Abstract: Pertussis is a highly contagious respiratory disease caused by Bordetella pertussis infection. In recent years, many countries with high pertussis vaccination coverage, including China, have experienced the “re-emergence of pertussis”, posing a significant challenge to public health. This has caused widespread concern both domestically and internationally. Pertussis cases surged, and deaths hit a record high in China in 2024. Meanwhile, pertussis infection in children, adolescents and adults are often misdiagnosed or underdiagnosed due to the difficulty in distinguishing them from other upper respiratory tract infections during the early symptoms of the infection. In fact, the morbidity of pertussis in China may be seriously underestimated. Severe pertussis poses a serious threat to life and health, as it carries a risk of death due to the severe complications that commonly accompany the disease. Early identification of high-risk patients can help healthcare professionals implement timely and targeted interventions to improve patient prognosis, reduce the incidence of complications and case fatality rates, enhance the quality and efficiency of healthcare, and lessen the economic burden on families as well as the consumption of public health resources caused by severe pertussis. This article reviews the influencing factors associated with the prognosis of severe pertussis, aiming to provide decision support for the rapid clinical identification of critically ill patients, as well as to provide a basis for the optimization of clinical diagnostic and treatment protocols and the development of novel preventive vaccines, and to provide a reference for similar studies in the future.

Key words: Severe pertussis, Prognosis, Influencing factors, Hyperleukocytosis, Pulmonary hypertension