Atypical lymphocytes in the peripheral blood of COVID-19 patients: A prognostic factor for the clinical course of COVID-19.

<h4>Background</h4>Clinical observations have shown that there is a relationship between coronavirus disease 2019 (COVID-19) and atypical lymphocytes in the peripheral blood; however, knowledge about the time course of the changes in atypical lymphocytes and the association with the clin...

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Autores principales:	Jun Sugihara, Sho Shibata, Masafumi Doi, Takuya Shimmura, Shinichiro Inoue, Osamu Matsumoto, Hiroyuki Suzuki, Ayaka Makino, Yasunari Miyazaki
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/e0f3cffbd3a442a0b2ad55fc806777c8
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spelling	oai:doaj.org-article:e0f3cffbd3a442a0b2ad55fc806777c82021-12-02T20:16:22ZAtypical lymphocytes in the peripheral blood of COVID-19 patients: A prognostic factor for the clinical course of COVID-19.1932-620310.1371/journal.pone.0259910https://doaj.org/article/e0f3cffbd3a442a0b2ad55fc806777c82021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0259910https://doaj.org/toc/1932-6203<h4>Background</h4>Clinical observations have shown that there is a relationship between coronavirus disease 2019 (COVID-19) and atypical lymphocytes in the peripheral blood; however, knowledge about the time course of the changes in atypical lymphocytes and the association with the clinical course of COVID-19 is limited.<h4>Objective</h4>Our purposes were to investigate the dynamics of atypical lymphocytes in COVID-19 patients and to estimate their clinical significance for diagnosis and monitoring disease course.<h4>Materials and methods</h4>We retrospectively identified 98 inpatients in a general ward at Kashiwa Municipal Hospital from May 1st, 2020, to October 31st, 2020. We extracted data on patient demographics, symptoms, comorbidities, blood test results, radiographic findings, treatment after admission and clinical course. We compared clinical findings between patients with and without atypical lymphocytes, investigated the behavior of atypical lymphocytes throughout the clinical course of COVID-19, and determined the relationships among the development of pneumonia, the use of supplemental oxygen and the presence of atypical lymphocytes.<h4>Results</h4>Patients with atypical lymphocytes had a significantly higher prevalence of pneumonia (80.4% vs. 42.6%, p < 0.0001) and the use of supplemental oxygen (25.5% vs. 4.3%, p = 0.0042). The median time to the appearance of atypical lymphocytes after disease onset was eight days, and atypical lymphocytes were observed in 16/98 (16.3%) patients at the first visit. Atypical lymphocytes appeared after the confirmation of lung infiltrates in 31/41 (75.6%) patients. Of the 13 oxygen-treated patients with atypical lymphocytes, approximately two-thirds had a stable or improved clinical course after the appearance of atypical lymphocytes.<h4>Conclusion</h4>Atypical lymphocytes frequently appeared in the peripheral blood of COVID-19 patients one week after disease onset. Patients with atypical lymphocytes were more likely to have pneumonia and to need supplemental oxygen; however, two-thirds of them showed clinical improvement after the appearance of atypical lymphocytes.Jun SugiharaSho ShibataMasafumi DoiTakuya ShimmuraShinichiro InoueOsamu MatsumotoHiroyuki SuzukiAyaka MakinoYasunari MiyazakiPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11, p e0259910 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jun Sugihara Sho Shibata Masafumi Doi Takuya Shimmura Shinichiro Inoue Osamu Matsumoto Hiroyuki Suzuki Ayaka Makino Yasunari Miyazaki Atypical lymphocytes in the peripheral blood of COVID-19 patients: A prognostic factor for the clinical course of COVID-19.
description	<h4>Background</h4>Clinical observations have shown that there is a relationship between coronavirus disease 2019 (COVID-19) and atypical lymphocytes in the peripheral blood; however, knowledge about the time course of the changes in atypical lymphocytes and the association with the clinical course of COVID-19 is limited.<h4>Objective</h4>Our purposes were to investigate the dynamics of atypical lymphocytes in COVID-19 patients and to estimate their clinical significance for diagnosis and monitoring disease course.<h4>Materials and methods</h4>We retrospectively identified 98 inpatients in a general ward at Kashiwa Municipal Hospital from May 1st, 2020, to October 31st, 2020. We extracted data on patient demographics, symptoms, comorbidities, blood test results, radiographic findings, treatment after admission and clinical course. We compared clinical findings between patients with and without atypical lymphocytes, investigated the behavior of atypical lymphocytes throughout the clinical course of COVID-19, and determined the relationships among the development of pneumonia, the use of supplemental oxygen and the presence of atypical lymphocytes.<h4>Results</h4>Patients with atypical lymphocytes had a significantly higher prevalence of pneumonia (80.4% vs. 42.6%, p < 0.0001) and the use of supplemental oxygen (25.5% vs. 4.3%, p = 0.0042). The median time to the appearance of atypical lymphocytes after disease onset was eight days, and atypical lymphocytes were observed in 16/98 (16.3%) patients at the first visit. Atypical lymphocytes appeared after the confirmation of lung infiltrates in 31/41 (75.6%) patients. Of the 13 oxygen-treated patients with atypical lymphocytes, approximately two-thirds had a stable or improved clinical course after the appearance of atypical lymphocytes.<h4>Conclusion</h4>Atypical lymphocytes frequently appeared in the peripheral blood of COVID-19 patients one week after disease onset. Patients with atypical lymphocytes were more likely to have pneumonia and to need supplemental oxygen; however, two-thirds of them showed clinical improvement after the appearance of atypical lymphocytes.
format	article
author	Jun Sugihara Sho Shibata Masafumi Doi Takuya Shimmura Shinichiro Inoue Osamu Matsumoto Hiroyuki Suzuki Ayaka Makino Yasunari Miyazaki
author_facet	Jun Sugihara Sho Shibata Masafumi Doi Takuya Shimmura Shinichiro Inoue Osamu Matsumoto Hiroyuki Suzuki Ayaka Makino Yasunari Miyazaki
author_sort	Jun Sugihara
title	Atypical lymphocytes in the peripheral blood of COVID-19 patients: A prognostic factor for the clinical course of COVID-19.
title_short	Atypical lymphocytes in the peripheral blood of COVID-19 patients: A prognostic factor for the clinical course of COVID-19.
title_full	Atypical lymphocytes in the peripheral blood of COVID-19 patients: A prognostic factor for the clinical course of COVID-19.
title_fullStr	Atypical lymphocytes in the peripheral blood of COVID-19 patients: A prognostic factor for the clinical course of COVID-19.
title_full_unstemmed	Atypical lymphocytes in the peripheral blood of COVID-19 patients: A prognostic factor for the clinical course of COVID-19.
title_sort	atypical lymphocytes in the peripheral blood of covid-19 patients: a prognostic factor for the clinical course of covid-19.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/e0f3cffbd3a442a0b2ad55fc806777c8
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Atypical lymphocytes in the peripheral blood of COVID-19 patients: A prognostic factor for the clinical course of COVID-19.

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