Lymphocyte count predicts the severity of COVID-19: Evidence from a meta-analysis

doi:10.5495/wjcid.v11.i3.49

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World Journal of Clinical Infectious Diseases

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Meta-Analysis

World J Clin Infect Dis. Nov 5, 2021; 11(3): 49-59
Published online Nov 5, 2021. doi: 10.5495/wjcid.v11.i3.49

Lymphocyte count predicts the severity of COVID-19: Evidence from a meta-analysis

Yi-Si Zhao, Ying-Xi Yu

Yi-Si Zhao, Ying-Xi Yu, Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China

Author contributions: Zhao YS wrote and revised this manuscript; Zhao YS and Yu YX participated in discussion the research; Zhao YS searched and collected bibliography.

Conflict-of-interest statement: We not received any fees for serving as a speaker. We not received any research funding from.

PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.

Corresponding author: Yi-Si Zhao, MM, Doctor, Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi road, Yuzhong District, Chongqing 400016, China. 476663973@qq.com

Received: February 27, 2021
Peer-review started: February 27, 2021
First decision: March 31, 2021
Revised: April 3, 2021
Accepted: September 10, 2021
Article in press: September 10, 2021
Published online: November 5, 2021
Processing time: 247 Days and 20.6 Hours

ARTICLE HIGHLIGHTS

Research background

In December 2019, coronavirus disease 2019 (COVID-19) was reported first in Wuhan, China. COVID-19 is currently a global pandemic.

Research motivation

COVID-19 with high morbidity is a life-threatening disease globally. It is important to develop a rapid, simple clinical method to identify severe COVID-19 cases.

Research objectives

The aim of this study was to assess the suitability of lymphocyte count as a biomarker of COVID-19 severity.

Research methods

We searched five literature databases (PubMed/MEDLINE, Web of Science, Google Scholar, Embase, and Scopus) to identify eligible articles. A meta-analysis was performed to calculate the standard mean difference (SMD) and 95% confidence interval (CI) of lymphocyte counts in coronaviral pneumonia cases.

Research results

Our research integrated eight studies, including 1057 patients. Lymphocyte counts were associated with severe coronavirus (CoV) infection (SMD = 1.35, 95%CI: 1.97 to 0.37, P < 0.001, I² = 92.6%). In the subgroup analysis stratified by prognosis, lymphocytes were associated with coronavirus infection mortality (n = 2, SMD = 0.42, 95%CI: 0.66 to 0.19, P < 0.001, I² = 0.0%), severity (n = 2, SMD = 0.93, 95%CI: 1.20 to 0.67, P < 0.001, I² = 0.0%), and diagnostic rate (n = 4, SMD = 2.32, 95%CI: 3.60 to 1.04, P < 0.001, I² = 91.2%).

Research conclusions

Lymphocyte count may represent a simple, rapid and commonly available laboratory index with which to diagnosis infection and predict the severity of CoV infections, including COVID-19.

Research perspectives

As a CoV hypotype, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is similar to the CoVs causing severe acute respiratory syndrome and Middle East respiratory syndrome. Hence, we performed a systematic review and meta-analysis of the literature to evaluate the diagnostic and prognostic utility of lymphocyte count in patients with viral pneumonia caused by CoV infections. Our aim was to explore the possibility that lymphocyte counts predict COVID-19 severity and provide associated evidence.