JOPIC

The JoPIC is an independent-unbiased, peer-reviewed, and open-access journal of current national and international issues and reviews for original clinical and experimental research, interesting case reports, surgical techniques, differential diagnoses, editorial opinions, letters to the editor, and educational papers in pulmonology, thoracic surgery, occupational diseases, allergology, and intensive care medicine.

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Original Article
Investigation of systemic inflammation levels in patients followed up with a diagnosis of pneumonia
Aims: Although pneumonia is typically considered a localized infection, it can trigger a systemic inflammatory response. Systemic inflammation is characterized by cytokine release throughout the body, increased acute phase reactants, and immune cell imbalance, which can elevate disease severity and the risk of complications. Recently, hematological parameters such as the systemic immune-inflammation index (SII) and systemic inflammatory response index (SIRI) have gained prominence in assessing this inflammatory response. This study aimed to evaluate systemic inflammation levels in patients diagnosed with pneumonia using SII and SIRI, and to analyze their correlation with classical inflammatory biomarkers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR).
Methods: A total of 50 patients hospitalized and followed up with a diagnosis of pneumonia between 01.01.2023 and 01.06.2025 at Yozgat Bozok University Research and Training Hospital's Departments of Pulmonology and Internal Medicine, and 50 healthy individuals admitted to the same clinics during the same period were included in the study. Demographic data (age, gender), smoking status, clinical histories, laboratory values, treatment processes, complete blood count (CBC), CRP level, and ESR were recorded. Patients with active malignancy, hematological or autoimmune diseases, or those under immunosuppressive therapy were excluded. SII and SIRI values were calculated for each participant.
Results: Of the participants, 66% were male and 34% female, with a mean age of 61.98 ± 16.78 years in the pneumonia group and 59.20 ± 16.10 years in the control group. SII was significantly higher in the pneumonia group (1301.28 ± 886.78) compared to the control group (545.20 ± 488.26), as was SIRI (5.66 ± 6.58 vs. 0.91 ± 1.21) (p<0.001 for both). Smokers exhibited significantly higher SII (1535.9 ± 1094.1 vs. 977.2 ± 560.3) and SIRI (7.51 ± 8.13 vs. 3.10 ± 3.72) values than non-smokers (p=0.031 and p=0.014, respectively).
Conclusion: This study demonstrated that new-generation inflammation indices such as SII and SIRI reflect the intensity of inflammatory response in pneumonia patients and show significant correlation with CRP levels. These findings suggest that integrating these indices into clinical practice may serve as effective tools in evaluating disease prognosis and monitoring treatment response.


1. Marrie TJ. Community-acquired pneumonia.Clin Infect Dis. 1994; 18(4):501-515. doi:10.1093/clinids/18.4.501
2. Cill&oacute;niz C, Rodr&iacute;guez-Hurtado D, Torres A. characteristics and management of community-acquired pneumonia in the era of global aging. Med Sci (Basel). 2018;6(2):35. doi:10.3390/medsci6020035
3. Yang CH, Wang XY, Zhang YH, Ding N. SIRI and SII as potential biomarkers of disease activity and lupus nephritis in systemic lupus erythematosus. Front Immunol. 2025;16:1530534. doi:10.3389/fimmu. 2025.1530534
4. Wang K, Diao F, Ye Z, et al. Prognostic value of systemic immune-inflammation index in patients with gastric cancer.Chin J Cancer. 2017; 36(1):75. doi:10.1186/s40880-017-0243-2
5. Hu B, Yang XR, Xu Y, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res. 2014;20(23):6212-6222. doi:10.1158/1078-0432.CCR-14-0442
6. Tortum F, Tekin E, Ozdal E. Use of the systemic immune-inflammation index to predict the severity of pneumonia in the emergency department. Med Res J. 2023;8(3):186-191. doi:10.5603/mrj.96312
7. Zeng X, Shen LI, Liu H. Systemic immune-inflammation index predicts stroke-associated pneumonia. J Apoplexy Nervous Dis. 2020;37(3):222-226.
8. Corica B, Tartaglia F, D&rsquo;Amico T, Romiti GF, Cangemi R. Sex and gender differences in community-acquired pneumonia. Intern Emerg Med. 2022;17(6):1575-1588. doi:10.1007/s11739-022-02999-7
9. Lee J, Taneja V, Vassallo R. Cigarette smoking and inflammation: cellular and molecular mechanisms.J Dent Res. 2012;91(2):142-149. doi: 10.1177/0022034511421200
10. Yang R, Chang Q, Meng X, Gao N, Wang W. Prognostic value of systemic immune-inflammation index in cancer: a meta-analysis.J Cancer. 2018;9(18):3295-3302. doi:10.7150/jca.25691
11. Wu J, Yan L, Chai K. Systemic immune-inflammation index is associated with disease activity in patients with ankylosing spondylitis. J Clin Lab Anal. 2021;35(9):e23964. doi:10.1002/jcla.23964
12. Shao L, Yu B, Lyu Y, Fan S, Gu C, Wang H. The clinical value of novel inflammatory biomarkers for predicting Mycoplasma pneumoniae infection in children.J Clin Lab Anal. 2025;39(3):e25150. doi:10.1002/jcla.25150
13. Elmeazawy R, Ayoub D, Morad LM, El-Moazen AMF. Role of systemic immune-inflammatory index and systemic inflammatory response index in predicting the diagnosis of necrotizing pneumonia in children. BMC Pediatr. 2024;24(1):496. doi:10.1186/s12887-024-04818-8
14. Miao H, Ge D, Wang Q, et al. Predictive significance of systemic immune-inflammation index combined with prealbumin for postoperative pneumonia following lung resection surgery.BMC Pulm Med. 2024;24(1):277. doi:10.1186/s12890-024-03086-7
15. Suwadi A, Tandarto K, Laksono S. Systemic immune-inflammation index as a potential biomarker for predicting acute pulmonary embolism: a systematic review.Rom J Intern Med. 2024;62(3):231-240. doi:10.2478/rjim-2024-0016
16. Zheng F, Gao W, Xiao Y, et al. Systemic inflammatory response index as a predictor of stroke-associated pneumonia in patients with acute ischemic stroke treated by thrombectomy: a retrospective study.BMC Neurol. 2024;24(1):287. doi:10.1186/s12883-024-03783-0
17. Wang RH, Wen WX, Jiang ZP, et al. The clinical value of neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), platelet-to-lymphocyte ratio (PLR) and systemic inflammation response index (SIRI) for predicting the occurrence and severity of pneumonia in patients with intracerebral hemorrhage.Front Immunol. 2023;14:1115031. doi:10.3389/fimmu.2023.1115031
18. Lee CH, Kim K, Hyun MK, Jang EJ, Lee NR, Yim JJ. Use of inhaled corticosteroids and the risk of tuberculosis.Thorax. 2013;68(12):1105-1113. doi:10.1136/thoraxjnl-2012-203175
19. Tabakoglu NT, Celik M. Investigation of the systemic immune inflammation (SII) index as an indicator of morbidity and mortality in type 2 diabetic retinopathy patients in a 4-year follow-up period. Medicina (Kaunas). 2024;60(6):855. doi:10.3390/medicina60060855
20. Fine MJ, Auble TE, Yealy DM, et al. A prediction rule to identify low-risk patients with community-acquired pneumonia.N Engl J Med. 1997;336(4):243-250. doi:10.1056/NEJM199701233360402
21. Chalmers JD, Singanayagam A, Akram AR, et al. Severity assessment tools for predicting mortality in hospitalised patients with community-acquired pneumonia. Systematic review and meta-analysis.Thorax. 2010;65(10):878-883. doi:10.1136/thx.2009.133280
22. Liu X, Guan G, Cui X, Liu Y, Liu Y, Luo F. Systemic immune-inflammation index (SII) can be an early indicator for predicting the severity of acute pancreatitis: a retrospective study.Int J Gen Med. 2021; 14:9483-9489. doi:10.2147/IJGM.S343110
23. Wang W, Yao W, Tang W, Li Y, Lv Q, Ding W. Nonlinear associations of systemic immune-inflammation index with all-cause and cardiovascular mortality in US adults with rheumatoid arthritis.Sci Rep. 2024;14(1):16639. doi:10.1038/s41598-024-67750-y
24. Martin SS, Aday AW, Almarzooq ZI, et al. Systemic immune-inflammation index is associated with adverse outcomes in rheumatoid arthritis. Circulation. 2024;149(8):e347-e913. doi:10.1161/CIR. 0000000000001209
25. Ding L, Jiang Y. Biomarkers associated with the diagnosis and prognosis of Mycoplasma pneumoniaepneumonia in children: a review.Front Cell Infect Microbiol. 2025;15:1552144. doi:10.3389/fcimb.2025.1552144
26. Prina E, Ferrer M, Ranzani OT, et al. Thrombocytosis is a marker of poor outcome in community-acquired pneumonia.Chest. 2013;143(3): 767-775. doi:10.1378/chest.12-1235
Volume 3, Issue 3, 2025
Page : 70-75
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