Absolute lymphocyte count is a prognostic marker in Covid-19: A retrospective cohort review

Int J Lab Hematol. 2020 Dec;42(6):761-765. doi: 10.1111/ijlh.13288. Epub 2020 Jul 10.

Abstract

Introduction: Prognostic factors are needed to aid clinicians in managing Covid-19, a respiratory illness. Lymphocytopenia has emerged as a simply obtained laboratory value that may correlate with prognosis.

Methods: In this article, we perform a retrospective cohort review study on patients admitted to one academic hospital for Covid-19 illness. We analyzed basic demographic, clinical, and laboratory data to understand the relationship between lymphocytopenia at the time of hospital admission and clinical outcomes.

Results: We discovered that lymphocyte count is lower (P = .01) and lymphocytopenia more frequent by an odds ratio of 3.40 (95% CI: 1.06-10.96; P = .04) in patients admitted to the Intensive Care Unit (ICU), a marker of disease severity, relative to those who were not. We additionally find that patients with lymphocytopenia were more likely to develop an acute kidney injury (AKI), a marker of organ failure, during admission by an odds ratio of 4.29 (95% CI: 1.35-13.57; P = .01).

Conclusion: This evidence supports the hypothesis 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.

Keywords: SARS-CoV-2 infection; acute kidney injury; covid-19; lymphopenia; prognosis.

MeSH terms

  • Acute Kidney Injury / blood
  • Acute Kidney Injury / epidemiology
  • Acute Kidney Injury / etiology
  • Adult
  • Aged
  • Anemia / etiology
  • COVID-19
  • Coronavirus Infections / blood*
  • Coronavirus Infections / complications
  • Coronavirus Infections / drug therapy
  • Coronavirus Infections / mortality
  • Female
  • Hospitals, Teaching / statistics & numerical data
  • Humans
  • Intensive Care Units
  • Intubation, Intratracheal / statistics & numerical data
  • Lymphocyte Count*
  • Lymphopenia / etiology
  • Male
  • Middle Aged
  • Odds Ratio
  • Pandemics
  • Pneumonia, Viral / blood*
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / drug therapy
  • Pneumonia, Viral / mortality
  • Prognosis
  • Retrospective Studies
  • Texas / epidemiology
  • Vasoconstrictor Agents / therapeutic use

Substances

  • Vasoconstrictor Agents