Long-term impacts of Legionnaires’ disease on health and wellbeing: rationale, study design and baseline findings of a matched cohort study (LongLEGIO)

BACKGROUND AND STUDY AIMS: Is there a post-acute infection syndrome for Legionnaires’ disease? Legionnaires’ disease is a form of primarily community-acquired pneumonia caused by Legionella spp. bacteria. Legionnaires’ disease and other forms of bacterial community-acquired pneumonia may lead to pe...

Full description

Saved in:
Bibliographic Details
Main Authors: Melina Bigler, Malina Vaucher, Manuel Wiederkehr, Sophia Brülisauer, Werner C. Albrich, Sarah Dräger, Valentin Gisler, Isabel Akers, Daniel Mäusezahl
Format: Article
Language:English
Published: SMW supporting association (Trägerverein Swiss Medical Weekly SMW) 2025-06-01
Series:Swiss Medical Weekly
Online Access:https://smw.ch/index.php/smw/article/view/4333
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850114948164747264
author Melina Bigler
Malina Vaucher
Manuel Wiederkehr
Sophia Brülisauer
Werner C. Albrich
Sarah Dräger
Valentin Gisler
Isabel Akers
Daniel Mäusezahl
author_facet Melina Bigler
Malina Vaucher
Manuel Wiederkehr
Sophia Brülisauer
Werner C. Albrich
Sarah Dräger
Valentin Gisler
Isabel Akers
Daniel Mäusezahl
author_sort Melina Bigler
collection DOAJ
description BACKGROUND AND STUDY AIMS: Is there a post-acute infection syndrome for Legionnaires’ disease? Legionnaires’ disease is a form of primarily community-acquired pneumonia caused by Legionella spp. bacteria. Legionnaires’ disease and other forms of bacterial community-acquired pneumonia may lead to persistent health and wellbeing impairments. It remains unclear whether these are caused by the community-acquired pneumonia-causing pathogen or the pneumonia itself. We present the rationale and design of a matched cohort study to investigate the persistent health impacts of Legionnaires’ disease and compare them with persistent manifestations of other bacterial (Legionella test-negative) community-acquired pneumonia. We also present baseline characteristics of the study cohorts. METHODS: Legionnaires’ disease patients and Legionella test-negative community-acquired pneumonia patients with confirmed or clinically suspected bacterial aetiology were recruited from university and cantonal/regional hospitals and matched for sex, age, hospital type and date of diagnosis. Questionnaire-based interviews are conducted at baseline and 2, 6 and 12 months after the start of appropriate antibiotics. The questionnaires focus on patient-reported outcome measures and cover long-term symptoms, use of health services and health-related quality of life. RESULTS: Between June 2023 and June 2024, 59 patients with Legionnaires’ disease (59.3% male, median age 69 years [interquartile range [IQR]: 57–80]) and 60 patients with other bacterial (Legionella test-negative) community-acquired pneumonia (63.3% male, median age 69 years [IQR: 60–79]) were enrolled. Admission to the intensive care unit was required for 13.6 % of Legionnaires’ disease patients and 8.3 % of other bacterial community-acquired pneumonia patients. Chronic kidney failure was more prevalent among Legionnaires’ disease patients (15.3% vs 10.0%), while chronic obstructive pulmonary disease (20.0% vs 11.9%), malignancies (33.3% vs 13.6%) and an immunocompromised status (25.0% vs 13.6%) were more common in Legionella test-negative community-acquired pneumonia patients. Furthermore, Legionella test-negative community-acquired pneumonia patients reported lower baseline quality of life scores than Legionnaires’ disease patients. Differences in pneumonia severity, comorbidities and self-reported quality of life scores will be accounted for in future analyses. CONCLUSIONS: The LongLEGIO study will contribute to research on post-acute infection syndromes and provide the data for a more holistic assessment of the disease burden of Legionnaires’ disease.
format Article
id doaj-art-ad276da718604f6984efbba56e8cc526
institution OA Journals
issn 1424-3997
language English
publishDate 2025-06-01
publisher SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
record_format Article
series Swiss Medical Weekly
spelling doaj-art-ad276da718604f6984efbba56e8cc5262025-08-20T02:36:42ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972025-06-01155610.57187/s.4333Long-term impacts of Legionnaires’ disease on health and wellbeing: rationale, study design and baseline findings of a matched cohort study (LongLEGIO)Melina Bigler0Malina Vaucher1Manuel Wiederkehr2Sophia Brülisauer3Werner C. Albrich4Sarah Dräger5Valentin Gisler6Isabel Akers7Daniel Mäusezahl8Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, SwitzerlandSwiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, SwitzerlandSwiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland Division of Infectious Diseases, Infection Prevention and Travel Medicine, HOCH Health Ostschweiz, Kantonsspital St. Gallen, St. Gallen, Switzerland Division of Infectious Diseases, Infection Prevention and Travel Medicine, HOCH Health Ostschweiz, Kantonsspital St. Gallen, St. Gallen, SwitzerlandDivision of Internal Medicine, University Hospital Basel, Basel, Switzerland; Department of Clinical Research, University of Basel, Basel, SwitzerlandInstitute for Laboratory Medicine, Cantonal Hospital Aarau, Aarau, Switzerland; Department for Infectious Diseases and Infection Prevention, Cantonal Hospital Aarau, Aarau, SwitzerlandDivision of Internal Medicine, Spital Limmattal, Zurich-Schlieren, SwitzerlandSwiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland BACKGROUND AND STUDY AIMS: Is there a post-acute infection syndrome for Legionnaires’ disease? Legionnaires’ disease is a form of primarily community-acquired pneumonia caused by Legionella spp. bacteria. Legionnaires’ disease and other forms of bacterial community-acquired pneumonia may lead to persistent health and wellbeing impairments. It remains unclear whether these are caused by the community-acquired pneumonia-causing pathogen or the pneumonia itself. We present the rationale and design of a matched cohort study to investigate the persistent health impacts of Legionnaires’ disease and compare them with persistent manifestations of other bacterial (Legionella test-negative) community-acquired pneumonia. We also present baseline characteristics of the study cohorts. METHODS: Legionnaires’ disease patients and Legionella test-negative community-acquired pneumonia patients with confirmed or clinically suspected bacterial aetiology were recruited from university and cantonal/regional hospitals and matched for sex, age, hospital type and date of diagnosis. Questionnaire-based interviews are conducted at baseline and 2, 6 and 12 months after the start of appropriate antibiotics. The questionnaires focus on patient-reported outcome measures and cover long-term symptoms, use of health services and health-related quality of life. RESULTS: Between June 2023 and June 2024, 59 patients with Legionnaires’ disease (59.3% male, median age 69 years [interquartile range [IQR]: 57–80]) and 60 patients with other bacterial (Legionella test-negative) community-acquired pneumonia (63.3% male, median age 69 years [IQR: 60–79]) were enrolled. Admission to the intensive care unit was required for 13.6 % of Legionnaires’ disease patients and 8.3 % of other bacterial community-acquired pneumonia patients. Chronic kidney failure was more prevalent among Legionnaires’ disease patients (15.3% vs 10.0%), while chronic obstructive pulmonary disease (20.0% vs 11.9%), malignancies (33.3% vs 13.6%) and an immunocompromised status (25.0% vs 13.6%) were more common in Legionella test-negative community-acquired pneumonia patients. Furthermore, Legionella test-negative community-acquired pneumonia patients reported lower baseline quality of life scores than Legionnaires’ disease patients. Differences in pneumonia severity, comorbidities and self-reported quality of life scores will be accounted for in future analyses. CONCLUSIONS: The LongLEGIO study will contribute to research on post-acute infection syndromes and provide the data for a more holistic assessment of the disease burden of Legionnaires’ disease. https://smw.ch/index.php/smw/article/view/4333
spellingShingle Melina Bigler
Malina Vaucher
Manuel Wiederkehr
Sophia Brülisauer
Werner C. Albrich
Sarah Dräger
Valentin Gisler
Isabel Akers
Daniel Mäusezahl
Long-term impacts of Legionnaires’ disease on health and wellbeing: rationale, study design and baseline findings of a matched cohort study (LongLEGIO)
Swiss Medical Weekly
title Long-term impacts of Legionnaires’ disease on health and wellbeing: rationale, study design and baseline findings of a matched cohort study (LongLEGIO)
title_full Long-term impacts of Legionnaires’ disease on health and wellbeing: rationale, study design and baseline findings of a matched cohort study (LongLEGIO)
title_fullStr Long-term impacts of Legionnaires’ disease on health and wellbeing: rationale, study design and baseline findings of a matched cohort study (LongLEGIO)
title_full_unstemmed Long-term impacts of Legionnaires’ disease on health and wellbeing: rationale, study design and baseline findings of a matched cohort study (LongLEGIO)
title_short Long-term impacts of Legionnaires’ disease on health and wellbeing: rationale, study design and baseline findings of a matched cohort study (LongLEGIO)
title_sort long term impacts of legionnaires disease on health and wellbeing rationale study design and baseline findings of a matched cohort study longlegio
url https://smw.ch/index.php/smw/article/view/4333
work_keys_str_mv AT melinabigler longtermimpactsoflegionnairesdiseaseonhealthandwellbeingrationalestudydesignandbaselinefindingsofamatchedcohortstudylonglegio
AT malinavaucher longtermimpactsoflegionnairesdiseaseonhealthandwellbeingrationalestudydesignandbaselinefindingsofamatchedcohortstudylonglegio
AT manuelwiederkehr longtermimpactsoflegionnairesdiseaseonhealthandwellbeingrationalestudydesignandbaselinefindingsofamatchedcohortstudylonglegio
AT sophiabrulisauer longtermimpactsoflegionnairesdiseaseonhealthandwellbeingrationalestudydesignandbaselinefindingsofamatchedcohortstudylonglegio
AT wernercalbrich longtermimpactsoflegionnairesdiseaseonhealthandwellbeingrationalestudydesignandbaselinefindingsofamatchedcohortstudylonglegio
AT sarahdrager longtermimpactsoflegionnairesdiseaseonhealthandwellbeingrationalestudydesignandbaselinefindingsofamatchedcohortstudylonglegio
AT valentingisler longtermimpactsoflegionnairesdiseaseonhealthandwellbeingrationalestudydesignandbaselinefindingsofamatchedcohortstudylonglegio
AT isabelakers longtermimpactsoflegionnairesdiseaseonhealthandwellbeingrationalestudydesignandbaselinefindingsofamatchedcohortstudylonglegio
AT danielmausezahl longtermimpactsoflegionnairesdiseaseonhealthandwellbeingrationalestudydesignandbaselinefindingsofamatchedcohortstudylonglegio