Absolute lymphocyte count may predict prognosis in Covid‐19: Study
Researchers at The University of Texas Health Science Center at Houston (UTHealth) have found in a retrospective cohort review that lymphocytopenia can be an early, useful, and easily obtained, prognostic factor in determining the clinical course and disease severity of a patient admitted to the hospital for Covid‐19.
The findings of the study may help clinicians better prepare for these patients.
The results of the findings were published today in the International Journal of Laboratory Hematology.
The severity of COVID-19 infections can range from little or no symptoms for some patients to fighting for their lives in the intensive care unit (ICU) for others. Little is known about what causes these differences.
"Because of the uncertainty surrounding the implications of this virus, we knew there needed to be a prognostic factor that could aid hospital workers in managing COVID-19," said Ahmad Farooq, MD, corresponding author on the study, and assistant professor of gastroenterology at McGovern Medical School at UTHealth. "In this study, we discovered evidence of a relationship between lymphocytopenia and disease severity that could really help clinicians prepare for critically ill patients."
Lymphocytopenia is the condition of having an abnormally low levels of white blood cells, called lymphocytes, which are key components of the immune system.
Using a cohort of 57 patients from a local Houston hospital, researchers analyzed basic, clinical, and laboratory data from a simple blood draw and found that patients who were admitted into an ICU showed signs of lymphocytopenia compared to patients who were not in the ICU.
"Lymphocytopenia is known to be common in many viral illnesses, in particular other coronaviruses including Severe Acute Respiratory Syndrome coronavirus (SARS-CoV) and Middle Eastern Respiratory Syndrome coronavirus (MERS-CoV)," said Jason Wagner, MD, lead author on the study and internal medicine resident at McGovern Medical School. "However, few studies have determined if lymphocytopenia found at the time of admission to the hospital is helpful in understanding the course of the disease."
At the time of hospital admission, patients who ended up in the ICU had lymphocytopenia in comparison to those not needing ICU admission, revealing that blood lymphocyte count could be a predictive marker in identifying who may be admitted into the ICU and suffer severe implications.
Additionally, researchers found that patients with lymphocytopenia were more likely to develop an acute kidney injury (AKI) during admission. According to Farooq, mortality rates are higher in patients who have both COVID-19 and AKI compared to those without AKI.
"The finding of an association with AKI warrants further research. Nevertheless, it is apparent here that lymphocytopenia may serve as a prognostic marker for AKI in patients with COVID-19," Farooq said.
Additional UTHealth authors include Andrew DuPont, MD, associate professor of gastroenterology; Scott Larson, MD, PhD, assistant professor of gastroenterology; and Brooks Cash, MD, professor and Dan and Lillie Sterling Professor in Clinical Gastroenterology.
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