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Lymphopenia and lung complications in patients with coronavirus disease-2019 (COVID-19): A retrospective study based on clinical data
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  • Ehsan Zaboli,
  • Hadi Majidi,
  • Reza Alizadeh-Navai,
  • Akbar Hedayatizadeh-Omran ,
  • Hossein Asgarian-Omran ,
  • Laleh Vahedi Larijani,
  • Vahid Khodaverdi,
  • Omolbanin Amjadi
Ehsan Zaboli
Mazandaran University of Medical Sciences Faculty of Health

Corresponding Author:[email protected]

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Hadi Majidi
Mazandaran University of Medical Sciences Faculty of Health
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Reza Alizadeh-Navai
Mazandaran University of Medical Sciences Faculty of Medicine
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Akbar Hedayatizadeh-Omran
Mazandaran University of Medical Sciences Faculty of Medicine
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Hossein Asgarian-Omran
Mazandaran University of Medical Sciences Faculty of Health
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Laleh Vahedi Larijani
Mazandaran University of Medical Sciences Faculty of Health
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Vahid Khodaverdi
Mazandaran University of Medical Sciences Faculty of Health
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Omolbanin Amjadi
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Abstract

Background: A rapid outbreak of novel coronavirus, COVID-19, made it a global pandemic. This study focused on the possible association between lymphopenia and Computed tomography (CT) scan features and COVID-19 patient mortality. Method: The clinical data of 596 COVID-19 patients were collected from February 2020 to September 2020. The patients’ serological survey and CT scan features were retrospectively explored. Results: The median age of the patients was 56.7±16.4 years old. Lung involvement was more than 50% in 214 COVID-19 patients (35.9%). The average blood lymphocyte percentage was 20.35 ±10.16. The levels of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and platelet-to-lymphocyte ratio (PLR) may not indicate the severity and prognosis of COVID-19. Patients with severe lung involvement and lymphopenia were found to be significantly associated with increased odds of death (odds ratio [OR], 9.24; 95% confidence interval [95 CI%], 4.32- 19.78). These results indicated that lymphopenia <20% along with pulmonary involvement >50% impose a multiplicative effect on the risk of mortality. The in-hospital mortality rate of this group was significantly higher than other COVID-19 hospitalized cases. Furthermore, they meaningfully experienced a prolonged stay in the hospital (P= 0.00). Conclusion: The Lymphocyte count less than 20% and chest CT scan findings with more than 50% involvement might be related to the patient’s mortality. It could act as laboratory and clinical indicators of disease severity and mortality.
Sep 2021Published in Journal of Medical Virology volume 93 issue 9 on pages 5425-5431. 10.1002/jmv.27060