Objective  To investigate the effect of inhaled corticosteroids (ICS) on adverse outcomes in chronic obstructive pulmonary disease (COPD) (COPD-CAP) patients with community-acquired pneumonia (CAP).

Methods  The clinical data of COPD-CAP patients who visited the respiratory department of respiratory of Wenzhou Integrated Traditional Chinese and Western Medicine Hospital from January 2021 to January 2023 was retrosspective collected. They were divided into an ICS group and a non ICS group based on whether they were eligible for ICS treatment. A univariate analysis was used to compare the differences in general data, imaging outcomes (multilobed infiltration and pleural effusion), and clinical outcomes (non-invasive mechanical ventilation, invasive mechanical ventilation, ICU admission, and 30-day mortality) between two groups. The Logistic regression was used to explore the relationship between ICS and imaging and clinical outcomes.

Result  A total of 120 COPD patients were included in this study, including 38 in the ICS group, 62 in the non ICS group . The univariate results showed that COPD- CAP patients in the ICS group had lower GOLD scores, PSI scores, and CURB-65 scores (P<0.05). The multivariate Logistic regression showed that the use of ICS reduces the risk of multi leaf infiltration [OR=0.291, 95%CI (0.123, 0.687), P=0.005], pleural effusion [OR=0.309, 95%CI(0.105, 0.908), P=0.033], non-invasive mechanical ventilation [OR=0.040, 95%CI(0.012, 0.129), P<0.001], invasive mechanical ventilation [OR=0.099, 95%CI(0.013, 0.783), P=0.028], ICU occupancy [OR=0.207, 95%CI(0.056, 0.762), P=0.018], and 30- day mortality [OR=0.179, 95%CI(0.039, 0.822), P=0.027].

Conclusion  ICS reduces the risk of multilobed infiltration, pleural effusion, mechanical ventilation usage, ICU occupancy, and 30-day mortality in COPD patients admitted to CAP.

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