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Objective: To investigate correlation between neutrophil lymphocyte ratio (NLR), IL-6 and lymphocyte subsets and prognosis of viral pneumonia complicated with acute respiratory distress syndrome (ARDS). Methods: A total of 98 patients with viral pneumonia complicated with ARDS admitted to Xinxiang Central Hospital/the Fourth Clinical College from May 2017 to June 2019 were selected, NLR, IL-6 and lymphocyte subsets expressions in patients with different severity were analyzed. Correlation between NLR, IL-6 and lymphocyte subsets levels in prognosis of viral pneumonia complicated with ARDS was analyzed by Pearson correlation. Logistc regression was used to analyze prognostic risk factors of viral pneumonia complicated with ARDS. Results: With aggravation of viral pneumonia complicated with ARDS, NLR and IL-6 levels were significantly increased (P<0.05), while CD3+T, CD4+T and CD19+T cells levels were significantly decreased (P<0.05). Pearson correlation analysis results showed that NLR and IL-6 were positively correlated with prognosis of viral pneumonia complicated with ARDS (P<0.05), while CD3+T, CD4+T, CD19+T and CD8+T cells were negatively correlated with prognosis of ARDS with viral pneumonia (P<0.05). Multivariate Logistic analysis showed that NLR, IL-6, CD3+T and CD19+T cells were risk factors for viral pneumonia complicated with ARDS (P<0.05). Conclusion: Serum NLR, IL-6, CD3+T and CD19+T cells are closely related to severity and prognosis of patients with viral pneumonia complicated with ARDS. [ABSTRACT FROM AUTHOR]