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Introduction: The aim was to evaluate the clinical characteristics and evolution of community acquired pneumonia with associated paraneumonic pleural effusion(PE-CAP). Methods: Prospective observational study of all immunocompetent patients hospitalized for PE-CAP in our Pulmonology Service between 2005 and 2019.We considered PE-CAP when compatible radiology.Pleural effusion (PE) was classified as complicated based on its biochemical and/or radiological characteristics.Empyema criteria:macroscopic pus or germs in microbiological analysis of pleural fluid (PF). Results: 3417 patients, of which 221(6.5%) had PE. PF analysis was performed in 158 patients, of which in 134 cases the microbiology was negative and in 24 positive (9 Streptococcus spp.,8 S.pneumoniae,3 S.aureus,3 S.viridans,1 Eikinella corrodens). Bacteremia was observed in 34(15.4%) patients with PE: 31 cases S.pneumoniae,2 S.pyogenes and 1 S. viridans. Positive blood culture and positive microbiology of PF were observed in 4 patients (3 S.pneumoniae and 1 S.viridans). Conclusions: 6.5% of our patients had PE-CAP but only 1.9% complicated PE. Microbiological diagnosis was obtained in 15% of analyzed PF, and S. pneumoniae was the most frequent microorganism. Patients with CAP and PE were younger, less frequently vaccinated and with less comorbidities.They had more bacteremia, therapeutic failure,longer hospital stay,and later clinical stability, although they had similar mortality.

Objective: Analyze the role of a new-onset atrial arrhythmia (AA) in the prognosis of pneumococcal pneumonia(PP). Methods: Prospective observational study, including immunocompetent adults hospitalized for PP in 2 hospitals for a 18 year period. The bacteriological diagnosis was based on the result of urinary antigen test and/or blood culture. We evaluated patients with PP who presented a new-onset AA during hospitalization and classified them according to the time (early AA -on hospital admission- or late- 24h after admission) and the duration of the AA (paroxysmal or persistent). All survived patients were followed-up for 6- months period after discharged. Patients with stable or exacerbated chronic AA were excluded. Survival was analyzed using the Kaplan-Meier method. Results: 1092 patients included. Of them 109 had a new-onset AA. An early AA was documented in 87 patients and late onset in 22. AA was persistent in 31 patients and paroxysmal in 78.Figure 1:demographics and in-hospital outcomes.Figure 2: Kaplan-Meier survival curve for patients according to time and duration of the AA (p Conclusions: 1.Nearly 8.3% of patients had a new AA during their hospitalization for PP. 2.New onset AA was associated with worst outcome and higher mortality. 3. Late and persistent new-onset AA were associated with worse prognosis.

CF-COVID19-Spain Registry Group., [Background] Given the high incidence of confirmed infection by SARS-CoV-2 and mortality by COVID-19 in the Spanish population, its impact was analysed among persons with Cystic Fibrosis (CF) as a group at risk of a worse evolution. The possible causes of the incidence observed in them are explained and how CF Units have faced this health challenge is detailed., [Methods] Retrospective descriptive observational study, for which a Spanish CF Patients with Confirmed COVID-19 Registry is created, requesting information on number of people affected between 8 March–16 May 2020 and their clinical-demographic characteristics from the CF Units participating in the European Cystic Fibrosis Society Patient Registry (ECFSPR). The accumulated incidence is calculated, compared with that of the general population. Additionally, a survey (CF-COVID19-Spain) is carried out on prevention of SARS-CoV-2 infection, workings of CF Units and possible reasons for the incidence observed., [Results] COVID-19 was diagnosed in eight CF patients, one of whom had received a lung transplant. The accumulated incidence was 32/10000 in CF patients and 49/10000 in the general population. General death rate was 5.85/10000 while no CF patients included in the ECFSPR died. The characteristics of those affected and the results of the survey are described., [Conclusions] Despite being considered a disease at high risk of severe COVID-19, the low incidence and mortality in CF patients in Spain contrasts with the figures for the general population. The possible factors that would explain such findings are discussed, with the help of the results of the CF-COVID19-Spain survey.

Objective: identify the microbial aetiology of community acquired pneumonia (CAP) and analyze it´s relationship with the pneumonia severity on admission. Methods: prospective observational study of all immunocompetent patients admitted for CAP to our Hospital between 11/2005 and 06/2018. Bacteriological diagnosis was obtained from urinary antigen test (UAT) for Legionella and S. pneumoniae, blood culture (BC), serologic test for atypical bacteria (SAB), pharyngeal swab for respiratory viruses, bronchoscopy or thoracocentesis. Pneumonia severity was estimated by PSI score. Results: 3306 patients (1210 women), mean age:63.3 years;etiology obtained in 1150. BC performed in 2303 (69.7%), being positive in 7.8%. UAT performed in 99.5%, positive for S. pneumoniae in 23.2% and for Legionella in 3.7%. SAB performed in 257 (7.7%), 38 positive. Bronchoscopy performed in 207 patients obtaining microbial aetiology in 22. Microorganisms observed in the pleural fluid of 18 patients. Table 1: relationship between microbial diagnosis and PSI. Table 2: profitability of UAT and BC in pneumococcal pneumonia according to PSI. Conclusions: 1. Bacteriological diagnosis was obtained in almost 35% of the patients, with pneumococcus being the microorganism most frequently identified. 2. Patients with a microbiological diagnosis had higher PSI score. 3. This correlation is due to the identification of S. pneumoniae, not being evident in the rest of microorganisms