Objective To explore the levels of serum forkhead transcription factor 1(FOXO1)and autoph-agy-related gene 7(ATG7)in elderly patients with severe pneumonia and their relationship with short-term prognosis.Methods A total of 122 elderly patients with severe pneumonia admitted to the hospital from Au-gust 2020 to August 2022 were selected as the case group,and 105 elderly people who came to the hospital for physical examination during the same period were selected as the control group.The serum levels of FOXO1 and ATG7 were detected by enzyme-linked immunosorbent assay(ELISA).The patients were divided into the survival group(n=91)and the death group(n=31)according to whether they died within 28 days after the diagnosis of severe pneumonia.Receiver operating characteristic(ROC)curve was used to evaluate the predic-tive value of serum FOXO1 and ATG7 levels for short-term mortality in elderly patients with severe pneumo-nia.The influencing factors for short-term mortality in elderly patients with severe pneumonia were explored by multivariate Logistic regression analysis.Results The serum FOXO1 and ATG7 levels in the case group were higher than those in the control group,and the differences were statistically significant(t=7.615,29.591,P＜0.05).The serum expression levels of FOXO1 and ATG7 in the death group were higher than those in the survival group,and the differences were statistically significant(t=10.029,9.399,P＜0.05).The area under the curve(AUC)of serum FOXO1 and ATG7 for predicting short-term mortality in elderly pa-tients with severe pneumonia was 0.733(95％CI:0.673-0.799)and 0.826(95％CI:0.756-0.893),respec-tively,and the AUC of FOXO1 combined with ATG7 for predicting short-term mortality in elderly patients with severe pneumonia was 0.908(95％CI:0.862-0.949).FOXO1 and ATG7 were positively correlated with acute physiology chronic health evaluation(APACHE Ⅱ)score(r=0.693,0.627,P＜0.05).The results of multivariate Logistic regression showed that APACHE Ⅱ score ≥22.56(OR=3.589,95％CI:1.714-7.515),FOXO1 ≥10.67 ng/mL(OR=2.529,95％CI:1.232-5.193),ATG7 ≥16.35 pg/mL(OR=2.875,95％CI:1.414-5.845)were risk factors for death in elderly patients with severe pneumonia(P＜0.05).Con-clusion Serum levels of FOXO1 and ATG7 are significantly increased in elderly patients with severe pneumo-nia,and both could be used to evaluate the short-term prognosis of elderly patients with severe pneumonia.