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. 2022 Mar 24;11(7):1803.
doi: 10.3390/jcm11071803.

Lymphopenia and Early Variation of Lymphocytes to Predict In-Hospital Mortality and Severity in ED Patients with SARS-CoV-2 Infection

Maxence Simon  1 , Pierrick Le Borgne  1   2 , François Lefevbre  3 , Sylvie Chabrier  1 , Lauriane Cipolat  4 , Aline Remillon  4 , Florent Baicry  1 , Pascal Bilbault  1 , Charles-Eric Lavoignet  5 , Laure Abensur Vuillaume  4
Affiliations

Lymphopenia and Early Variation of Lymphocytes to Predict In-Hospital Mortality and Severity in ED Patients with SARS-CoV-2 Infection

Maxence Simon et al. J Clin Med. .

Abstract

(1) Introduction: Multiple studies have demonstrated that lymphocyte count monitoring is a valuable prognostic tool for clinicians during inflammation. The aim of our study was to determine the prognostic value of delta lymphocyte H24 from admission from the emergency department for mortality and severity of SARS-CoV-2 infection. (2) Methods: We have made a retrospective and multicentric study in six major hospitals of northeastern France. The patients were hospitalized and had a confirmed diagnosis of SARS-CoV-2 infection. (3): Results: A total of 1035 patients were included in this study. Factors associated with infection severity were CRP > 100 mg/L (OR: 2.51, CI 95%: (1.40−3.71), p < 0.001) and lymphopenia < 800/mm3 (OR: 2.15, CI 95%: (1.42−3.27), p < 0.001). In multivariate analysis, delta lymphocytes H24 (i.e., the difference between lymphocytes values at H24 and upon admission to the ED) < 135 was one of the most significant biochemical factors associated with mortality (OR: 2.23, CI 95%: (1.23−4.05), p = 0.009). The most accurate threshold for delta lymphocytes H24 was 75 to predict severity and 135 for mortality. (4) Conclusion: Delta lymphocytes H24 could be a helpful early screening prognostic biomarker to predict severity and mortality associated with COVID-19.

Keywords: COVID-19; lymphopenia; mortality.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Receiver operating characteristics curve (ROC) for the ability of lymphocyte and early version to predict severity. Legend: CRP = C reactive protein, * = p < 0.005.
Figure 2
Figure 2
Receiver operating characteristics curve (ROC) for ability of lymphocyte and early variation to predict mortality. Legend: CRP = C reactive protein, * = p < 0.005.
See this image and copyright information in PMC

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