Abstract: Background: Pneumocystis pneumonia (PCP) incidence in acute myeloid leukemia (AML) patients have not been well described and some studies have shown the risk of this infection in these groups of patients. In this systematic review, we reviewed the published studies about PCP in AML to evaluate the PCP incidence and outcomes in these patients and then focuses on its immunological mechanism. Method: All articles reviewed in this collection are from recruited sites: PubMed and Embase databases. No time limit was considered for article searching. The following keywords were used: (“Pneumonia, Pneumocystis” OR Pneumocystis Pneumonia” OR “Pneumocystis jirovecii”), AND (“leukemia, myeloid, acute OR acute myeloid leukemia”). Our search strategy yielded 356 articles. After implementing the exclusion and inclusion criteria, the final papers were selected and reviewed. Result: By our search, 356 articles were found (316 in PubMed and 40 in Embase). After the implementation of inclusion and exclusion criteria, seven papers remained. A total of seven articles with a total number of 41 patients were included. Conclusion: Affected patients appear to have a clear resistance to PCP infection despite chemotherapy and bone marrow suppression due to the preservation of a specific immunological milieu in the lung. In fact, may be due to immunological stability of the lungs that remains intact. Further studies are needed.
Purpose: Considering the anti-inflammatory effect of atorvastatin and the role of medical comorbidities such as hypertension and coronary artery disease on prognosis of the COVID-19 patients, we aimed to assess the effect of atorvastatin add-on therapy on mortality due to COVID-19. Methods: We conducted a retrospective cohort study, including patients who were hospitalized with confirmed diagnosis of severe COVID-19. Baseline characteristics and related clinical data of patients were recorded. Clinical outcomes consist of in hospital mortality, need for invasive mechanical ventilation and hospital length of stay. COX regression analysis models were used to assess the association of independent factors to outcomes. Results: Atorvastatin was administered for 421 out of 991 patients. The mean age was 61.640±17.003 years. Older age, higher prevalence of hypertension and coronary artery disease reported in patients who received atorvastatin. These patients had shorter hospital length of stay (P=0.001). Based on COX proportional hazard model, in hospital use of atorvastatin was associated to decrease in mortality (HR=0.679, P=0.005) and lower need for invasive mechanical ventilation (HR=0.602, P=0.014). Conclusions: Atorvastatin add-on therapy in patient with severe COVID-19 was associated with lower in hospital mortality and reduced the risk of need for invasive mechanical ventilation which support to continue the prescription of the medication.