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Neutrophilia and Lymphopenia Occur Coincidentally with Pneumonia Progression in Severe COVID-19 Patients
33 Pages Posted: 26 May 2020
More...Abstract
Background: A critical issue is to identify COVID-19 patients early who develop severe pneumonia. Understanding the relationship of the laboratory parameters and radiological features of COVID-19 patients may improve the diagnosis of severe pneumonia.
Methods: A retrospective analysis was performed on 55 confirmed COVID-19 patients included mild, moderate, and severe cases. The kinetic of clinical characteristics of these groups were compared. Blood parameters and CT values, estimated by chest CT scan, in 23 COVID-19 patients were analyzed. Bayesian inference was used to quantify the trend of major parameters.
Findings: Principal Component Analysis indicated that higher Neutrophil to Lymphocyte Ratio and lower lymphocyte counts contributed most to disease severity among all variables. Neutrophil counts were dramatically increased while lymphocyte counts were lower in severe COVID-19 patients during disease compared to the other two groups. Neutrophilia occurred in 6 of 8 severe COVID-19 patients at 7 to 19 days after symptom onset. In severe cases, neutrophilia or lymphopenia coincided with the enlargement or consolidation of existing lesions or with the appearance of new lesions. There was a clear trend of increasing neutrophil counts parallel to increasing CT values of lung lesions during progressing pneumonia. Lymphocyte counts showed a clear decreasing trend inversely to CT values.
Interpretation: Neutrophilia and lymphopenia occurred coincidently with progressing lung lesions in severe COVID-19 patients about 7 days after symptom onset, indicating their vital role in lung injury associated with SARS-CoV-2 infection.
Funding Statement: This work was supported by the foundation of Wuxi Medical Development Discipline for Infectious Disease (FZXK006) and Wuxi Young Medical Talents (Q201743), Health and Science Bureau of Wuxi (MS201731, CSE31N1712).
Declaration of Interests: All authors disclose that there are no conflicts of interest.
Ethics Approval Statement: A written informed consent was obtained from all patients from the Fifth People's Hospital, Wuxi, China. The study was approved by the Ethics Committee of the Fifth People's Hospital, Wuxi (NO.2020-006-1).
Keywords: COVID-19, SARS-CoV-2, neutrophilia, lymphopenia, pneumonia
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