Lymphocytopenia as a biomarker of severity in pediatric patients with COVID-19
Keywords:
lymphocytes, lymphopenia, lymphocyte count, pediatrics, SARS-CoV-2.Abstract
Introduction: COVID-19 in pediatric ages presents unique features; a small number of pediatric patients develop severe clinical status.
Objectives: To evaluate whether lymphocytopenia is a predictor of severity in pediatric patients with COVID-19.
Methods: In 706 patients were studied the variables age, sex, personal pathological history of childhood chronic diseases (bronchial asthma, diabetes mellitus), comorbidities, clinical status, lymphocyte values, absolute lymphocyte count (= 1 x 109/L = lymphocytopenia). According to clinical status patients were grouped into 5 groups, from asymptomatic to critical. The correlation between clinical status and absolute lymphocyte count was determined; its discriminative capacity to estimate prognosis was determined.
Results: The mean age was 8.6 years; 6.2% of patients progressed to severe or critical condition; 74.6% had normal lymphocyte values, 16.14% high and 9.2% low. Lymphocytopenia presented 4.2%; it was significantly correlated with severe condition, area under the curve of 0.711 (95% CI: 0.595-0.827); 46% sensitivity and 98% specificity.
Conclusions: Lymphocytopenia is a biomarker that can estimate prognosis in pediatric patients with COVID-19 who develop severe clinical status.
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References
2. Rabaan AA, Al-Ahmed SH, Haque S, Sah R, Tiwari R, Mallk YS, et al. SARS-CoV-2, SARS-CoV, and MERS-COV: A comparative overview. Le Infezioni in Medicina. 2020 [acceso: 31/07/2022]; 28(2):174-84. Disponible en: https://infezmed.it/media/journal/Vol_28_2_2020_7.pdf
3. Chafekar A, Fielding BC. MERS-CoV: Understanding the Latest Human Coronavirus Threat. Viruses. 2018; 10(2):93. Published 2018 Feb 24. DOI: 10.3390/v10020093
4. Zhang JJ, Dong X, Cao YY, Yuan Y, Yang Y, Yan Y, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy. 2020; 75:1730-1741. DOI: 10.1111/all.1423
5. Al Johani S, Hajeer AH. MERS-CoV diagnosis: An update. J Infect Public Health. 2016 [acceso: 31/07/2022]; 9(3):216-9. Disponible en: https://www.sciencedirect.com/science/article/pii/S1876034116300223
6. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. 2020; 395(10229):1038. DOI: 10.1016/S0140-6736(20)30566-3
7. Hoang VT, Dao TL, Gautret P. Recurrence of positive SARS-CoV-2 in patients recovered from COVID-19. J Med Virol. 2020 [acceso: 30/06/2022]; 92(11):2366-7. Disponible en: https://onlinelibrary.wiley.com/doi/10.1002/jmv.26056
8. López-Escobar A, Madurga R, Castellano JM, Ruiz de Aguiar S, Velázquez S, Bucar M, et al. Hemogram as marker of in-hospital mortality in COVID-19. J Investig Med. 2021; [acceso: 31/07/2022]; 69(5):962-9. Disponible en: https://web.archive.org/web/20210429073154id_/https://jim.bmj.com/content/jim/-early/2021/04/12/jim-2021-001810.full.pdf
9. Qu R, Ling Y, Zhang YH. Platelet-to-lymphocyte ratio is associated with prognosis in patients with coronavirus disease-19. J Med Virol. 2020; 92(9):1533-41. DOI: 10.1002/jmv.25767
10. Sun X, Liu X, Liu J, Chen S, Xu D, Li W, et al. Preoperative neutrophil-to-lymphocyte ratio plus platelet-to-lymphocyte ratio in predicting survival for patients with stage I-II gastric cancer. Chin J Cancer. 2016; [acceso: 30/06/2022]; 35(1):57. Disponible en: https://cancercommun.biomedcentral.com/articles/10.1186/s40880-016-0122-2
11. Huang I, Pranata R. Lymphopenia in severe coronavirus disease-2019 (COVID-19): systematic review and meta-analysis. J Intensive Care. 2020; 8(36):[aprox. 20 p.]. DOI: 10.1186/s40560-020-00453-4
12. Zhang JJ, Dong X, Cao YY, Yuan YD, Yang YB, Yan YQ, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy. 2020; 75(7):1730-41. DOI: 10.1111/all.14238
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