Abstract

BackgroundTo explore the relationship between peripheral lymphocyte counts (PLCs) and the mortality risk of coronavirus disease 2019 (COVID-19), as well as the potential of PLC for predicting COVID-19 hospitalized patients death.MethodsBaseline characteristics, laboratory tests, imaging examinations, and outcomes of 134 consecutive COVID-19 hospitalized patients were collected from a tertiary hospital in Wuhan city from January 25 to February 24, 2020. Multiple regression analysis was used to analyze the relationship between the PLC at admission and mortality risk in COVID-19 patients and to establish a model for predicting death in COVID-19 hospitalized patients based on PLC.ResultsAfter adjusting for potential confounding factors, we found a non-linear relationship and threshold saturation effect between PLC and mortality risk in COVID-19 patients (infection point of PLC: 0.95 × 109/L). Multiple regression analysis showed that when PLCs of COVID-19 patients were lower than 0.95 × 109/L, the patients had a significantly higher mortality risk as compared to COVID-19 patient with PLCs > 0.95 × 109/L (OR 7.27; 95% CI 1.10–48.25). The predictive power of PLC for death in COVID-19 patients (presented as area under the curve) was 0.78. The decision curve analysis showed that PLC had clinical utility for the prediction of death in COVID-19 inpatients.ConclusionsPLC had a non-linear relationship with mortality risk in COVID-19 inpatients. Reduced PLCs (< 0.95 × 109/L) were associated with an increased mortality risk in COVID-19 inpatients. PLCs also had a potential predictive value for the death of COVID-19 inpatients.

Highlights

  • To explore the relationship between peripheral lymphocyte counts (PLCs) and the mortality risk of coronavirus disease 2019 (COVID-19), as well as the potential of Peripheral lymphocyte count (PLC) for predicting COVID-19 hospitalized patients death

  • Coronavirus disease 2019 (COVID-19) is a severe acute respiratory infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and it has been designated by the World Health Organization as a pandemic [1,2,3]

  • A non-linear relationship was observed between the PLCs and mortality risk from COVID-19 in smooth curve fitting (Fig. 1)

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Summary

Introduction

To explore the relationship between peripheral lymphocyte counts (PLCs) and the mortality risk of coronavirus disease 2019 (COVID-19), as well as the potential of PLC for predicting COVID-19 hospitalized patients death. Lymphocytes produced by lymphoid organs are the smallest white blood cells (WBCs) and are important cellular components of the immune response in the body. They are the main executor of immune functions of the lymphatic system and the front-line defense against external pathogens in the body [7, 8]. The host innate and adaptive immune responses play an important role in resisting the progression and prognosis of COVID-19 [9], indicating the close relationship between peripheral lymphocyte counts (PLCs) and the occurrence and progression of COVID-19. The aim of this study was to perform a retrospective cohort study to analyze the specific relationship between PLCs and the mortality risk of COVID19 inpatients and to determine the potential of PLCs in predicting death in COVID-19 inpatients

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