Community-acquired pneumonia in adults: acute and long-term complications

Annually, community-acquired pneumonia (CAP) affects millions of individuals worldwide, resulting in more than 200 000 hospital admissions in England alone. CAP is a major cause of morbidity and mortality. Previous studies have explored the causes, risk factors, and the clinical course of CAP in detail. Sepsis and respiratory failure are important well-recognised consequences of progressive infection and have been researched extensively. In this Review, we focus on complications of CAP beyond the natural history of the condition. These sequelae of CAP often have long-term implications for patients and encompass a wide range of physical, functional, and psychosocial impairments, including reduced functional ability and persistent symptoms that adversely affect quality of life. Research on complications after CAP has increased since the COVID-19 pandemic. A growing body of literature informs clinical trials and guides clinical management. We explore the recovery trajectory and discuss updates in the management of post-CAP pleural infection, the established risk of cardiovascular events after CAP, and association of CAP with cognitive impairment and lung cancer. Finally, we conclude that improved long-term data, standardisation, and targeted research are needed to understand, prevent, and manage these outcomes effectively.