• Mari C de la Torre, Elisabet Palomera, Mateu Serra-Prat, Estel Güell, Joan Carles Yébenes, Jesús F Bermejo-Martín, and Jordi Almirall.
• Unidad Medicina Intensiva, Hospital de Mataró, Barcelona, Spain. Electronic address: mctorre@csdm.cat.
• J Crit Care. 2016 Oct 1; 35: 115-9.

BackgroundMortality in patients with community-acquired pneumonia (CAP) remains high despite improvements in treatment.ObjectiveTo determine immunoglobulin levels in patients with CAP and impact on disease severity and mortality.MethodologyObservational study. Hospitalized patients with CAP were followed up for 30 days. Levels of immunoglobulin G (IgG) and subclasses, immunoglobulin A (IgA) and immunoglobulin M (IgM) were measured in serum within 24 hours of CAP diagnosis.ResultsThree hundred sixty-two patients with CAP were enrolled -172 ward-treated and 190 intensive care unit-treated. Intensive care unit-treated patients had significantly lower values of IgG1, IgG2, IgG3 subclasses, and IgA than ward-treated patients. Thirty-eight patients died before 30 days. Levels of IgG2 were significantly lower in non-survivors than survivors (P=.004) and IgG2 <301 mg/dL was associated with poorer survival according to both the bivariate (hazard ratio 4.47; P<.001) and multivariate (HR 3.48; P=.003) analyses.ConclusionsPatients with CAP with IgG2 levels <301 mg/dL had a poorer prognosis and a higher risk of death. Our study suggests the usefulness of IgG2 to predict CAP evolution and to provide support measures or additional treatment.Copyright © 2016 Elsevier Inc. All rights reserved.

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