Analysis of lymphocyte subsets in COVID-19 patients: a retrospective observational study


Submitted: 7 December 2022
Accepted: 29 June 2023
Published: 18 December 2023
Abstract Views: 719
PDF: 49
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In this retrospective study, we analyzed the possible predictive changes in lymphocyte subsets of Coronavirus Disease 19 (COVID-19) hospitalized patients. We enrolled 107 COVID-19 patients older than 18 years of age, admitted to Alessandria Hospital with a confirmed diagnosis of SARS-CoV-2 infection by Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR), who performed the analysis of lymphocyte subsets, between 2020 March 01 and 2021 May 31. Patients have been split up into two groups, based on clinical manifestations: group 1 non-severe disease (n=44) and group 2 severe disease (n=63), according to the World Health Organization (WHO) interim guidance. For the comparison between the two groups of patients, statistical significance was tested with the Mann-Whitney and the Chi-Square test. In the group of patients with severe disease, the blood cell analysis showed a significant reduction in the counts of total lymphocytes, absolute CD3 lymphocytes, and CD8 lymphocytes, as well as a significant reduction in monocyte percent and a very significant increase in neutrophil counts. From the results obtained, it can be stated that lymphocytopenia is associated with the progression of the disease and increased mortality.


Zhu N, Zhang D, Wang W, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 2020;382:727-33. DOI: https://doi.org/10.1056/NEJMoa2001017

Li Q, Guan X, Wu P, et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med. 2020;382:1199-207. DOI: https://doi.org/10.1056/NEJMoa2001316

World Health Organization. Clinical management of severe acute respiratory infection when novel coronavirus (2019-nCoV) infection is suspected: interim guidance. 2020. Available from: https://apps.who.int/iris/handle/10665/330893

Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet Lond Engl. 2020;395:497-506. DOI: https://doi.org/10.1016/S0140-6736(20)30183-5

Grant MC, Geoghegan L, Arbyn M, et al. The prevalence of symptoms in 24,410 adults infected by the novel coronavirus (SARS-CoV-2; COVID-19): A systematic review and meta-analysis of 148 studies from 9 countries. PloS One. 2020;15:e0234765. DOI: https://doi.org/10.1371/journal.pone.0234765

Zheng Z, Peng F, Xu B, et al. Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis. J Infect. 2020;81:e16-25. DOI: https://doi.org/10.1016/j.jinf.2020.04.021

Betti M, Bertolotti M, Ferrante D, et al. Baseline clinical characteristics and prognostic factors in hospitalized COVID-19 patients aged ≤ 65 years: A retrospective observational study. PloS One. 2021;16:e0248829. DOI: https://doi.org/10.1371/journal.pone.0248829

Iannetta M, Buccisano F, Fraboni D, et al. Baseline T-lymphocyte subset absolute counts can predict both outcome and severity in SARS-CoV-2 infected patients: a single center study. Sci Rep. 2021;11:12762. DOI: https://doi.org/10.1038/s41598-021-90983-0

Ashrafi F, Nematollahi P, Salmasi M, et al. Association of lymphocyte subsets with mortality in severe COVID-19 pneumonia patients. J Clin Lab Anal. 2021;35:e24046. DOI: https://doi.org/10.1002/jcla.24046

Yang G, Feng F, Li X, et al. Changes of lymphocyte subsets in patients with COVID-19 and clinical significance: a case-control observational study. J Bio-X Res. 2021;4:36-9. DOI: https://doi.org/10.1097/JBR.0000000000000089

Deng Z, Zhang M, Zhu T, et al. Dynamic changes in peripheral blood lymphocyte subsets in adult patients with COVID-19. Int J Infect Dis IJID Off Publ Int Soc Infect Dis. 2020;98:353-8. DOI: https://doi.org/10.1016/j.ijid.2020.07.003

Huang W, Berube J, McNamara M, et al. Lymphocyte Subset Counts in COVID-19 Patients: A Meta-Analysis. Cytom Part J Int Soc Anal Cytol. 2020;97:772-6. DOI: https://doi.org/10.1002/cyto.a.24172

Harris PA, Taylor R, Thielke R, et al. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42:377-81. DOI: https://doi.org/10.1016/j.jbi.2008.08.010

Liu J, Li S, Liu J, et al. Longitudinal characteristics of lymphocyte responses and cytokine profiles in the peripheral blood of SARS-CoV-2 infected patients. EBioMedicine. 2020;55:102763. DOI: https://doi.org/10.1016/j.ebiom.2020.102763

Liu K, Chen Y, Lin R, Han K. Clinical features of COVID-19 in elderly patients: A comparison with young and middle-aged patients. J Infect. 2020;80:e14-8. DOI: https://doi.org/10.1016/j.jinf.2020.03.005

Zhu J, Paul WE. CD4 T cells: fates, functions, and faults. Blood. 2008;112:1557-69. DOI: https://doi.org/10.1182/blood-2008-05-078154

Gan J, Li J, Li S, Yang C. Leucocyte Subsets Effectively Predict the Clinical Outcome of Patients With COVID-19 Pneumonia: A Retrospective Case-Control Study. Front Public Health. 2020;8:299. DOI: https://doi.org/10.3389/fpubh.2020.00299

Tang Y, Liu J, Zhang D, et al. Cytokine Storm in COVID-19: The Current Evidence and Treatment Strategies. Front Immunol. 2020;11:1708. DOI: https://doi.org/10.3389/fimmu.2020.01708

Akbari H, Tabrizi R, Lankarani KB, et al. The role of cytokine profile and lymphocyte subsets in the severity of coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis. Life Sci. 2020;258:118167. DOI: https://doi.org/10.1016/j.lfs.2020.118167

Ciriello, M. M., Tommasi, N., Massarino, C., Cassinari, A., Bensi, T., Doglio, R., Roveta, A., & Maconi, A. (2023). Analysis of lymphocyte subsets in COVID-19 patients: a retrospective observational study. Working Paper of Public Health, 11(1). https://doi.org/10.4081/wpph.2023.9643

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