Characteristics of peripheral white blood cells in COVID-19 patients revealed by a retrospective cohort study

Abstract

Background Peripheral hematological changes in severe COVID-19 patients may reflect the immune response during SARS-CoV-2 infection. Characteristics of peripheral white blood cells as early signals were needed to be investigated for clarifying its associations with the fatal outcomes in COVID-19 patients. Methods A retrospective cohort study was performed and the hospitalized COVID-19 patients were recruited in wards of Sino-French New City Branch of Tongji Hospital in Wuhan, Hubei province, China. Characteristics of peripheral white blood cells in survivors and non-survivors were analyzed. Comparison among patients with different level of eosinophils was performed. Results Of 198 patients included in this study, 185 were discharged and 13 died. Levels of eosinophils, lymphocytes and basophils in non-survivors were significantly lower than those in survivors. Death rate in low eosinophils group was higher and no patient died in normal eosinophils group (16.7% vs 0, P < 0.001). The proportion of patients in low eosinophils group who used glucocorticoids was higher than in normal eosinophils group, but glucocorticoids usage was not an indicator for death in subgroup analysis in low eosinophils patients. Moreover, positive correlation was found between the counts of lymphocytes and eosinophils in patients with glucocorticoids use but not in patients without the treatment. Conclusions Hematological changes differed between survivors and non-survivors with COVID-19. Lymphopenia and eosinopenia could be predictors for poor prognosis of COVID-19 patients. Initial counts of eosinophils may guide us in usage of glucocorticoids for COVID-19 treatment.

Evaluation of individual and combined NLR, LMR and CLR ratio for prognosis disease severity and outcomes in patients with COVID-19

“…Basophils and eosinophils, which play a greater role in other innate immune functions, such as allergic and anti-microbial responses, are nevertheless also impacted in COVID-19 [31] . In this study, we demonstrated that basophils and eosinophils levels were significantly higher in COVID-19 patients with critical disease, when compared to those with moderate diseases.…”

“…The relatively limited data indicate depletion of basophils and eosinophils occurs in the blood in COVID-19, showing some associations with severe disease. Eosinopenia is frequent and has been linked to mortality in different settings during critical COVID-19 illness [31] , [32] . By contrast, Chen R. et al [33] found that eosinophil counts, while low at admission, ultimately rebounded in a cohort of patients who ultimately recovered from severe COVID-19.…”

“…The significance of these changes in basophils and eosinophils numbers is not yet clear. It has been suggested, however, that decreased basophil and eosinophils counts in the blood could be attributed to migration to the lungs [31] , [32] . A possible explanation for the discrepancy between our results and the earlier findings could be the differences in races and ethnicity.…”

Can Lung Imaging Scores and Clinical Variables Predict Severe Course and Fatal Outcome in COVID-19 Pneumonia Patients? A Single-Center Observational Study

“…Multiple studies reported a significant association between elevated leukocyte counts and decreased lymphocyte counts among patients with severe cases of COVID-19 compared with those with mild cases [ 15 , 29 ]. However, in our study population, a decreased leukocyte count was predictive of more severe disease.…”

Dysregulated Immune Responses in SARS-CoV-2-Infected Patients: A Comprehensive Overview

“…During the acute phase of SARS-CoV-2 infection, a decreased basophil count in the peripheral blood of patients was noted [ 123 ]. Importantly, the number of basophils was significantly reduced in patients with an unfavorable outcome relative to the values obtained for patients who recovered from COVID-19 [ 124 ]. Moreover, higher relative and absolute basophil numbers were found to negatively correlate with the risk of severe COVID-19 [ 125 ].…”