Blood cell counts and lymphocyte subsets of patients admitted during the COVID‐19 pandemic: a prospective cohort study

Hengeveld, Paul J.; Khader, Aaram Omar; Bruin, Linda H.A. de; Geelen, Inge G.P.; Baalen, Eske A. van; Jansen, E.; Bouwer, Nathalie I; Balak, Ömer; Riedl, Jürgen; Langerak, Anton W.; Westerweel, Peter E.; Levin, Mark‐David

doi:10.1111/bjh.16983

Cited by 10 publications

(8 citation statements)

References 10 publications

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“…In a similar way to chronic infections, COVID-19 might damage CD4+ T cells function and promote the excessive activation of CD8+ T cells with the subsequent potential exhaustion [23]. The results of a recent prospective study in hospitalized Covid-19 patients are in accordance with our data with CD4+ and CD8+ T cells decreased with a later reconstitution of CD8+ T cells [24].…”

Section: Discussionsupporting

confidence: 90%

CD4 and CD8 Lymphocyte Counts as Surrogate Early Markers for Progression in SARS-CoV-2 Pneumonia: A Prospective Study

Calvet

Gratacós

Amengual³

et al. 2020

Viruses

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Background: COVID-19 pathophysiology and the predictive factors involved are not fully understood, but lymphocytes dysregulation appears to play a role. This paper aims to evaluate lymphocyte subsets in the pathophysiology of COVID-19 and as predictive factors for severe disease. Patient and methods: A prospective cohort study of patients with SARS-CoV-2 bilateral pneumonia recruited at hospital admission. Demographics, medical history, and data regarding SARS-CoV-2 infection were recorded. Patients systematically underwent complete laboratory tests, including parameters related to COVID-19 as well as lymphocyte subsets study at the time of admission. Severe disease criteria were established at admission, and patients were classified on remote follow-up according to disease evolution. Linear regression models were used to assess associations with disease evolution, and Receiver Operating Characteristic (ROC) and the corresponding Area Under the Curve (AUC) were used to evaluate predictive values. Results: Patients with critical COVID-19 showed a decrease in CD3+CD4+ T cells count compared to non-critical (278 (485 IQR) vs. 545 (322 IQR)), a decrease in median CD4+/CD8+ ratio (1.7, (1.7 IQR) vs. 3.1 (2.4 IQR)), and a decrease in median CD4+MFI (21,820 (4491 IQR) vs. 26,259 (3256 IQR)), which persisted after adjustment. CD3+CD8+ T cells count had a high correlation with time to hospital discharge (PC = −0.700 (−0.931, −0.066)). ROC curves for predictive value showed lymphocyte subsets achieving the best performances, specifically CD3+CD4+ T cells (AUC = 0.756), CD4+/CD8+ ratio (AUC = 0.767), and CD4+MFI (AUC = 0.848). Conclusions: A predictive value and treatment considerations for lymphocyte subsets are suggested, especially for CD3CD4+ T cells. Lymphocyte subsets determination at hospital admission is recommended.

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Section: Discussionsupporting

confidence: 90%

CD4 and CD8 Lymphocyte Counts as Surrogate Early Markers for Progression in SARS-CoV-2 Pneumonia: A Prospective Study

Calvet

Gratacós

Amengual³

et al. 2020

Viruses

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“…When we analyzed the BIC populations in our study, we observed that the SARS-CoV-2 infection in elderly patients induced a significant increase in granulocyte populations. These results are in line with several reports indicating alterations of the granulocytes counts in patients with COVID-19, especially in those who required hospitalization [8] [26] [27] [28] [29] [30]. The significant increase in blood neutrophils counts in the first days after admission to hospitals together with the presence of immature granulocytes including myelocytes and metamyelocytes in blood has been reported in patients with severe COVID-19 of all ages [26].…”

Section: Discussionsupporting

confidence: 91%

“…In addition to the increase of blood granulocytes counts, several studies reported that lymphopenia is a consistent finding in SARS-CoV-2-infected patients [28]. The decrease of blood lymphocytes counts has been associated with disease severity and therefore, this parameter has been proposed as predictive marker of enhanced risk of hospitalization and mortality [29] [30].…”

Section: Discussionmentioning

confidence: 98%

Alterations of Blood Immune Cells in Elderly Patients with COVID-19 and with or without Pre-Existing Type 2 Diabetes

Salva¹,

Kolling²,

Argañaraz³

et al. 2022

OJI

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Elderly individuals, especially those with pre-existing conditions like type 2 diabetes mellitus (T2DM), have a high risk for developing severe cases of COVID-19. The aim of this work was to characterize the alterations of blood immune cells (BIC) in patients with symptomatic COVID-19 and confirmed SARS-CoV-2 infection, ≥60 years and who needed hospitalization in the Centro de Salud Hospital of Tucuman, Argentina, during the second peak of the pandemic in Argentina. Ten patients were enrolled from December 2020 to May 2021. Blood samples were taken at the time of admission (day 0) and five days after (day 5) for routine laboratory tests and the characterization of BIC by flow cytometry. Most of the patients were men (70%) aged between 60 and 78 years. The 70% of patients had T2DM while 50% had arterial hypertension. At day 0, all the patients had increased neutrophils and inflammatory markers (C reactive protein and D-dimers) and reduced numbers of lymphocytes, HLA-DR hi monocytes, CD16 + CD56 + NK cells, CD3 + HLA − DR + CD25 + cells, CD4 + and CD8 + T cells in blood. Patients received a standard treatment *Contributed equally.

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“…Several studies have shown that lymphopenia is a peculiar finding in SARS-CoV-2-infected patients, even in the early stages of the disease 13 , 14 . Lymphopenia and N/L ratio have been associated with disease severity, thus allowing for their use as predictive markers of increased risk of in-hospital mortality and ICU admission 8 , 15 .…”

Section: Discussionmentioning

confidence: 99%

Baseline T-lymphocyte subset absolute counts can predict both outcome and severity in SARS-CoV-2 infected patients: a single center study

Iannetta

Buccisano

Fraboni

et al. 2021

Sci Rep

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The aim of this study was to evaluate the role of baseline lymphocyte subset counts in predicting the outcome and severity of COVID-19 patients. Hospitalized patients confirmed to be infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) were included and classified according to in-hospital mortality (survivors/nonsurvivors) and the maximal oxygen support/ventilation supply required (nonsevere/severe). Demographics, clinical and laboratory data, and peripheral blood lymphocyte subsets were retrospectively analyzed. Overall, 160 patients were retrospectively included in the study. T-lymphocyte subset (total CD3+, CD3+ CD4+, CD3+ CD8+, CD3+ CD4+ CD8+ double positive [DP] and CD3+ CD4− CD8− double negative [DN]) absolute counts were decreased in nonsurvivors and in patients with severe disease compared to survivors and nonsevere patients (p < 0.001). Multivariable logistic regression analysis showed that absolute counts of CD3+ T-lymphocytes < 524 cells/µl, CD3+ CD4+ < 369 cells/µl, and the number of T-lymphocyte subsets below the cutoff (T-lymphocyte subset index [TLSI]) were independent predictors of in-hospital mortality. Baseline T-lymphocyte subset counts and TLSI were also predictive of disease severity (CD3+ < 733 cells/µl; CD3+ CD4+ < 426 cells/µl; CD3+ CD8+ < 262 cells/µl; CD3+ DP < 4.5 cells/µl; CD3+ DN < 18.5 cells/µl). The evaluation of peripheral T-lymphocyte absolute counts in the early stages of COVID-19 might represent a useful tool for identifying patients at increased risk of unfavorable outcomes.

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Blood cell counts and lymphocyte subsets of patients admitted during the COVID‐19 pandemic: a prospective cohort study

Cited by 10 publications

References 10 publications

CD4 and CD8 Lymphocyte Counts as Surrogate Early Markers for Progression in SARS-CoV-2 Pneumonia: A Prospective Study

CD4 and CD8 Lymphocyte Counts as Surrogate Early Markers for Progression in SARS-CoV-2 Pneumonia: A Prospective Study

Alterations of Blood Immune Cells in Elderly Patients with COVID-19 and with or without Pre-Existing Type 2 Diabetes

Baseline T-lymphocyte subset absolute counts can predict both outcome and severity in SARS-CoV-2 infected patients: a single center study

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