Effect of blood analysis and immune function on the prognosis of patients with COVID-19

Abstract

Introduction This retrospective study investigated the implications of changes in blood parameters and cellular immune function in patients with Coronavirus Disease 2019 (COVID-19). Methods Records were reviewed of 85 patients admitted with COVID-19 between February 4 and 16, 2020. The primary outcome was in-hospital death. Results Fourteen patients died. The baseline leukocyte count, neutrophil count and hemoglobin was significantly higher in non-survivors compared with survivors, while the reverse was true of lymphocyte count, platelet, PaO 2 /FiO 2 , CD3+ count and CD4+ count. The percentage of neutrophil count > 6.3×10 9 /L in death group was significantly higher than that in survival group, and multivariate logistic regression showed neutrophil count > 6.3×10 9 /L was independently associated with mortality. However, there were not significant difference in IgG, IgM, IgA, C3, C4 and the percentage of IgE > 100 IU/ml between the death group and survival group. Areas under the receiver operating characteristic curves of the following at baseline could significantly predict mortality: leukocyte, neutrophil, lymphocyte, CD3+ and CD4+ counts. Conclusions For hospitalized patients with COVID-19, lymphocyte, CD3+ and CD4+ counts that marked decrease suggest a poor outcome. Admission neutrophil count > 6.3 ×10 9 /L is independently associated with mortality. At admission, leukocyte, neutrophil, lymphocyte, CD3+ and CD4+ counts should receive added attention.

Serum Complement C3 and C4 and COVID-19 Severity and Mortality: A Systematic Review and Meta-Analysis With Meta-Regression

“…After a full-text review of the remaining 21 articles, two were excluded because they did not meet the inclusion criteria. Thus, 19 studies were included in the meta-analysis (Figure 1) (22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40). These studies enrolled 3,764 COVID-19 patients, 2,643 (48% males, mean age 54 years) with low disease severity or survivor status and 1,121 (58% males, mean age 65 years) with high severity or non-survivor status during follow up.…”

“…One study was conducted in Turkey ( 23), one in Spain (33), and the remaining 17 in China (22,(24)(25)(26)(27)(28)(29)(30)(31)(32)(34)(35)(36)(37)(38)(39)(40). Of the 17 studies conducted in China, 10 were from the Renmin Hospital, Wuhan (24-29, 35, 38-40) (Supplementary Table ).…”

“…In 13 studies, patients with high severity or non-survivor status had lower C4 concentrations when compared to those with low severity or survivor status (mean difference range, -1.43 to -0.10) (22-24, 27, 29, 32, 33, 36-40), with a significant difference in seven (22,23,27,29,32,33,40). No between-group difference was observed in two studies (mean difference 0.00) (31,34), whereas in the remaining five the C4 concentration was lower in patients with low severity or survivor status (mean difference range, 0.10 to 0.77) (25,26,28,30,35), with a significant difference in two (28,30). The pooled results confirmed that C4 concentrations were significantly lower in patients with high severity or non-survivor status during follow up (SMD -0.29, 95% CI -0.49 to -0.09, p=0.005) (Figure 6).…”

How Do Inflammatory Mediators, Immune Response and Air Pollution Contribute to COVID-19 Disease Severity? A Lesson to Learn

“…Beyond this limited time window, the interaction between host and etiological agent advances, and the immune defensive response requires more complex B and T cell mechanisms to be efficient. Accordingly, a reduction in both T cells and natural killer (NK) cells is a relevant feature of COVID-19 and is linked to the disease severity [92][93][94][95]. The therapeutic advantages resulting from the use of antibodies capable of hindering the infection leads us to think about B cells' prevailing role compared to cytotoxic immune mechanisms.…”

Hypoxia may be a determinative factor in COVID-19 progression

“…The fatal outcome of COVID-19 can be predicted early on the basis of some laboratory data. In the study published recently ( Fu Y.-Q. et al, 2020 ) the entry records of 85 COVID-19 patients hospitalized in Wuhan in February 2020 were analyzed, and the data of 14 patients who deceased during hospital stay within the first week of hospitalization were compared with the data of 71 who survived and were discharged from the hospital before April 1st.…”