Severity of Pneumonia in Adult Asthma Patients in a Tertiary Care Hospital

Open Access

Abstract

Background: Pneumonia is an important cause of morbidity and mortality among patients with bronchial asthma. Early identification of severe pneumonia is essential for appropriate management and prevention of adverse outcomes. Objective: To assess the severity and clinical outcomes of pneumonia among adult asthma patients admitted to a tertiary care hospital. Methods & Materials: This observational study was conducted in the Department of Respiratory Medicine, Monno Medical College and Hospital, Bangladesh, from January 2025 to December 2025. A total of 350 consecutive patients aged ≥18 years with bronchial asthma and clinically and radiologically diagnosed pneumonia were enrolled. Demographic, asthma-related, clinical, laboratory, radiological, treatment, and outcome data were collected. Pneumonia severity was assessed using the Pneumonia Severity Index (PSI) and CURB-65. Statistical analysis was performed using SPSS version 25.0, with p<0.05 considered statistically significant. Results: Cough (92.6%), dyspnea (88.6%), fever (81.7%), and sputum production (79.4%) were the predominant presentations. Elevated CRP was present in 77.7%, while SpO₂ <90% occurred in 24.0%. According to PSI, 46.9% were classified as class IV-V, while 15.5% had CURB-65 scores of 3-5. Severe pneumonia was significantly associated with age >60 years, previous asthma exacerbation, poor asthma control, bilateral infiltrates, multilobar involvement, SpO₂ <90%, and elevated CRP (all p<0.05). Severe cases had longer hospital stays, more complications, greater respiratory support requirements, and higher mortality (11.0% vs. 2.2%, p=0.001). Conclusion: Severe pneumonia was common among hospitalized adult asthma patients and was associated with substantial morbidity and mortality. Early severity assessment and close monitoring may improve clinical management and outcomes.