Low serum lymphocyte level is associated with poor exercise capacity and quality of life in chronic obstructive pulmonary disease

Abstract

The purpose of this study was to evaluate the association of serum lymphocyte level with several clinical parameters in COPD. The study population included 451 COPD patients from the Korean Obstructive Lung Disease cohort study. Serum lymphocyte level was measured every year along with various clinical parameters, such as lung function, 6-min walking (6 MW) distance, quality of life using COPD assessment test (CAT) and St. George's Respiratory Questionnaire (SGRQ) scores, exacerbations, and survival. Serum lymphocyte level less than 20% was considered as a low lymphocyte level. Normal lymphocyte and low lymphocyte groups comprised of 409 (90.7%) and 42 (9.3%) patients, respectively. Clustered analysis showed that patients in low lymphocyte group had a lower post-bronchodilator forced expiratory volume in 1 s % predicted (estimated mean = − 5.70%; P = 0.001), a lower forced vital capacity % predicted (estimated mean = − 5.63%; P = 0.005), a shorter 6 MW distance (estimated mean = − 41.31 m; P < 0.001), a higher CAT score (estimated mean = 2.62; P = 0.013), and a higher SGRQ score (estimated mean = 10.10; P < 0.001). Serum lymphocyte level was not associated with frequent acute exacerbations nor mortality. Low serum lymphocyte group showed poorer pulmonary function, lower 6 MW distance, and worse quality of life. Serum lymphocyte levels could be a simple and widely available predictive marker for variable clinical outcomes in COPD patients.

Practical parameters that can be used for nutritional assessment in patients hospitalized in the intensive care unit with the diagnosis of chronic obstructive pulmonary disease

“…There are studies showing the relationship between low lymphocyte count and poor prognosis in patients with COPD [32] . In addition, the relationship between eosinophils and basophils and COPD has been demonstrated in different studies [33–35] However, in our study, no statistically significant correlation was found between eosinophil values and PNI.…”

Lymphopenia as a Predictor for Adverse Clinical Outcomes in Hospitalized Patients with COVID-19: A Single Center Retrospective Study of 4485 Cases

“…A decrease in lymphocyte counts has been described in many respiratory infections caused by viruses [13,14]. Importantly, a low lymphocyte count has been proposed as a worse prognostic marker in patients with influenza virus infection [15,16], chronic obstructive pulmonary disease [17], heart diseases [18,19], and malignancy [20]. In patients infected with SARS-CoV-2, a low lymphocyte count in peripheral blood is a common clinical feature, particularly in patients with severe COVID-19 [2,21,22].…”

The mechanistic role of neutrophil lymphocyte ratio perturbations in the leading non communicable lifestyle diseases

“…Lymphocytopenia has been strongly implicated as a marker of multiple chronic inflammatory pathologies and has been shown as a marker/prognostic indicator of disease severity Studies have reported low lymphocyte count in COPD to be associated with lung function, exercise tolerance, quality of life, disease severity, prognosis, etc. 130 Evidence reports enhanced apoptosis of both CD4 + and CD8 + subtypes, though apoptosis of CD4 + cells seems to predominate in stable COPD. 131 Chronic activation and the resultant enhanced apoptosis could set up an amplified inflammatory cascade triggering progressive lung damage.…”

“…131,133,134 Multiple mechanisms of lymphocytopenia have been proposed which include chronic activation of lymphocytes and resultant increased lymphocyte apoptosis, stress-induced lymphocytopenia (due to enhanced production of cortisol and pro-inflammatory cytokines), and inflammation-induced tissue trafficking/redistribution of lymphocytes to the site/tissue of damage. 130,135,136 4.B.i) Role of T lymphocytes (Figure 6): 4.B.i.I) CD8+ T lymphocytes: a) Activation of CD8+ T cells (Figure 6): Studies emphasize that COPD is characterized by a chronically activated state of CD8 + T lymphocytes.…”