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

By L. Tan, Qi Wang, Duanyang Zhang, Jinya Ding, Qianchuan Huang, Yi-Quan Tang, Qiongshu Wang, Hongming Miao. Signal Transduction and Targeted Therapy, 2020

1,585 citations recorded by the source corpus.

Background: Coronavirus disease-2019 (COVID-19) is a rapidly escalating epidemic caused by SARS-CoV-2. Identification of a simple and effective indicator to assess disease severity and outcome is urgently needed. Methods: This study retrospectively analyzed dynamic changes of lymphocyte percentage (LYM%) in 15 death cases, 15 severe cases as well as 40 moderate cases of COVID-19 patients. Next, prognostic role of lymphopenia in COVID-19 were verified in 92 hospitalized cases. Results: Our results from death and severe cases showed that LYM% in blood test were inversely associated with the progression and severity of COVID-19. LYM% in patients with moderate COVID-19 remained higher than 20% 10-12 days after symptom onset. In contrast, LYM% was lower than 20% in severe cases. However, LYM% in severe cases was higher than 5% 17-19 days after the onset of the disease, while it fell below 5% in death cases. Therefore, we established a reliable Time from symptom onset-LYM% model (TLM), which could be used to evaluate disease severity and predict the outcomes of hospitalized patients with COVID-19. Conclusion: Lymphopenia can be used to indicate clinical course, treatment effect and outcomes of COVID-19 patients.

Subfields: Dermatology, Infectious Diseases

View Paper: https://www.semanticscholar.org/paper/8887b4de1ce8a9d30eeb62566368cc4bffd8865f

How researchers see this paper

The researchers whose trusted networks rank it highest, strongest advocate first. Every researcher gets a different order.

In Infectious Diseases

1. Bo Huang
2. Youhai H. Chen
3. X. Wan
4. Jinyan Liu
5. Zhixin Zhang
6. Yi Zhang
7. T. Kanneganti
8. Shasha Liu

Citations in the corpus

• Neutrophil to Lymphocyte Ratio: An Emerging Marker of the Relationships between the Immune System and Diseases (2022, background): “To date, it is well known that the onset of SARS-CoV-2 infection is characterized by lymphocyte reduction and that the rate of this reduction inversely correlates with disease severity [31].”
• COVID-19: immunopathogenesis and Immunotherapeutics (2020, background): “(4) Finally, an increased level of lactic acid was detected in the blood of patients with severe COVID-19,(9) which may inhibit lymphocyte proliferation.(14)”
• Hematological findings and complications of COVID‐19 (2020, background): “Tan et al have proposed a model based on lymphocyte counts at two time points; patients with less than 20% lymphocytes at days 10-12 from the onset of symptoms, and less than 5% at days 17-19 have the worst prognosis.(32) Recent studies have shown that myocardial injury among inpatients with COVID-1”
• Synergism of TNF-α and IFN-γ Triggers Inflammatory Cell Death, Tissue Damage, and Mortality in SARS-CoV-2 Infection and Cytokine Shock Syndromes (2020, positive): “Lymphopenia is one of the hallmarks of severity and hospitalization in patients with COVID-19 (Tan et al., 2020; Zhao et al., 2020).”
• Predictors of COVID-19 severity: A literature review (2020, background): “Further evidence also links the severity of COVID-19 to the degree of lymphopenia, in which blood lymphocyte percentage is inversely associated with severity and prognosis.(89,90) A recent meta-analysis of 20 peer-”
• Kidney disease is associated with in-hospital death of patients with COVID-19 (2020, neutral): “Based on review of the literature, 14, 27, 28 several covariates were selected for analysis as potential confounding variables in our regression analyses.”