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Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia

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Delayed Radiological Resolution: A Comparative Longitudinal Study of Viral Pneumonia Evolution in Diabetic vs.

Ana Maria Mihai^1,2,3, Ovidiu Rosca^2,3, Florina Lucaciu^1,2,3

¹Doctoral School, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania.

Diseases (Basel, Switzerland)

|June 25, 2026

Summary

Diabetic patients with viral pneumonia show higher initial severity and a persistent radiological lag in lung recovery. This delay is primarily due to higher baseline severity and comorbidities, not diabetes itself.

Keywords:

attrition bias chest radiography diabetes mellitus hyperglycemia lethal split prognosis pulmonary clearance radiological lag risk stratification viral pneumonia

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Area of Science:

Infectious Diseases
Pulmonology
Endocrinology

Background:

Diabetic patients experience more severe viral respiratory infections.
Radiological lung recovery in diabetic patients with viral pneumonia is not well understood.

Purpose of the Study:

To quantify and compare radiological lung recovery in diabetic versus non-diabetic patients with viral pneumonia.
To investigate factors contributing to delayed radiological clearance in diabetic patients.

Main Methods:

Prospective study of 430 patients with viral pneumonia.
Radiological severity and pleural effusion scored at admission and day 6 follow-up.
Attrition analysis to compare mortality and departure patterns.

Main Results:

Diabetics had significantly higher baseline radiological severity (p < 0.0001).
A radiological lag persisted in diabetics at day 6 (p < 0.0001), but this was attenuated after adjusting for baseline severity and comorbidities.
Diabetic attrition was characterized by higher early mortality (60.9%) compared to non-diabetics.

Conclusions:

The observed radiological lag in diabetic patients with viral pneumonia is largely explained by higher initial disease severity and comorbidity burden.
Diabetes itself does not appear to be an independent acute factor for delayed radiographic resolution.
Early mortality in high-risk diabetic cases may underestimate the true disease burden and recovery lag.