Clinical Characteristics of Influenza Pneumonia in Patients with Lung Adenocarcinoma Receiving Immunotherapy

Abstract

The objective of this study is to examine the general characteristics, clinical manifestations, laboratory findings, and imaging features of patients with lung adenocarcinoma who develop influenza pneumonia while undergoing immunotherapy. A retrospective analysis was conducted on the clinical data of 48 patients with lung adenocarcinoma and pulmonary infections who received immunotherapy as a stand-alone treatment between September 2022 and September 2024 at the Affiliated Hospital of North China University of Science and Technology. Clinical characteristics of patients with concurrent influenza pneumonia were assessed. When compared with the non-influenza pneumonia group, patients in the influenza pneumonia group demonstrated significantly more severe systemic symptoms, elevated urea nitrogen levels, reduced platelet counts, decreased serum albumin levels, lower Prognostic Nutritional Index values, and higher prevalence of bilateral and multilobed lung involvement. Chest imaging frequently revealed ground glass opacities, reticular patterns, and the “crazy paving” sign. Additionally, this group exhibited higher CURB-65 scores and an increased need for intensive care unit admission, with all comparisons yielding p values <0.05. Hypotension emerged as a potential factor influencing mortality in both groups (odds ratio = 9.094, p = 0.041). Among the 19 patients with lung adenocarcinoma and influenza pneumonia, 89.5% had coinfections with other pathogens. Gram-negative bacterial infections were the most common (64.7%), with Klebsiella pneumoniae subspecies, Pseudomonas aeruginosa, and Haemophilus parainfluenzae identified as the leading pathogens. Fungal infections, primarily involving Aspergillus species, accounted for 23.5% of cases. General characteristics, clinical manifestations, laboratory findings, and imaging features are essential references for the diagnosis and management of lung adenocarcinoma complicated by influenza pneumonia. Particular attention should be directed to blood pressure fluctuations, with careful monitoring of low blood pressure, especially when accompanied by bacterial infections.