CD4+ and CD8+ cell counts are significantly correlated with absolute lymphocyte count in hospitalized COVID-19 patients: a retrospective study.

Background: Coronavirus disease 2019 (COVID-19) is a contagious respiratory illness that was declared a pandemic in March 2020. Lymphopenia is one of the specific laboratory results disturbance in COVID-19 patients. Such findings are frequently associated with substantial changes in T-cell counts, particularly CD4+ and CD8+ T-cells. This study aimed to examine the correlation between CD4+ and CD8+ cell counts and absolute lymphocyte count (ALC) in COVID-19 patients and analyze its difference based on the COVID-19 patients' severity. Methods: From March 2022 to May 2022, we conducted a retrospective cohort study using medical records and laboratory data from patients diagnosed with COVID-19 at our hospital who met the inclusion and exclusion criteria. The total sampling method was used to recruit study participants. We conducted bivariate analysis, which consisted of correlation and comparative analysis. Results: Thirty-five patients met the inclusion and exclusion criteria and were divided into two severity groups (mild-moderate and severe-critical). The findings of this study revealed a significant correlation between CD4+ cell count and ALC on admission (r = 0.69, p < 0.001) and the tenth day of onset (r = 0.559, p < 0.001). Similarly, there was a correlation between CD8+ and ALC at admission (r = 0.543, p = 0.001) and on the tenth day of onset (r = 0.532, p = 0.001). Individuals with severe-critical illness had lower ALC, CD4+, and CD8+ cell counts than those with mild-moderate illness. Conclusion: According to the findings of this study, there is a correlation between CD4+ and CD8+ cell counts and ALC in COVID-19 patients. All lymphocyte subsets also showed a lower value in severe forms of the disease.

D-Dimer as a Sensitive Biomarker of Survival Rate in Patients with COVID-19.

OBJECTIVE: The global case fatality rate of coronavirus disease 2019 is 2.16% as announced by the World Health Organization. In Indonesia, according to the Ministry of Health, the number is even higher, reaching a 2.8% case fatality rate. D-dimer levels were found to affect coronavirus disease 2019 patient's survival in several studies. The study aimed to determine whether the amount of D-dimer predicted survival in coronavirus disease 2019 patients. MATERIALS AND METHODS: This research was performed in a retrospective cohort design and used survival analysis. From March 1, 2020, to August 31, 2020, the samples were collected from polymerase chain reaction-confirmed coronavirus disease 2019 patients at Mohammad Hoesin General Hospital in Palembang, South Sumatera, Indonesia. We used electronic medical records to obtain demographic (age and gender), coexisting condition, laboratory (coagulation and hematologic test), and outcome (non-survivors or survivors) data. The chi-square and Mann-Whitney tests were used to evaluate the results. The Kaplan-Meier method and the Mantel-Haenszel log-rank test were used to examine D-dimer levels and patient outcomes. Youden index was calculated to determine the optimal cut-off value of D-dimer. RESULTS: There were 52 non-survivors and 235 survivors among the 287 patients who met the inclusion criterion. Non-survivors had D-dimer levels of more than 1.49 mg/L in 82.69%of cases. Males had lower cut-off compared to females (>1.49 mg/L vs. >2.2 mg/L). The researchers discovered a highly significant correlation between D-dimer levels and coronavirus disease 2019 mortality (P=.001). The c-index analysis showed that D-dimer (0.79, 95% CI: 0.73-0.83) ability for mortality prediction was the second-best compared with other laboratory markers. CONCLUSION: D-dimer can be used as a predictor of coronavirus disease 2019 in-hospital mortality for early identification of coagulopathy.

Lymphocyte Levels in Predicting the Outcome of COVID-19 Patient: A Prognostic Study from Single Center in Indonesia.

BACKGROUND: Several laboratory parameters have been linked to Corona Virus Disease 2019 (COVID-19), with lymphocytes being one of the most important. Lymphopenia is frequently linked to a worsening of clinical symptoms and an increased risk of death in COVID-19. This study aimed to determine the role of lymphocyte levels in predicting COVID-19 patient mortality. METHODS: This is a prognostic study that is conducted from March 1 to August 31, 2020. Data from medical records and laboratory findings of COVID-19 patients were used in the study. Patient distribution and complete blood count were among the information gathered. ROC curve analysis, bivariate analysis (Chi-Square and Mann Whitney), in addition to survival analysis (Kaplan-Meier) were used to analyze the data. RESULTS: In a total of 318 patients, 59 were non-survivors and 259 were survivors. Besides, a cut-off value of ?1460 cells/µL (P<0.05) was used for lymphocyte levels. Lymphopenia also has a 4.35-fold increase in the risk of mortality. Furthermore, the survival analysis revealed differences in the probability of survival within 30 days between COVID-19 patients with lymphopenia and those without (HR: 5.5722 (3.2509-9.5510), 95% CI; p<0.0001). A lymphocyte count of ?1460 cell/µL can increase the risk of death by fourfold. CONCLUSIONS: The findings of this study indicated a significant difference in outcome between lymphopenia and non-lymphopenia patients. Lymphopenia plays an important role in estimating COVID-19 patient mortality.