Most patients survive with timely treatment and return to their normal baseline level of health. Clinical response to treatment is usually prompt, within 2-5 days.[67]Mykietiuk A, Carratala J, Fernandez-Sabe N, et al. Clinical outcomes for hospitalized patients with Legionella pneumonia in the antigenuria era: the influence of levofloxacin therapy. Clin Infect Dis. 2005 Mar 15;40(6):794-9.
http://www.ncbi.nlm.nih.gov/pubmed/15736010?tool=bestpractice.com
Persistent symptoms and impaired quality-of-life measures that persist for >28 days are likely to be due to age and comorbidity rather than the pneumonia itself.[80]El Moussaoui R, Opmeer BC, de Borgie CA, et al. Long-term symptom recovery and health-related quality of life in patients with mild-to-moderate-severe community-acquired pneumonia. Chest. 2006 Oct;130(4):1165-72.
http://www.ncbi.nlm.nih.gov/pubmed/17035452?tool=bestpractice.com
A study of survivors of Legionnaires' disease found that symptoms and impaired quality-of-life measures may persist for several years.[81]Lettinga KD, Verbon A, Nieuwkerk PT, et al. Health-related quality of life and posttraumatic. stress disorder among survivors of an outbreak of Legionnaires disease. Clin Infect Dis. 2002 Jul 1;35(1):11-7.
https://academic.oup.com/cid/article-lookup/doi/10.1086/340738
http://www.ncbi.nlm.nih.gov/pubmed/12060869?tool=bestpractice.com
Legionnaires’ disease has a mortality rate of 8% to 12% in most people (if given appropriate antibiotic treatment), but this may be higher in older adults or people who have preexisting medical conditions, smoke, have nosocomial cases, or have a delay in diagnosis and treatment of their disease.[4]Phin N, Parry-Ford F, Harrison T, et al. Epidemiology and clinical management of Legionnaires' disease. Lancet Infect Dis. 2014 Oct;14(10):1011-21.
https://www.doi.org/10.1016/S1473-3099(14)70713-3
http://www.ncbi.nlm.nih.gov/pubmed/24970283?tool=bestpractice.com
[82]Dominguez A, Alvarez J, Sabria M, et al. Factors influencing the case-fatality rate of Legionnaires' disease. Int J Tuberc Lung Dis. 2009 Mar;13(3):407-12.
http://www.ncbi.nlm.nih.gov/pubmed/19275805?tool=bestpractice.com
The average case-fatality rate is 9% in Europe and 7% in the US.[6]US Centers for Disease Control and Prevention. Legionnaires' disease surveillance summary report, United States 2018-2019. Mar 2021 [internet publication].[Full Text]
https://www.cdc.gov/legionella/health-depts/surv-reporting/2018-19-surv-report-508.pdf
[7]European Centre for Disease Prevention and Control (ECDC). Legionnaires’ disease: annual epidemiological report for 2021. Jul 2023 [internet publication].
https://www.ecdc.europa.eu/en/publications-data/legionnaires-disease-annual-epidemiological-report-2021
A complication such as lung abscess may require surgery and worsens prognosis significantly.