COVID-19-associated lymphopenia

For COVID-19 frequently asked inpatient questions, click here
For COVID-19 frequently asked outpatient questions, click here

WikiDoc Resources for COVID-19-associated lymphopenia
Articles
Most recent articles on COVID-19-associated lymphopenia Most cited articles on COVID-19-associated lymphopenia Review articles on COVID-19-associated lymphopenia Articles on COVID-19-associated lymphopenia in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on COVID-19-associated lymphopenia Images of COVID-19-associated lymphopenia Photos of COVID-19-associated lymphopenia Podcasts & MP3s on COVID-19-associated lymphopenia Videos on COVID-19-associated lymphopenia
Evidence Based Medicine
Cochrane Collaboration on COVID-19-associated lymphopenia Bandolier on COVID-19-associated lymphopenia TRIP on COVID-19-associated lymphopenia
Clinical Trials
Ongoing Trials on COVID-19-associated lymphopenia at Clinical Trials.gov Trial results on COVID-19-associated lymphopenia Clinical Trials on COVID-19-associated lymphopenia at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on COVID-19-associated lymphopenia NICE Guidance on COVID-19-associated lymphopenia NHS PRODIGY Guidance FDA on COVID-19-associated lymphopenia CDC on COVID-19-associated lymphopenia
Books
Books on COVID-19-associated lymphopenia
News
COVID-19-associated lymphopenia in the news Be alerted to news on COVID-19-associated lymphopenia News trends on COVID-19-associated lymphopenia
Commentary
Blogs on COVID-19-associated lymphopenia
Definitions
Definitions of COVID-19-associated lymphopenia
Patient Resources / Community
Patient resources on COVID-19-associated lymphopenia Discussion groups on COVID-19-associated lymphopenia Patient Handouts on COVID-19-associated lymphopenia Directions to Hospitals Treating COVID-19-associated lymphopenia Risk calculators and risk factors for COVID-19-associated lymphopenia
Healthcare Provider Resources
Symptoms of COVID-19-associated lymphopenia Causes & Risk Factors for COVID-19-associated lymphopenia Diagnostic studies for COVID-19-associated lymphopenia Treatment of COVID-19-associated lymphopenia
Continuing Medical Education (CME)
CME Programs on COVID-19-associated lymphopenia
International
COVID-19-associated lymphopenia en Espanol COVID-19-associated lymphopenia en Francais
Business
COVID-19-associated lymphopenia in the Marketplace Patents on COVID-19-associated lymphopenia
Experimental / Informatics
List of terms related to COVID-19-associated lymphopenia

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Oluwabusola Fausat Adogba, MD

Synonyms and keywords:

Overview

Coronavirus disease 2019 (COVID-19) has been considered as a global pandemic since its first emergence in Wuhan,China.On March 12, 2020, the World Health Organization declared the COVID-19 outbreak a pandemic.There is no established system for the classification regarding COVID-19 related lymphopenia. four hypothetical mechanism regarding lymphopenia are : Direct infection of Lymphocyt, direct destroying of lymphocytic organs, inflamatory cytokins such as TNFɑ, IL-6,Lymphocyte inhibition,

Historical Perspective

• Coronavirus disease 2019 (COVID-19) has been considered as a global pandemic since its first emergence in Wuhan,China.

• On March 12, 2020, the World Health Organization declared the COVID-19 outbreak a pandemic.
• Since the first descriptive study lymphocyte count has been a marker of interest.

Classification

There is no established system for the classification regarding COVID-19 related lymphopenia.

Pathophysiology

• There are four hypothetical mechanisms regarding lymphopenia
  • Direct infection of Lymphocytes
  • Direct destroying lymphatic organs
  • Inflammatory cytokines such as TNF ɑ, IL-6 , etc inducing lymphopenia
  • Inhibition of lymphocytes by metabolic molecules such as hyperlactic acidemia

Differentiating COVID-19 related Lymphocytopenia from other Diseases

COVID-19 related Lymphocytopenia starts acutely in the course of the disease, with other manifestations of the disease.

Lymphocytopenia, is associated with corticosteroid use, infections with HIV and other viral, bacterial, and fungal agents, Hodgkin's disease, leukemia, malnutrition, systemic lupus erythematosus, high stress levels, whole body radiation, rheumatoid arthritis, and iatrogenic conditions.

In alphabetical order.

• After influenza
• After snakebite
• Anesthesia
• Antibody deficiency syndrome
• Aplastic Anemia
• Banti's Syndrome
• Burns
• Congenital immune deficiency
• Cushing's Disease
• Dermatomyositis
• Drugs, toxins
• Exudative enteropathy
• Felty's Syndrome
• Heavy exercise
• HIV
• Hodgkin's Lymphoma
• Inflammatory Bowel Disease
• Lymphocyte tuberculosis
• Measles
• Paroxysmal nocturnal hemoglobinuria
• Polycythemia
• Postoperative
• Pregnancy
• Sarcoidosis
• Scarlet Fever
• Secondary hypersplenism
• Single non-Hodgkin's lymphomas
• Surgery
• Systemic Lupus Erythematosus
• Trauma
• Tuberculosis
• Uremia
• Whipple's Disease
• Zinc deficiency

Epidemiology and Demographics

• The incidence of the Coronavirus Disease 2019 (COVID-19) as of June 28, 2020 is approximately 9,843,073 cases worldwide with 495,760 deaths.
• Patients of all age groups may develop COVID-19. However, the elderly population and immunocompromised individuals are more likely to develop severe cases of COVID-19.

Risk Factors

People of any age with certain underlying medical conditions are at increased risk for severe illness from COVID-19. These medical conditions include:

• Chronic kidney disease
• Chronic obstructive pulmonary disease
• Immunocompromised state (weakened immune system) from solid organ transplant
• Obesity (body mass index [BMI] of 30 or higher)
• Serious heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies
• Sickle cell disease
• Type 2 diabetes mellitus

Screening

• Lymphopenia as a result of COVID-19 or any other acquired disease cannot be prevented.
• A routine CBC with diffrential should be done in COVID-19 patients to detect and monitor the progression of lymphopenia.

Natural History, Complications, and Prognosis

• Common hematologic complications of coronavirus include lymphopenia, neutrophilia and thrombocytosis.
• Lymphopenia is a prominent part of severe COVID-19 and a lymphocyte count of less than 1.5 × 109/L may be useful in predicting the severity of clinical outcomes.
• Lymphopenia is lymphocyte count of less than 1.5 × 109/L. It is associated with a 3-fold increased risk of severe COVID-19 infection.
• Patients with lymphopenia on admission have been associated with poor prognostic outcomes. Recent studies have shown that 85% of severely ill patients have lymphopenia. Futhermore, patients who have died from COVID-19 infection showed significantly lower lymphocyte level than survivors.

Diagnosis

Diagnostic Choice of Study

Lymphopenia refers to a count of less than 1,000 lymphocytes per microliter of blood in adults, or less than 3,000 lymphocytes per microliter of blood in children. The following tests are used to diagnose lymphopenia:

• Complete Blood test
• Flow cytometry

History and Symptoms

Lymphopenia as a result of COVID-19 can present with different symptoms. People with COVID-19 have had a wide range of symptoms reported – ranging from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus. People with these symptoms may have COVID-19:

• Fever or chills
• Cough
• Shortness of breath or difficulty breathing
• Fatigue
• Muscle or body aches
• Headache
• New loss of taste or smell
• Sore throat
• Congestion or runny nose
• Nausea or vomiting
• Diarrhea

References

Template:WikiDoc Sources