Lymphopenia predicts disease severity of COVID-19: a descriptive and predictive study

Tan, Li; Wang, Qi; Zhang, Duanyang; Ding, Jinya; Huang, Qingchun; Tang, Yueming; Wang, Qiongshu; Miao, Hongming

doi:10.1038/s41392-020-0148-4

Cited by 1,445 publications

(1,465 citation statements)

References 7 publications

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“…Consistent with this study, Li Tan et al suggest that lymphocytopenia can be used as an useful prognostic factor for severe COVID-19 patients [12] .…”

Section: Introductionsupporting

confidence: 85%

“…preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in The copyright holder for this this version posted March 23, 2020. . https://doi.org/10.1101/2020.03.20.20039818 doi: medRxiv preprint potential mechanisms of lymphopenia, particularly the decrease of CD4 + and CD8 + T cell counts in COVID-19 patients remain unclear, the SARS-CoV-2 might have a direct influence on lymphocytes or lymphatic organs, or through an indirect pathway [12,13] . The corresponding mechanisms warrant further investigation.…”

Section: Discussionmentioning

confidence: 99%

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Potential Factors for Prediction of Disease Severity of COVID-19 Patients

zhang

wang

et al. 2020

Preprint

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Objective: Coronavirus disease 2019 is an escalating global epidemic caused by SARS-CoV-2, with a high mortality in critical patients. Effective indicators for predicting disease severity in SARS-CoV-2 infected patients are urgently needed. Methods: In this study, 43 COVID-19 patients admitted in ChongqingPublic Health Medical Center were involved. Demographic data, clinical features, and laboratory examinations were obtained through electronic medical records. Peripheral blood specimens were collected from COVID-19 patients and examined for lymphocyte subsets and cytokine profiles by flow cytometry. Potential contributing factors for prediction of disease severity were further analyzed.Results: A total of 43 COVID-19 patients were included in this study, including 29 mild patients and 14 sever patients. Severe patients were significantly older (61.9±9.4 vs 44.4±15.9) and had higher incidence in co-infection with bacteria compared to mild group (85.7%vs27.6%).Significantly more severe patients had the clinical symptoms of anhelation (78.6%) and asthma (71.4%). For laboratory examination, 57.1% severe cases showed significant reduction in lymphocyte count.The levels of Interluekin-6 (IL6), IL10, erythrocyte sedimentation rate (ESR) and D-Dimer (D-D) were significantly higher in severe patients than mild patients, while the level of albumin (ALB) was remarkably : medRxiv preprint lower in severe patients. Further analysis demonstrated that ESR, D-D, age, ALB and IL6 were the major contributing factors for distinguishing severe patients from mild patients. Moreover, ESR was identified as the most powerful factor to predict disease progression of COVID-19 patients. Conclusion:Age and the levels of ESR, D-D, ALB and IL6 are closely related to the disease severity of COVID-19 patients. ESR can be used as a valuable indicator for distinguishing severe COVID-19 patients in early stage, so as to increase the survival of severe patients.

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“…Consistent with this study, Li Tan et al suggest that lymphocytopenia can be used as an useful prognostic factor for severe COVID-19 patients [12] .…”

Section: Introductionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Potential Factors for Prediction of Disease Severity of COVID-19 Patients

zhang

wang

et al. 2020

Preprint

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“…Studies on epidemiological features of COVID -19 showed that about 80 percent of patients are asymptomatic or are presented with mild manifestations [51,52], but almost all of the patients included in our study had moderate to severe characteristics. It seems that fever and cough are the most common clinical features among moderate to severe patients (Table 4) Studies show different laboratory abnormalities in COVID-19 infected patients, such as hypoalbuminemia or elevated inflammatory markers [53]. However, our data suggest that C-reactive protein is the most elevated factor among infected cases ( Table 5).…”

Section: Discussionmentioning

confidence: 57%

The Novel Coronavirus Disease (COVID-19): A PRISMA Systematic Review and Meta-analysis of Clinical and Paraclinical characteristics

Hasani

Mardi

Shakerian

et al. 2020

Preprint

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An outbreak of pneumonia, caused by a novel coronavirus was Identified in China in Dec 2019. This virus expanded worldwide, causing global concern. Clinical, laboratory and imaging features of this infection are characterized in some observational studies. We undertook a systematic review and meta-analysis to assess the frequency of clinical, laboratory, and CT features in COVID-19 patients.We did a systematic review and meta-analysis using three databases to identify clinical, laboratory, and CT features of rRT-PCR confirmed cases of COVID-19. Data for 3420 patients from 30 observational studies were included.Overall, the results showed that fever (84.2%, 95%CI 82.6-85.7), cough (62%, 95%CI 60-64), and fatigue (39.4%, 95%CI 37.2-41.6%) were the most prevalent symptoms in COVID-19 patients. Increased CRP level, decreased lymphocyte count, and increased D-dimer level were the most common laboratory findings. Among COVID-19 patients, 92% had a positive CT finding, most prevalently GGO (60%, 95%CI 58-62) and peripheral distribution (64%, 95%CI 60-69).These results demonstrate the clinical, paraclinical, and imaging features of COIVD-19.

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“…be best if we could have a surrogate marker to predict which transplant recipients are more likely to have a complicated course than others. Studies on COVID-19 patients, in general, have shown lymphopenia as a poor prognostic factor [10]. In HCT, interpretation of lymphopenia is not straight forward and multiple other non-COVID-19 causes like non-SARS-CoV-2 viral infections, conditioning chemotherapy, pending bone marrow recovery, transfusion-associated graft-versus-host disease, etc.…”

Section: The Daunting Task Of Differentiating Covid-19 From Other Oppmentioning

confidence: 99%

Facing COVID-19 in the hematopoietic cell transplant setting: A new challenge for transplantation physicians

Sahu

Jindal

Siddiqui

et al. 2020

Blood Cells, Molecules, and Diseases

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Lymphopenia predicts disease severity of COVID-19: a descriptive and predictive study

Cited by 1,445 publications

References 7 publications

Potential Factors for Prediction of Disease Severity of COVID-19 Patients

Potential Factors for Prediction of Disease Severity of COVID-19 Patients

The Novel Coronavirus Disease (COVID-19): A PRISMA Systematic Review and Meta-analysis of Clinical and Paraclinical characteristics

Facing COVID-19 in the hematopoietic cell transplant setting: A new challenge for transplantation physicians

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