Clinical characteristics of patients with severe viral pneumonia and their correlation with infectious pathogens

WANG Cong-wei; HU Han-rong; SHUI Jing-wei; LIU Qing-yan; LIU Yun-tao

doi:10.13820/j.cnki.gdyx.20251536

Abstract：Objective To investigate the clinical characteristics of patients with severe pneumonia caused by re-spiratory viral infections and to analyze their correlation with different pathogens.Methods Patients with severe COVID-19,who were admitted by the Medical Team of Guangdong Provincial Hospital of Traditional Chinese Medicine from De-cember 2019 to January 2023,were enrolled as COVID-19 group,and then were divided into 3 subgroups according to the different prevalent strain types:wild type group,Delta group,and Omicron group.Patients with other lower respiratory tract viral infection from January 2013 to December 2023 were included as control group.Electronic medical records of these subjects,including baseline information,pre-admission symptoms,and laboratory test results were collected.The clinical characteristics of these patients in different groups were compared.Results Across all types of viral infections causing severe pneumonia,the proportion of male patients was high,with Omicron-infected patients showing the highest male ratio(71.9％).The median age of patients with other lower respiratory tract viral infections was 46 years,signifi-cantly younger than that of patients with severe CO VID-19(64 years).Patients with pre-existing comorbidities were more likely to progress to severe disease.Initial symptoms in severe COVID-19 cases included fever(66.7％),cough(62.0％),dyspnea(47.1％),fatigue(39.2％),and sputum production(22.9％).In contrast,patients with severe pneumonia caused by other respiratory viruses most commonly presented with cough(79.6％),fever(75.7％),dyspnea(70.0％),sputum production(64.1％),and fatigue(18.4％).Abnormal laboratory indicators were less frequent in patients infected with the wild-type strain of SARS-CoV-2 than in those with Delta,Omicron,or other respiratory vi-ruses,the latter groups showing generally higher rates of abnormal findings.Conclusion Regardless of the causative pathogen,males are more likely to develop severe pneumonia.As SARS-CoV-2 evolves,the clinical manifestations of severe COVID-19 increasingly resemble those of severe pneumonia caused by other lower respiratory tract viruses,reduc-ing their diagnostic specificity.