Is leukopenia and lymphopenia a characteristic feature of COVID-19 in children?

Bari, Attia; Aimen, Ch; Bano, Iqbal; Saqlain, Nazish

doi:10.12669/pjms.37.3.3848

Cited by 22 publications

(25 citation statements)

References 17 publications

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“…We identified 9937 potentially relevant records from the literature databases and registers, and 1575 records from the additional searches. After screening the titles, abstracts and full texts, 56 studies (22 cohort studies, 9 case-control studies, and 25 case series) with a total of 79,104 patients were included [ [10] , [11] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , [74] , [75] , [76] ] ( Fig. 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…A total of 23 studies assessed risk factors for progression to severe or critical disease [ 25 , 26 , 28 , 30 , 33 , 36 , 42 , 49 , [51] , [52] , [53] , 55 , 59 , 60 , 61 , 63 , [65] , [66] , [67] , [68] , [69] , 71 , 76 ]. Neurological diseases ( OR =5.16, 95% CI 2.30 to 11.60, five studies, moderate-quality evidence) increased the odds of severe or critical disease.…”

Section: Resultsmentioning

confidence: 99%

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Risk factors for poor prognosis in children and adolescents with COVID-19: A systematic review and meta-analysis

et al. 2021

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Background This study provides the first systematic review and meta-analysis to identify the predictors of unfavorable prognosis of COVID-19 in children and adolescents. Methods We searched literature databases until July 2021 for studies that investigated risk factors for unfavorable prognosis of children and adolescents with COVID-19. We used random-effects models to estimate the effect size with 95% confidence interval ( CI ). Findings We identified 56 studies comprising 79,104 individuals. Mortality was higher in patients with multisystem inflammatory syndrome (MIS-C) (odds ratio [ OR ]=58.00, 95% CI 6.39–526.79) and who were admitted to intensive care ( OR =12.64, 95% CI 3.42–46.68). Acute respiratry distress syndrme (ARDS) ( OR =29.54, 95% CI 12.69–68.78) and acute kidney injury (AKI) ( OR =55.02, 95% CI 6.26–483.35) increased the odds to be admitted to intensive care; shortness of breath ( OR =16.96, 95% CI 7.66–37.51) increased the need of respiratory support; and neurological diseases ( OR =5.16, 95% CI 2.30–11.60), C-reactive protein (CRP) level ≥80 mg/L ( OR =11.70, 95% CI 4.37–31.37) and D-dimer level ≥0.5ug/mL ( OR =20.40, 95% CI 1.76–236.44) increased the odds of progression to severe or critical disease. Interpretation Congenital heart disease, chronic pulmonary disease, neurological diseases, obesity, MIS-C, shortness of breath, ARDS, AKI, gastrointestinal symptoms, elevated CRP and D-dimer are associated with unfavourable prognosis in children and adolescents with COVID-19.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Risk factors for poor prognosis in children and adolescents with COVID-19: A systematic review and meta-analysis

et al. 2021

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“…Previous studies had shown that COVID-19-infected adult exhibited reduced lymphocyte and elevated platelet counts although there was no decrement in children. 1 - 3 These observations suggested that platelet-to-lymphocyte ratio (PLR) might be a new indicator in the monitoring of patients with COVID-19. 2 , 4 , 5 Clinical research of 456 patients with COVID-19 showed that severe cases had higher neutrophil-to-lymphocyte ratio (NLR) and lower lymphocyte count than less severe cases.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic value of neutrophil-to-lymphocyte, lymphocyte-to-monocyte and platelet-to-lymphocyte ratio among patients with COVID-19 pneumonia: A retrospective study

Long¹,

Zhang²,

Duan

2022

Pak J Med Sci

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Objectives: Our study was aimed to investigate the clinical characteristics of the patients with COVID-19 pneumonia and research new diagnostic methods for the disease. Methods: In this retrospective study, medical records of 46 novel coronavirus-infected pneumonia (NCIP) patients and 30 healthy individuals in the two multiple hospitals from January 2020 to March 2020 were studied. Clinical characteristics, chest computed tomographic (CT) scans, medicine treatment and laboratory information were collected and retrospectively analyzed. Neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR) and platelet-to-lymphocyte ratio (PLR) were evaluated. Results: The main symptoms of the patients with NCIP were fever (100%), cough (82.6%), anorexia (37%), expectoration (34.8%) and fatigue (21.7%), dyspnea (15.2%). Ground glass opacity (GGO) with patch shadow was the main observation of the CT imaging (43.4%), followed by GGO (21.7%), patch shadow (19.5%), GGO with consolidation (8.7%) and GGO with reticular pattern (2.1%). The median white blood cell (WBC) count, lymphocyte count, platelet, and lymphocyte-monocyte ratio (LMR) in NCIP group were all significantly lower than in control group (p<0.001, for all comparisons), while the median neutrophil-monocyte ratio (NLR) and platelets-monocyte ratio (PLR) were both significantly higher (p<0.001, for both comparisons). Median WBC count, lymphocyte count, and platelet count on discharge were significantly higher than on admission (p<0.05). Median PLR was significantly lower two weeks after discharge (p<0.001), while NLR remained the same. The area under the curve (AUC) value of WBC, lymphocyte and platelet counts, NLR, LMR and PLR were 0.766, 0.931, 0.655, 0.780, 0.847 and 0.845, respectively. Early stages of the disease were associated with quick changes in WBC, lymphocyte, and platelet levels. However, NLR did not recover even two weeks after the discharge. Conclusion: Changes in WBC, lymphocyte, and platelet counts, as well as NLR, LMR and PLR are strongly associated with COVID-19 pneumonia. Monitoring blood markers may assist in evaluating the progression of the disease doi: https://doi.org/10.12669/pjms.38.5.5798 How to cite this:Long X, Zhang T, Duan S. Diagnostic value of neutrophil-to-lymphocyte, lymphocyte-to-monocyte and platelet-to-lymphocyte ratio among patients with COVID-19 pneumonia: A retrospective study. Pak J Med Sci. 2022;38(5):---------. doi: https://doi.org/10.12669/pjms.38.5.5798 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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“…The copyright holder for this preprint this version posted June 27, 2022. ; https://doi.org/10.1101/2022.06. 23.22276825 doi: medRxiv preprint complications in children as well. Furthermore, children may not have symptoms even during the acute disease.…”

Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 99%

Covid-19 Disease in Pediatric Emergency Room: The Dilemma of Cycle Threshold Value

Timur

Demirpek

Demirbaş

et al. 2022

Preprint

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BACKGROUND: The havoc of this SARS-CoV-2 pandemic was being distributed unequally. Children, of all ages, and in all countries, are being affected. Testing for infection with SARS-CoV-2, helps to determine what interventions may need to be put in place to control the spread of disease within a community. A PCR test for COVID-19 is a test used to diagnose children infected with SARS-CoV-2, the virus that causes COVID-19. Cycle threshold (Ct) is a semi-quantitative value that tells us approximately how much viral genetic material is in the sample following testing by RT-PCR. Our aim was to evaluate how RT-PCR Ct values among children with confirmed SARS-CoV-2 compared with clinical, laboratory and demographic data. MATERIALS AND METHODS: In the study, demographic, laboratory, radiological and clinical characteristics and the effect of Ct value of patients with positive Covid-19 PCR test who applied to the Emergency Pediatric Service with the suspicion of infectious disease between May 3,2020 and August 3, 2020 were retrospectively examined. RESULTS: There was no statistical significance between the patient's hospitalization status, admission symptoms other than fever, and laboratory parameters and the mean Ct value. It was determined that the mean Ct value of the patients who had symptoms at the time of admission to the hospital was statistically significantly lower. CONCLUSION: In this study, symptomatic patients had lower Ct than asymptomatic patients; this reflects the clinical impact of increased viral load. In our study, the low Ct values in symptomatic patients and higher values in asymptomatic patients; reflects the importance of the effect on the clinic with the increase of viral load. In evidence-based medicine practices, it will be useful to check the compatibility of complaints and findings with laboratory data while evaluating patients. In addition, if the patient is symptomatic and has a high ct value, co-infections should be considered. Keywords: Children, COVID-19, Cycle Threshold, RT-PCR, pandemic

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Is leukopenia and lymphopenia a characteristic feature of COVID-19 in children?

Cited by 22 publications

References 17 publications

Risk factors for poor prognosis in children and adolescents with COVID-19: A systematic review and meta-analysis

Risk factors for poor prognosis in children and adolescents with COVID-19: A systematic review and meta-analysis

Diagnostic value of neutrophil-to-lymphocyte, lymphocyte-to-monocyte and platelet-to-lymphocyte ratio among patients with COVID-19 pneumonia: A retrospective study

Covid-19 Disease in Pediatric Emergency Room: The Dilemma of Cycle Threshold Value

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