Lymphopenia predicted illness severity and recovery in patients with COVID-19: A single-center, retrospective study

PLoS One. 2020 Nov 18;15(11):e0241659. doi: 10.1371/journal.pone.0241659. eCollection 2020.

Abstract

The outbreak of SARS-CoV-2 began in December 2019 and rapidly became a pandemic. The present study investigated the significance of lymphopenia on disease severity. A total of 115 patients with confirmed COVID-19 from a tertiary hospital in Changsha, China, were enrolled. Clinical, laboratory, treatment and outcome data were gathered and compared between patients with and without lymphopenia. The median age was 42 years (1-75). Fifty-four patients (47.0%) of the 115 patients had lymphopenia on admission. More patients in the lymphopenia group had hypertension (30.8% vs. 10.0%, P = 0.006) and coronary heart disease (3.6% vs. 0%, P = 0.029) than in the nonlymphopenia group, and more patients with leukopenia (48.1% vs 14.8%, P<0.001) and eosinopenia (92.6% vs 54.1%, P<0.001) were observed. Lymphopenia was also correlated with severity grades of pneumonia (P<0.001) and C-reactive protein (CRP) level (P = 0.0014). Lymphopenia was associated with a prolonged duration of hospitalization (17.0 days vs. 14.0 days, P = 0.002). Lymphocyte recovery appeared the earliest, prior to CRP and chest radiographs, in severe cases, which suggests its predictive value for disease improvement. Our results demonstrated the clinical significance of lymphopenia for predicting the severity of and recovery from COVID-19, which emphasizes the need to dynamically monitor lymphocyte count.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • COVID-19 / complications*
  • COVID-19 / diagnosis*
  • COVID-19 / epidemiology
  • Female
  • Humans
  • Lymphopenia / complications*
  • Male
  • Middle Aged
  • Pandemics
  • Prognosis
  • Retrospective Studies
  • Severity of Illness Index*
  • Young Adult

Grants and funding

This research was supported in part by the National Natural Science Foundation of China in the form of grants awarded to LH (81800198) and PH (81670160), the Innovative Major Emergency Project Funding against the New Coronavirus Pneumonia in Hunan Province in the form of grants awarded to LJ (2020SK3014) and TX (2020SK3045), Scientific Research Project of Hunan Provincial Health Commission in the form of a grant awarded to LJ (20200216), and the Natural Science Foundation of Hunan Province in the form of a grant (2019JJ50863).