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Association between Peripheral Lymphocyte Count and the Mortality Risk of COVID-19
24 Pages Posted: 9 Apr 2020
More...Abstract
Objective: 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.
Methods: Baseline 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.
Results: After 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 patients.
Conclusions: PLC had a non-linear relationship with mortality risk in COVID-19 patients. Reduced PLCs (<0.95×109/L) were associated with an increased mortality risk in COVID-19 patients. PLCs also had a potential predictive value for the death of COVID-19 patients.
Funding Statement: This project was supported by the Research Project of Emergency Prevention and Control of COVID-19 in Jinhua City (No. 2020XG-15).
Declaration of Interests: The authors have no conflicts of interest.
Ethics Approval Statement: This study adhered to the ethical principles of the Declaration of Helsinki and was approved by the Ethics Committee of Wuhan Fourth Hospital (No. KY2020-033-01). All study data were collected from an electronic medical record system, and written informed consent was waived by the Ethics Committee of Wuhan Fourth hospital for emerging infectious diseases.
Keywords: Coronavirus disease 2019; lymphocyte count; non-linear relationship; mortality; prediction
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