# Predicting the potentially exacerbation of severe viral pneumonia in hospital by MuLBSTA score joint CD4 + and CD8 +T cell counts: construction and verification of risk warning model

## TL;DR

This study builds a risk model for severe viral pneumonia using immune markers and patient data, showing better prediction than previous methods.

## Contribution

A new risk warning model for severe viral pneumonia combining MuLBSTA score with CD4+ and CD8+ T cell counts is developed and validated.

## Key findings

- The model includes age, bacterial coinfection, CD4+, CD4+/CD8+, lung infiltrations, smoking, hypertension, and admission days.
- The model achieved an AUROC of 0.94397, outperforming the original MuLBSTA score (AUROC = 0.8241).
- 41 out of 138 patients (29.7%) developed severe or critical illness, validating the model's relevance.

## Abstract

This study mainly focuses on the immune function and introduces CD4+, CD8+ T cells and their ratios based on the MuLBSTA score, a previous viral pneumonia mortality risk warning model, to construct an early warning model of severe viral pneumonia risk.

A retrospective single-center observational study was operated from January 2021 to December 2022 at the People's Hospital of Liangjiang New Area, Chongqing, China. A total of 138 patients who met the criteria for viral pneumonia in hospital were selected and their data, including demographic data, comorbidities, laboratory results, CT scans, immunologic and pathogenic tests, treatment regimens, and clinical outcomes, were collected and statistically analyzed.

Forty-one patients (29.7%) developed severe or critical illness. A viral pneumonia severe risk warning model was successfully constructed, including eight parameters: age, bacterial coinfection, CD4+, CD4+/CD8+, multiple lung lobe infiltrations, smoking, hypertension, and hospital admission days. The risk score for severe illness in patients was set at 600 points. The model had good predictive performance (AUROC = 0.94397), better than the original MuLBSTA score (AUROC = 0.8241).

A warning system constructed based on immune function has a good warning effect on the risk of severe conversion in patients with viral pneumonia.

The online version contains supplementary material available at 10.1186/s12890-024-03073-y.