Impact of age and gender on lymphocyte subset counts in patients with COVID-19
Phillip Löhr1, Stefan Schiele2, Tim Tobias Arndt2
1Department of Hematology and Oncology, Medical Faculty, University of Augsburg, Augsburg, Germany.
Insights
Lymphocyte counts decrease in COVID-19 patients, with age and gender significantly impacting these cell alterations. Understanding these factors is crucial for accurate assessment of immune cell changes.
Area of Science:
- Immunology
- Hematology
- Virology
Background:
- Lymphocytopenia is a common finding in symptomatic Coronavirus disease 2019 (COVID-19) patients.
- Previous assessments of COVID-19-related cell count alterations have not adequately considered age and gender.
- Understanding demographic influences on lymphocyte subsets is vital for accurate COVID-19 patient assessment.
Purpose of the Study:
- To analyze the impact of COVID-19, age, and gender on various lymphocyte subsets.
- To compare lymphocyte subset counts in COVID-19 patients versus healthy individuals.
- To determine the independent and combined effects of COVID-19, age, and gender on lymphocyte populations.
Main Methods:
- Comparative analysis of lymphocyte subset counts in 33 COVID-19 patients and 50 healthy controls.
- Utilized multivariate analysis to assess the influence of COVID-19, age, and gender.
- Examined a wide range of lymphocyte subsets, including T cells (CD4+, CD8+), B cells, and NK cells.
Main Results:
- COVID-19 patients showed reduced counts of total lymphocytes, B cells, NK cells, and cytotoxic/helper T cells, observed in both moderate and severe cases.
- Age-dependent reductions were noted in total lymphocytes, CD8+ central memory (CM) and early subsets, and CD4+ naïve, CM, and regulatory subsets.
- Male gender was associated with lower CD3+ and CD4+ lymphocyte counts, independent of COVID-19 status or age.
Conclusions:
- COVID-19 significantly reduces lymphocyte and subset counts, but age and gender are critical confounding factors in interpretation.
- Age independently affects specific CD4+ and CD8+ T cell subsets, particularly naïve CD8+ cells.
- Gender influences overall CD3+ and CD4+ T cell numbers, necessitating consideration in clinical assessments.
Abstract:
In symptomatic patients with acute Coronavirus disease 2019 (COVID-19), lymphocytopenia is one of the most prominent laboratory findings. However, to date age and gender have not been considered in assessment of COVID-19-related cell count alterations. In this study, the impact of COVID-19 as well as age and gender on a large variety of lymphocyte subsets was analyzed in 33 COVID-19 patients and compared with cell counts in 50 healthy humans. We confirm that cell counts of total lymphocytes, B, NK, cytotoxic and helper T cells are reduced in patients with severe COVID-19, and this tendency was observed in patients with moderate COVID-19. Decreased cell counts were also found in all subsets of these cell types, except for CD4+ and CD8+ effector memory RA+ (EMRA) and terminal effector CD8+ cells. In multivariate analysis however, we show that in addition to COVID-19, there is an age-dependent reduction of total, central memory (CM), and early CD8+ cell subsets, as well as naïve, CM, and regulatory CD4+ cell subsets. Remarkably, reduced naïve CD8+ cell counts could be attributed to age alone, and not to COVID-19. By contrast, decreases in other subsets could be largely attributed to COVID-19, and only partly to age. In addition to COVID-19, male gender was a major factor influencing lower counts of CD3+ and CD4+ lymphocyte numbers. Our study confirms that cell counts of lymphocytes and their subsets are reduced in patients with COVID-19, but that age and gender must be considered when interpreting the altered cell counts.
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