The clinical features of viral respiratory infections in individuals with rheumatic immune diseases, renal diseases, hematological diseases, and healthy individuals were analyzed. Additionally, the impact of immunosuppressive therapy on the clinical manifestations of viral respiratory infections was explored. Patients attending the outpatient clinic of the Department of Rheumatology and Immunology at Suzhou Hospital of Traditional Chinese Medicine from October 1, 2023, to May 1, 2024, as well as healthy individuals undergoing physical examinations, were selected for the study. Data were collected through questionnaires, including information on viral respiratory infections, vaccination status, clinical symptoms, and medication use. A total of 425 questionnaires were collected. There were significant differences among groups in recovery time, disease classification, vaccination rates, and specific clinical symptoms (p < 0.05). Immunosuppressive therapy significantly reduced the incidence of runny nose (p = 0.046) and chills (p < 0.001) but was associated with a higher proportion of ordinary cases, suggesting that it may be associated with increased disease severity (p = 0.012). Multivariate logistic regression analysis showed that the use of glucocorticoids significantly prolonged both recovery time (p = 0.007) and duration of cough (p = 0.044). The rheumatology group experienced shorter recovery time (p = 0.016) and a lower risk of fever (38°C–39°C), whereas the hematology group had an increased risk of high fever (>39°C; p = 0.037). Vaccination significantly increased the likelihood of mild cases (p = 0.041), serving as an important protective factor. Additionally, younger patients and females tended to exhibit relatively more severe clinical manifestations. Significant differences between the groups existed in terms of symptomatology, clinical symptoms, and time to recovery, and the use of immunosuppressive therapy, especially glucocorticoids, may have exacerbated the patient’s condition. Vaccination provided a protective effect for patients undergoing immunosuppressive therapy, mitigating the condition to a certain extent.