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. 2023 Apr 12;10(5):ofad192.
doi: 10.1093/ofid/ofad192. eCollection 2023 May.

Risk of Pneumococcal Disease in US Adults by Age and Risk Profile

Lindsay R Grant  1 , Aster Meche  2 , Leah McGrath  2 , Amanda Miles  2 , Tamuno Alfred  3 , Qi Yan  1 , Erica Chilson  1
Affiliations

Risk of Pneumococcal Disease in US Adults by Age and Risk Profile

Lindsay R Grant et al. Open Forum Infect Dis. .

Abstract

Background: Older age and certain medical conditions are known to modify the risk of pneumococcal disease among adults. We quantified the risk of pneumococcal disease among adults with and without medical conditions in the United States between 2016 and 2019.

Methods: This retrospective cohort study used administrative health claims data from Optum's de-identified Clinformatics Data Mart Database. Incidence rates of pneumococcal disease-all-cause pneumonia, invasive pneumococcal disease (IPD), and pneumococcal pneumonia-were estimated by age group, risk profile (healthy, chronic, other, and immunocompromising medical condition), and individual medical condition. Rate ratios and 95% CIs were calculated comparing adults with risk conditions with age-stratified healthy counterparts.

Results: Among adults aged 18-49 years, 50-64 years, and ≥65 years, the rates of all-cause pneumonia per 100 000 patient-years were 953, 2679, and 6930, respectively. For the 3 age groups, the rate ratios of adults with any chronic medical condition vs healthy counterparts were 2.9 (95% CI, 2.8-2.9), 3.3 (95% CI, 3.2-3.3), and 3.2 (95% CI, 3.2-3.2), while the rate ratios of adults with any immunocompromising condition vs healthy counterparts were 4.2 (95% CI, 4.1-4.3), 5.8 (95% CI, 5.7-5.9), and 5.3 (95% CI, 5.3-5.4). Similar trends were observed for IPD and pneumococcal pneumonia. Persons with other medical conditions, such as obesity, obstructive sleep apnea, and neurologic disorders, were associated with increased risk of pneumococcal disease.

Conclusions: The risk of pneumococcal disease was high among older adults and adults with certain risk conditions, particularly immunocompromising conditions.

Keywords: Streptococcus pneumoniae; chronic condition; comorbidity; pneumococcal disease; pneumonia.

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Conflict of interest statement

Potential conflicts of interest. L.R.G., A.Mi., L.M., A.Me., T.A., Q.Y., and E.C. are employees of Pfizer and may hold stock and/or stock options.

Figures

Figure 1.
Figure 1.
A, Study design. B, Patient flow chart.
Figure 2.
Figure 2.
Rates of all-cause pneumonia and invasive pneumococcal disease among adults with chronic medical conditions or immunocompromising conditions by number of conditions. Abbreviation: IPD, invasive pneumococcal disease.
See this image and copyright information in PMC

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