{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T11:01:21Z","timestamp":1777633281700,"version":"3.51.4"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Influenza A virus (IAV) pneumonia poses a significant threat to the elderly, often leading to severe outcomes due to age-related immunological decline. Early and accurate assessments of disease severity is critical for improving clinical management and prognosis. The Systemic Inflammatory Response Index (SIRI), which integrates neutrophil, monocyte, and lymphocyte counts, may serve as a novel biomarker to reflect the systemic inflammatory state and predict disease progression in older adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective analysis was conducted involving 160 patients aged 65\u202fyears or older who were diagnosed with IAV pneumonia at China Resources Wuhan Iron and Steel General Hospital between December 2024 and March 2025. Patients were categorized into favorable (CURB-65 [confusion, urea, respiratory rate, blood pressure, age \u2265 65\u202fyears] score &amp;lt;3,\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f71) and unfavorable (CURB-65 score \u22653,\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f89) prognosis groups. Demographic, clinical, and laboratory data were collected. The SIRI was calculated as (neutrophils\u202f\u00d7\u202fmonocytes)\/lymphocytes. Statistical analyses were performed using\n                      <jats:italic>t<\/jats:italic>\n                      -tests, chi-squared tests, logistic regression, and receiver operating characteristic (ROC) curve analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      SIRI levels were significantly higher in the unfavorable prognosis group than in the favorable prognosis group (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). Additionally, a positive correlation was found between SIRI levels and CURB-65 scores (r\u202f=\u202f0.433,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). A multivariate logistic regression analysis confirmed that the SIRI is an independent predictor of disease severity after adjusting for gender, age, and smoking history (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). The ROC analysis demonstrated that the SIRI had an area under the curve of 0.806 for predicting severe disease, outperforming traditional inflammatory markers such as C-reactive protein, interleukin-6, and erythrocyte sedimentation rate.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The SIRI is a reliable and objective biomarker for assessing disease severity and predicting prognosis in elderly patients with IAV pneumonia. Its use may facilitate early identification of high-risk individuals, guide timely clinical intervention, and ultimately improve patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1807561","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T04:33:02Z","timestamp":1777437182000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The predictive value of the Systemic Inflammatory Response Index in evaluating the severity of influenza A-induced viral pneumonia among elderly patients: a retrospective analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Piaopiao","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Geriatrics, CR & WISCO General Hospital","place":["Wuhan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingping","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, CR & WISCO General Hospital","place":["Wuhan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiadun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, CR & WISCO General Hospital","place":["Wuhan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"688","DOI":"10.13381\/j.cnki.cjm.202406010","article-title":"The relationship between intestinal flora imbalance and Streptococcus pneumoniae infection in elderly patients with severe pneumonia caused by influenza a","volume":"36","author":"Tursun","year":"2024","journal-title":"Chin J Microecol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1186\/s12871-024-02648-w","article-title":"Clinical significance of lactate-to-albumin ratio in patients with influenza a virus-induced acute respiratory distress syndrome: a single-center retrospective study","volume":"24","author":"Gao","year":"2024","journal-title":"BMC Anesthesiol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"2389","DOI":"10.1016\/j.ajpath.2019.08.017","article-title":"Age-related pathology associated with H1N1 a\/California\/07\/2009 influenza virus infection","volume":"189","author":"Bissel","year":"2019","journal-title":"Am J Pathol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"692546","DOI":"10.1155\/2015\/692546","article-title":"The impact of immunosenescence on pulmonary disease","volume":"2015","author":"Murray","year":"2015","journal-title":"Mediat Inflamm"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1601","DOI":"10.1007\/s12325-023-02445-w","article-title":"High clinical burden of influenza disease in adults aged \u2265 65 years: can we do better? A systematic literature review","volume":"40","author":"Langer","year":"2023","journal-title":"Adv Ther"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"917","DOI":"10.1080\/02770903.2021.1895211","article-title":"Physical activity behavior in people with asthma and COPD overlap residing in Spain: a cross-sectional analysis","volume":"59","author":"Sanchez Castillo","year":"2022","journal-title":"J Asthma"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"EVIDoa2300361","DOI":"10.1056\/EVIDoa2300361","article-title":"Influenza infection and acute myocardial infarction","volume":"3","author":"de Boer","year":"2024","journal-title":"NEJM Evid"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"867","DOI":"10.3390\/healthcare12090867","article-title":"Systemic inflammation response index (SIRI) and monocyte-to-lymphocyte ratio (MLR) are predictors of good outcomes in surgical treatment of periprosthetic joint infections of lower limbs: a single-center retrospective analysis","volume":"12","author":"Vitiello","year":"2024","journal-title":"Healthcare (Basel)"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"323","DOI":"10.13493\/j.issn.1672-7878.2020.03-006","article-title":"Analysis of relevant factors associated with antibiotic use in adult patients with community-acquired pneumonia in hospital settings based on the \u201cguidelines for the diagnosis and treatment of community-acquired pneumonia (2016 edition)\u201d","volume":"17","author":"Cao","year":"2020","journal-title":"Antiinfect Pharm"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"394","DOI":"10.7326\/M17-0848","article-title":"Diagnostic accuracy of novel and traditional rapid tests for influenza infection compared with reverse transcriptase polymerase chain reaction: a systematic review and meta-analysis","volume":"167","author":"Merckx","year":"2017","journal-title":"Ann Intern Med"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1571","DOI":"10.13343\/j.cnki.wsxb.20210516","article-title":"Inflammatory response induced by viral infection: the \u201cdouble-edged sword\u201d of the host defense against viruses","volume":"62","author":"Ge","year":"2022","journal-title":"Acta Microbiol Sin"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"2151","DOI":"10.1080\/07853890.2022.2105395","article-title":"Systemic inflammatory response index over neutrophil-lymphocyte ratio and monocyte-lymphocyte ratio: comparison of prognostic performance in predicting major adverse cardiac events","volume":"54","author":"Mangalesh","year":"2022","journal-title":"Ann Med"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"38","DOI":"10.12114\/j.issn.1008-5971.2023.00.161","article-title":"The relationship between the systemic inflammatory response index and post-stroke depression: a study based on propensity score matching and inverse probability of treatment weighting methods","volume":"31","author":"Huang","year":"2023","journal-title":"J Pract Cardiovasc Cerebrov Pulm Dis"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1038\/s41577-025-01245-7","article-title":"Neutrophils as critical orchestrators of chronic inflammation","author":"Torfs","year":"2025","journal-title":"Nat Rev Immunol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1654","DOI":"10.1515\/cclm-2025-0180","article-title":"Cell population data for early detection of sepsis in patients with suspected infection in the emergency department","volume":"63","author":"Cancella De Abreu","year":"2025","journal-title":"Clin Chem Lab Med"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"e28894","DOI":"10.1002\/jmv.28894","article-title":"Fatal outcome of severe fever with thrombocytopenia syndrome (SFTS) and severe and critical COVID-19 is associated with the hyperproduction of IL-10 and IL-6 and the low production of TGF-\u03b2","volume":"95","author":"Kang","year":"2023","journal-title":"J Med Virol"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1807561\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T04:33:16Z","timestamp":1777437196000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1807561\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,29]]},"references-count":16,"alternative-id":["10.3389\/fmed.2026.1807561"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1807561","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,29]]},"article-number":"1807561"}}