Clinical features in 52 patients with COVID-19 who have increased leukocyte count: a retrospective analysis

Abstract

Recent reports have showed that a proportion of patients with Coronavirus Disease 2019 (COVID-19) presented elevated leukocyte count. Clinical data about these patients is scarce. We aimed to evaluate the clinical findings of patients with COVID-19 who have increased leukocyte at admission. We retrospectively collected the clinical data on the 52 patients who have increased leukocyte count at admission from the 619 patients with confirmed COVID-19 who had pneumonia with abnormal features on chest CT scan in Renmin Hospital of Wuhan University in Wuhan, China, from February 3 to March 3, 2020. The mean age of the 52 patients with increased leukocyte count was 64.7 (SD 11.4) years, 32 (61.5%) were men and 47 (90.4%) had fever. Compared with the patients with non-increased leukocyte count, the patients with increased leukocyte count were significantly older (P < 0.01), were more likely to have underlying chronic diseases (P < 0.01), more likely to develop critically illness (P < 0.01), more likely to admit to an ICU (P < 0.01), more likely to receive mechanical ventilation (P < 0.01), had higher rate of death (P < 0.01) and the blood levels of neutrophil count and the serum concentrations of CRP and IL-6 were significantly increased, (P < 0.01). The older patients with COVID-19 who had underlying chronic disorders are more likely to develop leukocytosis. These patients are more likely to develop critical illness, with a high admission to an ICU and a high mortality rate.

The Neutrophil-to-Monocyte Ratio and Lymphocyte-to-Neutrophil Ratio at Admission Predict In-Hospital Mortality in Mexican Patients with Severe SARS-CoV-2 Infection (Covid-19)

“…In particular, the blood levels of D-dimer, ferritin, C-reactive protein (CRP), troponin I, lactate dehydrogenase (LDH), and procalcitonin have been extensively studied due to their apparently good accuracy to discriminate patients with the most severe courses of the disease [ 8 , 9 , 10 , 11 , 12 , 13 ]. In parallel, numerous studies have also proposed the use of hematological markers such as lymphocyte, monocyte, and neutrophil counts that seem to associate with increased severity and mortality in patients with Covid-19 [ 14 , 15 ]. Actually, it has been consistently demonstrated that, in seriously ill patients with Covid-19, the blood count of lymphocyte and monocyte populations decreases whereas neutrophil counts increase [ 15 ].…”

“…Actually, it has been consistently demonstrated that, in seriously ill patients with Covid-19, the blood count of lymphocyte and monocyte populations decreases whereas neutrophil counts increase [ 15 ]. However, total counts of these white blood cells (WBC) are merely associated with severity and mortality of Covid-19 but fails to predict death risk in clinical practice [ 14 ]. For this reason, a growing body of evidence has now proposed that ratios among lymphocytes, monocytes, and neutrophils are more accurate to predict mortality than cell count of lymphocytes, monocytes, and neutrophils by itself [ 16 , 17 ].…”

<p>High Mortality Rate in Adult COVID-19 Inpatients in Eastern Sudan: A Retrospective Study</p>

“…5 The real-time polymerase chain reaction (RT-PCR) test is a standard diagnostic test to detect viral nucleotides via an oropharyngeal swab, nasopharyngeal swab, bronchoalveolar lavage, or tracheal aspirate. 6 Increased levels of inflammatory markers, such as a high white blood count 7 and a higher D-dimer level, 8 are used as supporting tools for diagnosing COVID-19 infections. Moreover, radiological features of the chest are very important findings that can suggest COVID-19 pneumonia 9 with a high degree of diagnostic accuracy.…”

Clinical and hematological characteristics of 88 patients with COVID‐19

“…Neutrophils are activated by the pathogen and release a large number of cytokines, chemokines, and various proteolytic enzymes to eliminate the pathogen. There is evidence that peripheral blood neutrophils in patients with severe bacterial infection are affected by cytokines, and neutrophil apoptosis is significantly inhibited, resulting in a significant increase in the number of peripheral blood neutrophils 18,19. Because neutrophils are the main source of chemokines and cytokines and cytokine storms can F I G U R E 2 Trends in CBC results over time after disease onset [Colour figure can be viewed at wileyonlinelibrary.com] lead to ARDS, neutrophils are strongly related to the development of ARDS and critical illness 20.…”