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This prospective cohort study evaluated changes in hematologic parameters and lymphocyte subsets in 197 patients with COVID-19 infection compared with 354 controls. Thrombocytopenia was more prevalent in patients with COVID-19, with anemia more so in critically ill COVID-19 patients. Mild lymphopenia (ALC <1.5 x 109), but not severe lymphopenia (ALC <1 x 109), was more common in COVID-19 patients. CD4+ lymphopenia (CD4+ count <300 cells/mm2) was associated with an increased risk of in-hospital mortality in COVID-19 patients. Lymphocyte count recovery occurred approximately 14 days post admission, with delayed CD8+ reconstitution.
Thrombocytopenia and lymphopenia are common (and nonspecific) in COVID-19 infection. While lymphocyte count recovery occurred around day 14 post admission, delayed CD8+ lymphocyte recovery was observed. CD4+ lymphopenia was associated with increased mortality.
– Curtis Lachowiez, MD
This abstract is available on the publisher's site.
Aberrant blood cell counts, most prominently lymphopenia, have been identified as markers of the degree of severity of coronavirus disease 2019 (COVID‐19).1-5 However, most of these studies lack comparison to a COVID‐19‐negative contemporary control group. Additionally, the longitudinal composition and dynamics of lymphocyte subsets in patients with COVID‐19 are insufficiently characterised. We performed a prospective cohort study, in which we compared blood cell and lymphocyte subset counts between (i) hospital‐admitted patients with COVID‐19 and a large contemporary COVID‐19‐negative hospitalised control group, and (ii) non‐critically and critically ill patients with COVID‐19. In addition, we evaluated the impact of these parameters on the in‐hospital mortality rate of COVID‐19. Finally, we assessed the dynamics of lymphocyte reconstitution in patients with COVID‐19 over time.