Check for lymphopenia on day 1, 7 and 14
in COVID 19 patients
Dr KK Aggarwal
President CMAAO, HCFI and Past national president IMA
Dengue taught us the value of platelet count interpreted
along with haematocrit and COVID 19 is now teaching us the value of lymphocytes
in blood test.
It has been a standard teaching that all viral fever
will have high lymphocytes counts. Low count will only occur with HIV, SARS
like illness, measles and hepatitis.
Now all studies have shown it to be an important marker
of COVID 19
In the latest study published in March 9, 2020, the Lancet,
the authors showed that baseline lymphocyte count was significantly higher in
survivors than non-survivors; in survivors, lymphocyte count was lowest on day
7 after illness onset and improved during hospitalisation, whereas severe
lymphopenia was observed until death in non-survivors.
Clues for COVID-19 include leukopenia, seen in 30% to
45% of patients, and lymphocytopenia, seen in 85% of the patients in the case
series from China,
Other associated
lab findings are elevated alanine aminotransferase
and aspartate aminotransferase levels (37%).
High D-dimer levels and more severe lymphopenia have been
associated with mortality.
1. Chen N, Zhou M, Dong X, Qu J, Gong F. Epidemiological and clinical
characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan,
China: a descriptive study. Lancet. 2020 Jan 30. [Epub ahead of
print]
2. Li Q, Guan X, Wu P, Wang X, Zhou L, et al. Early Transmission Dynamics
in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med.
2020 Jan 29.
