timing and causes of death in community-acquired pneumonia",

abstract = "OBJECTIVE: We assessed the timing and causes of death in subjects hospitalised with community-acquired pneumonia (CAP).METHODS: A cohort of 2,918 immunocompetent adults hospitalised with CAP followed for 90 days between 2017-2020. Each immediate and underlying cause of death was independently assessed by two physicians.RESULTS: Overall, 19\% (562/2918) of patients died within 90 days. Pneumonia-related deaths (243/562 [43\%]) primarily occurred within the first two weeks of admission, and respiratory failure was the most common cause of death overall (272/562 [48\%]). Later deaths were either unrelated to pneumonia (159/562 [28\%]) or unknown (160/562 [28\%]), if they occurred out of hospital. Of deceased patients 314/562 (56\%) transitioned to palliative care within the last 7 days of life.CONCLUSION: In a contemporary cohort, CAP-related mortality occurred early while later deaths were driven by comorbidities and increased frailty. Understanding the burden of CAP through specific cause-of death assessment is critical to evaluate treatment effects, and to improve outcomes for increasingly frail patient populations.",

keywords = "CAP, Causes of death, Community-acquired pneumonia, Hospitalization, Mortality",

author = "Fatimah Al-Zergani and Alessandra Meddis and Clausen, \{Clara Lundetoft\} and Pernille Ravn and Roldgaard, \{Marcus Sebastian\} and Lilian Kolte and Hacer Sarac and Markus Fally and Israelsen, \{Simone Bastrup\} and Thomas Benfield",

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doi = "10.1016/j.cmi.2026.03.016",

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T1 - Characterizing the timing and causes of death in community-acquired pneumonia

AU - Al-Zergani, Fatimah

AU - Meddis, Alessandra

AU - Clausen, Clara Lundetoft

AU - Ravn, Pernille

AU - Roldgaard, Marcus Sebastian

AU - Kolte, Lilian

AU - Sarac, Hacer

AU - Fally, Markus

AU - Israelsen, Simone Bastrup

AU - Benfield, Thomas

PY - 2026/3/14

Y1 - 2026/3/14

N2 - OBJECTIVE: We assessed the timing and causes of death in subjects hospitalised with community-acquired pneumonia (CAP).METHODS: A cohort of 2,918 immunocompetent adults hospitalised with CAP followed for 90 days between 2017-2020. Each immediate and underlying cause of death was independently assessed by two physicians.RESULTS: Overall, 19% (562/2918) of patients died within 90 days. Pneumonia-related deaths (243/562 [43%]) primarily occurred within the first two weeks of admission, and respiratory failure was the most common cause of death overall (272/562 [48%]). Later deaths were either unrelated to pneumonia (159/562 [28%]) or unknown (160/562 [28%]), if they occurred out of hospital. Of deceased patients 314/562 (56%) transitioned to palliative care within the last 7 days of life.CONCLUSION: In a contemporary cohort, CAP-related mortality occurred early while later deaths were driven by comorbidities and increased frailty. Understanding the burden of CAP through specific cause-of death assessment is critical to evaluate treatment effects, and to improve outcomes for increasingly frail patient populations.

AB - OBJECTIVE: We assessed the timing and causes of death in subjects hospitalised with community-acquired pneumonia (CAP).METHODS: A cohort of 2,918 immunocompetent adults hospitalised with CAP followed for 90 days between 2017-2020. Each immediate and underlying cause of death was independently assessed by two physicians.RESULTS: Overall, 19% (562/2918) of patients died within 90 days. Pneumonia-related deaths (243/562 [43%]) primarily occurred within the first two weeks of admission, and respiratory failure was the most common cause of death overall (272/562 [48%]). Later deaths were either unrelated to pneumonia (159/562 [28%]) or unknown (160/562 [28%]), if they occurred out of hospital. Of deceased patients 314/562 (56%) transitioned to palliative care within the last 7 days of life.CONCLUSION: In a contemporary cohort, CAP-related mortality occurred early while later deaths were driven by comorbidities and increased frailty. Understanding the burden of CAP through specific cause-of death assessment is critical to evaluate treatment effects, and to improve outcomes for increasingly frail patient populations.

KW - CAP

KW - Causes of death

KW - Community-acquired pneumonia

KW - Hospitalization

KW - Mortality

UR - https://www.scopus.com/pages/publications/105034535817

U2 - 10.1016/j.cmi.2026.03.016

DO - 10.1016/j.cmi.2026.03.016

M3 - Journal article

C2 - 41839423

SN - 1198-743X

JO - Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases

JF - Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases

ER -

Characterizing the timing and causes of death in community-acquired pneumonia

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Keywords

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