Climate change will further increase not only the frequency but also the intensity of extreme weather events. As a result, weather conditions favouring pneumonia occurrence - suddenly warmer weather during cold seasons - can increase due to higher meteorological variability which is also linked with climate change. These meteorological trends are expected to lead to adverse effects on peoples' health (Sohn et al., 2019). Community-acquired pneumonia, in the following simply called pneumonia, is one of the most common causes of death worldwide (Aliberti et al., 2021). At the same time, clear linkages between this disease and both meteorological and air conditions are present (Wang et al., 2021). Consequently, it is crucial to understand the effect of these meteorological and air conditions on pneumonia cases more deeply but also more specifically how these effects interact and depend on the personal characteristics and medical backgrounds of patients. It is well studied that especially extreme weather and air conditions, the latter including air quality and wind conditions, have an impact on the number of people hospitalized for pneumonia (Y. Liu et al., 2014; Onozuka et al., 2009). However, many studies analyse the effects of meteorological and air conditions separately with mortality data as an endpoint while predominantly covering the Asian continent and specifically larger cities (Basu & Samet, 2002; Chung et al., 2009; Ge et al., 2013). Therefore, data on other geographical regions and combinations of rural and metropolitan areas are required. Additionally, little is known about how personal characteristics (age, sex) and health background (smoking history, chronic lung diseases, heart insufficiency, overweight) affect the sensitivity of pneumonia cases regarding meteorological and air conditions. We close this research gap by analysing a prospective multicenter cohort that was treated in an in- or outpatient setting for pneumonia in 22 German hospitals or outpatient clinics. The dataset contains personal and health information for more than 10,000 patients. We match this data with daily regional meteorological and air.

Abstract: There are few data on mortality after discharge with community-acquired pneumonia (CAP). Therefore, we evaluated risk factors for 30-day post-discharge mortality after CAP. We included all patients of the prospective multi-national CAPNETZ study between 2002 and 2018 with (1) hospitalized CAP, (2) survival until discharge, and (3) complete follow-up data. The study endpoint was death within 30 days after discharge. We evaluated risk factors including demographics, comorbidities, admission CAP severity, and laboratory values and treatment-related factors in uni- and multivariable analyses. A total of 126 (1.6%) of 7882 included patients died until day 30 after discharge, corresponding to 26% of all 476 deaths. After multivariable analysis, we identified 10 independent risk factors: higher age, lower BMI, presence of diabetes mellitus, chronic renal or chronic neurological disease (other than cerebrovascular diseases), low body temperature or higher thrombocytes on admission, extended length of hospitalization, oxygen therapy during hospitalization, and post-obstructive pneumonia. By addition these factors, we calculated a risk score with an AUC of 0.831 (95%CI 0.822-0.839, p