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Coronavirus FAQ PDF
Dengue taught us the value of platelet count interpreted along with hematocrit and COVID-19 is now teaching us the value of lymphocytes in blood test.
It has been a standard teaching that all viral fevers will have high lymphocyte counts. Low count will only occur with HIV, SARS-like illness, measles and hepatitis.
All studies have now shown it to be an important marker of COVID-19.
In a study published in the Lancet, it was shown 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 hospitalization, while 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.
- 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]
- 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.
Dr KK Aggarwal
President CMAAO, HCFI and Past National President IMA