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Lymphocyte subsets as a predictor of severity and prognosis in COVID-19 patients
Peng Zhang1,2, Wei Du2,3, Ting Yang2,4
1Department of Hematology, General Hospital of Southern Theater Command, Guangzhou, China.
Insights
Blood cell counts and lymphocyte subsets can help predict COVID-19 severity. Higher counts of lymphocytes and T cells correlate with better outcomes and shorter hospital stays for coronavirus disease 2019 patients.
Area of Science:
- Hematology
- Immunology
- Infectious Diseases
Background:
- Coronavirus disease 2019 (COVID-19) poses a global health threat.
- Early prediction of COVID-19 patient severity is crucial for reducing mortality and controlling the pandemic.
Purpose of the Study:
- To investigate the diagnostic and prognostic utility of blood cell counts and lymphocyte subsets in COVID-19 patients.
- To identify key hematological parameters for predicting disease severity and patient outcomes.
Main Methods:
- Analysis of clinical data from 301 COVID-19 patients in Wuhan.
- Utilized receiver operator characteristic (ROC) curves to differentiate between mild and severe/critical cases.
- Employed multivariable Cox regression analysis to identify independent risk factors for in-hospital death.
Main Results:
- Significant differences in blood cell counts and lymphocyte subsets were observed across mild, severe, and critical COVID-19 cases.
- Lymphocyte, CD3+ T cells, CD4+ T cells, and CD8+ T cells showed high diagnostic utility (Area Under ROC: 0.718, 0.721, 0.718, 0.670, respectively).
- Higher counts of these cells correlated with shorter hospital stays and were independent risk factors for in-hospital death.
Conclusions:
- Blood cell counts and lymphocyte subsets are valuable indicators of COVID-19 severity.
- These hematological parameters can aid in predicting patient prognosis and outcomes.
Background:
Coronavirus disease 2019 (COVID-19) had become a worldwide health threat. Early prediction of the severity of COVID-19 patients was important for reducing death rate and controlling this disease.
Methods And Materials:
A total of 301 patients confirmed with COVID-19 in Wuhan from 8 February to 10 April 2020 were included. Clinical data were collected and analyzed. Diagnostic and prognostic utility of blood cell counts and lymphocyte subsets in COVID-19 patients were investigated. The receiver operator characteristic curve (ROC) was used in discriminating the mild and severe/critical cases.
Results:
There were difference in blood cell counts and lymphocyte subsets among mild, severe and critical patients, which were also influenced by comorbidities and duration of disease. The area under the ROC of lymphocyte, CD3+ T cells, CD4+ T cells, and CD8+ T cells were 0.718, 0.721, 0.718, and 0.670, which were higher than that of other hematological parameters. The optimal threshold was 1205, 691, 402, and 177 per μl, respectively. Patients with higher counts of lymphocyte, CD3+ T cells, CD4+ T cells, or CD8+ T cells were correlated with shorter length of stay in hospital (p < 0.05). Multivariable Cox regression analysis showed disease severity, CD3+ T cells counts and time when the nucleic acid turned negative were independent risk factors for in-hospital death of COVID-19 patients (p < 0.05).
Conclusion:
Blood cell counts and lymphocyte subsets correlated with severity of COVID-19.
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