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. 2021 Dec 9;21(1):1236.
doi: 10.1186/s12879-021-06899-7.

Characteristics of peripheral white blood cells in COVID-19 patients revealed by a retrospective cohort study

Xunliang Tong  1 , Anqi Cheng  2   3   4   5 , Xueting Yuan  6 , Xuefeng Zhong  1 , He Wang  1 , Wei Zhou  1 , Xiaomao Xu  7 , Yanming Li  8
Affiliations

Characteristics of peripheral white blood cells in COVID-19 patients revealed by a retrospective cohort study

Xunliang Tong et al. BMC Infect Dis. .

Abstract

Background: Peripheral hematological changes in severe COVID-19 patients may reflect the immune response during SARS-CoV-2 infection. Characteristics of peripheral white blood cells as early signals were needed to be investigated for clarifying its associations with the fatal outcomes in COVID-19 patients.

Methods: A retrospective cohort study was performed and the hospitalized COVID-19 patients were recruited in wards of Sino-French New City Branch of Tongji Hospital in Wuhan, Hubei province, China. Characteristics of peripheral white blood cells in survivors and non-survivors were analyzed. Comparison among patients with different level of eosinophils was performed.

Results: Of 198 patients included in this study, 185 were discharged and 13 died. Levels of eosinophils, lymphocytes and basophils in non-survivors were significantly lower than those in survivors. Death rate in low eosinophils group was higher and no patient died in normal eosinophils group (16.7% vs 0, P < 0.001). The proportion of patients in low eosinophils group who used glucocorticoids was higher than in normal eosinophils group, but glucocorticoids usage was not an indicator for death in subgroup analysis in low eosinophils patients. Moreover, positive correlation was found between the counts of lymphocytes and eosinophils in patients with glucocorticoids use but not in patients without the treatment.

Conclusions: Hematological changes differed between survivors and non-survivors with COVID-19. Lymphopenia and eosinopenia could be predictors for poor prognosis of COVID-19 patients. Initial counts of eosinophils may guide us in usage of glucocorticoids for COVID-19 treatment.

Keywords: COVID-19; Eosinophils; Immune response; Lymphocytes; Prognosis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Characteristics of peripheral blood cells between survivors and non-survivors. Figure shows the counts of peripheral blood cells among survivors and non-survivors on admission (OA) and end hospitalization (End)
Fig. 2
Fig. 2
Correlation networks for peripheral blood cells among survivors and non-survivors. Networks showed different profiles of correlations in non-survivors (A and C) and survivors (B and D), on admission (A and B) and end hospitalization (C and D). The width of the edge showing stronger or weaker interactions is proportional to the absolute value of cell–cell correlation (|r|). Edges were shown only when |r|> 0.2. An orange edge indicates a positive correlation, and a blue edge indicates a negative correlation
Fig. 3
Fig. 3
Correlation networks for peripheral blood cells among patients with and without glucocorticoids. Networks showed different profiles of correlations in patients with glucocorticoids (A and C) and without glucocorticoids (B and D), on admission (A and B) and end hospitalization (C and D). The width of the edge showing stronger or weaker interactions is proportional to the absolute value of cell–cell correlation (|r|). Edges were shown only when |r|> 0.2. An orange edge indicates a positive correlation, and a blue edge indicates a negative correlation
See this image and copyright information in PMC

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