COVID-19: Lymphocyte Subpopulations Monitoring in Critically Ill Patients

Abstract

Background: The alteration of lymphocyte subpopulations can help to predict the severity and the prognosis of severe Coronavirus disease 2019 (COVID-19). Our goal was to describe the kinetics of lymphocyte subsets, and their impact on the severity and mortality in critically ill COVID-19 patients. Methods: We collected demographic data, comorbidities, clinical signs on admission, laboratory findings on admission then a follow-up during hospitalization. Lymphocyte subsets including CD3+ T cells, CD4+ T cells, CD8+ T cells, B cells, and natural killer (NK) cells were counted by flow cytometer. Results: On admission, we observed lymphopenia in 57% of cases, decreased CD3+ T cells in 76% of cases, decreased CD4+ T cells in 81% of cases, decreased CD8+ T cells in 62% of cases, decreased B cells in 52% of cases, and decreased natural killer (NK) cells in 33% of cases. After treatment, decreased CD3+ T cells, decreased CD4+ T cells, decreased CD8+ T cells, and decreased natural killer cells were predictor factors of mortality, in the univariable analysis. Conclusion: CD3+ T cells, CD4+ T cells, CD8+ T cells, and natural killer cells were predictor factors of severity, ICU mortality, and also a useful tool for predicting disease progression.