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Check for lymphopenia on day 1, 7 and 14 in COVID-19 patients (For attention of Doctors) |
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Check for lymphopenia on day 1, 7 and 14 in COVID-19 patients (For attention of Doctors)

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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.

  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.

3.     Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020; 395:507.

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA

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