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. 2020 Sep:508:122-129.
doi: 10.1016/j.cca.2020.05.027. Epub 2020 May 14.

The underlying changes and predicting role of peripheral blood inflammatory cells in severe COVID-19 patients: A sentinel?

Da-Wei Sun  1 , Dong Zhang  2 , Run-Hui Tian  3 , Yang Li  4 , Yu-Shi Wang  5 , Jie Cao  6 , Ying Tang  7 , Nan Zhang  8 , Tao Zan  9 , Lan Gao  10 , Yan-Zhu Huang  11 , Chang-Lei Cui  12 , Dong-Xuan Wang  13 , Yang Zheng  14 , Guo-Yue Lv  15
Affiliations

The underlying changes and predicting role of peripheral blood inflammatory cells in severe COVID-19 patients: A sentinel?

Da-Wei Sun et al. Clin Chim Acta. 2020 Sep.

Abstract

Background: The underlying changes of peripheral blood inflammatory cells (PBICs) in COVID-19 patients are little known. Moreover, the risk factors for the underlying changes of PBICs and their predicting role in severe COVID-19 patients remain uncertain.

Material and methods: This retrospective study including two cohorts: the main cohort enrolling 45 patients of severe type serving as study group, and the secondary cohort enrolling 12 patients of no-severe type serving as control group. The PBICs analysis was based on blood routine and lymphocyte subsets. The inflammatory cell levels were compared among patients according to clinical classifications, disease-associated phases, as well as one-month outcomes.

Results: Compared with patients of non-severe type, the patients of severe type suffered from significantly decreased counts of lymphocytes, eosinophils, basophils, but increased counts of neutrophils. These PBICs alterations got improved in recovery phase, but persisted or got worse in aggravated phase. Compared with patients in discharged group, the patients in un-discharged/died group suffered from decreased counts of total T lymphocytes, CD4 + T lymphocytes, CD8 + T lymphocytes, as well as NK cells at 2 weeks after treatment. Clinical classification-critically severe was the independently risk factor for lymphopenia (OR = 7.701, 95%CI:1.265-46.893, P = 0.027), eosinopenia (OR = 5.595, 95%CI:1.008-31.054, P = 0.049), and worse one-month outcome (OR = 8.984; 95%CI:1.021-79.061, P = 0.048).

Conclusion: Lymphopenia and eosinopenia may serve as predictors of disease severity and disease progression in COVID-19 patients, and enhancing the cellular immunity may contribute to COVID-19 treatment. Thus, PBICs might become a sentinel of COVID-19, and it deserves attention during COVID-19 treatment.

Keywords: Blood routine test; COVID-19; Lymphocytes subsets; Peripheral blood inflammatory cells (PBICs); Severe type.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
The flow chart for patients inclusion, sample collection as well as purposes in this study.
See this image and copyright information in PMC

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