Abstract
Clinical observations have shown that there is a relationship between coronavirus disease 2019 (COVID-19) and atypical lymphocytes in the peripheral blood; however, knowledge about the time course of the changes in atypical lymphocytes and the association with the clinical course of COVID-19 is limited. Our purposes were to investigate the dynamics of atypical lymphocytes in COVID-19 patients and to estimate their clinical significance for diagnosis and monitoring disease course. We retrospectively identified 98 inpatients in a general ward at Kashiwa Municipal Hospital from May 1st, 2020, to October 31st, 2020. We extracted data on patient demographics, symptoms, comorbidities, blood test results, radiographic findings, treatment after admission and clinical course. We compared clinical findings between patients with and without atypical lymphocytes, investigated the behavior of atypical lymphocytes throughout the clinical course of COVID-19, and determined the relationships among the development of pneumonia, the use of supplemental oxygen and the presence of atypical lymphocytes. Patients with atypical lymphocytes had a significantly higher prevalence of pneumonia (80.4% vs. 42.6%, p < 0.0001) and the use of supplemental oxygen (25.5% vs. 4.3%, p = 0.0042). The median time to the appearance of atypical lymphocytes after disease onset was eight days, and atypical lymphocytes were observed in 16/98 (16.3%) patients at the first visit. Atypical lymphocytes appeared after the confirmation of lung infiltrates in 31/41 (75.6%) patients. Of the 13 oxygen-treated patients with atypical lymphocytes, approximately two-thirds had a stable or improved clinical course after the appearance of atypical lymphocytes. Atypical lymphocytes frequently appeared in the peripheral blood of COVID-19 patients one week after disease onset. Patients with atypical lymphocytes were more likely to have pneumonia and to need supplemental oxygen; however, two-thirds of them showed clinical improvement after the appearance of atypical lymphocytes.
Highlights
Coronavirus disease 2019 (COVID-19), an emerging disease caused by a coronavirus, has imposed a substantial health burden worldwide
Atypical lymphocytes appeared after the confirmation of lung infiltrates in 31/41
Atypical lymphocytes frequently appeared in the peripheral blood of COVID-19 patients one week after disease onset
Summary
Coronavirus disease 2019 (COVID-19), an emerging disease caused by a coronavirus, has imposed a substantial health burden worldwide. Several studies have shown that atypical lymphocytes have been found in the peripheral blood [3,4,5] and bronchoalveolar lavage (BAL) samples [6] of COVID-19 patients. It may reflect the disease pathophysiology and provide important information about the diagnosis or prognosis of the disease. Clinical observations have shown that there is a relationship between coronavirus disease 2019 (COVID-19) and atypical lymphocytes in the peripheral blood; knowledge about the time course of the changes in atypical lymphocytes and the association with the clinical course of COVID-19 is limited
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