Lymphocyte cell population as a potential hematological index for early diagnosis of COVID-19

Yihua Zhu; XingJian Cao; Yonghui Lu; Dongsheng Xu; Renfei Lu; Xinling Li

doi:10.14715/cmb/2020.66.7.31

Issue

Vol. 66 No. 7: Issue 7

Issue Published : November 9, 2020

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Lymphocyte cell population as a potential hematological index for early diagnosis of COVID-19

https://doi.org/10.14715/cmb/2020.66.7.31

Yihua Zhu

Clinical Laboratory, The Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China

XingJian Cao

Clinical Laboratory, The Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China

Yonghui Lu

Clinical Laboratory, The Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China

Dongsheng Xu

CBL Path Incorporated, Rye Brook, New York 10573, USA

Renfei Lu

Clinical Laboratory, Nantong Third Hospital Affiliated to Nantong University, Nantong, Jiangsu, China

Xinling Li

Department of Neurology, The Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China

Corresponding Author(s) : Xinling Li

cvffv1@163.com

Cellular and Molecular Biology, Vol. 66 No. 7: Issue 7
Article Published : October 31, 2020

Abstract

The pandemic diseases caused by SARS-CoV-2 are now threatening human health and survival. Early diagnosis and isolation of mild or asymptomatic COVID-19 patients is important to control the spread of SARS-CoV-2. In this study, we investigate the potential clinical utility of lymphocyte CPD for early diagnosis of COVID-19. To investigate the potential of lymphocyte cell population data (lymphocyte CPD) for use in early diagnosis of coronavirus disease 2019 (COVID-19). Lymphocyte CPD of healthy control (n = 51), common cold patients (n = 49) and mild COVID-19 patients (n = 126) were generated using hematology analyzer. The parameters were subjected to sensitivity and specificity analysis to determine their suitability as biomarkers for early diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Normality analysis showed that lymphocyte CPD followed a normal distribution. There were no significant differences in white blood cells (WBC) and lymphocyte (LY#) counts as well as the neutrophil-to-lymphocyte ratio (NLR) among the groups (p > 0.05). Lymphocyte volume standard deviation (LV-SD), lymphocyte conductivity standard deviation (LC-SD) and lymphocyte light scatter standard deviation (LS-SD) were significantly higher in the COVID-19 group than in common cold and control groups (p < 0.05). The corresponding mean lymphocyte light scattering (MLS) was significantly reduced in the COVID-19 group, relative to the common cold group, but was significantly increased, when compared with the control group (p < 0.05). Moreover, there was no significant difference in mean lymphocyte volume (MLV) between the COVID-19 group and the common cold or control group (p > 0.05), but it was significantly higher in the common cold group than in the control group (p < 0.05). At a cutoff value â‰¥ 16.38, LS-SD was more sensitive and specific than other lymphocyte CPD parameters. At a cutoff value â‰¥ 11.89, LC-SD achieved 84.4 % sensitivity, 87.5 % specificity, and an area under the curve (AUC) of 0.888. However, at a cutoff value â‰¥ 15.95, LS-SD reached 81.3 % sensitivity, 75 % specificity and an AUC of 0.876. These results suggest that lymphocyte CPD parameters have great diagnostic potential for SARS-CoV-2 infection and can be used for early diagnosis of the disease.

Keywords

COVID-19 Diagnosis Hematology analyzer Lymphocyte cell population data SARS-CoV-2 infection.

Zhu, Y., Cao, X., Lu, Y., Xu, D., Lu, R., & Li, X. (2020). Lymphocyte cell population as a potential hematological index for early diagnosis of COVID-19. Cellular and Molecular Biology, 66(7), 202–206. https://doi.org/10.14715/cmb/2020.66.7.31

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References

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Li T, Qiu Z, Zhang L, Han Y, He W, Liu Z, et al. Significant changes of peripheral T lymphocyte subsets in patints with severe acute respiratory syndrome. J Infect Dis 2004; 189: 648-651.
Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterization and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet 2020; 395: 565-574.
Gómez-Angelats M, Bortner CD, Cidlowski JA. Cell volume regulation in immune cell apoptosis. Cell Tissue Res 2000; 301: 33-42.

References

Chang LM, Wei L. Epidemiologic and Clinical Characteristics of Novel Coronavirus Infections Involving 13 Patients Outside Wuhan, China. JAMA 2020; 323: 1092-1093.

Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents 2020; 17: 105924.

Jing L, Sumeng L, Jia L, Liang BY, Wang XB, Wang H, et al. Longitudinal characteristics of lymphocyte responses and cytokine profiles in the peripheral blood of SARS-CoV-2 infected patients. EBioMedicine 2020; 55: 102763.

Chen N, Zhou M, Dong X, Qu JM, Gong FY, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020; 395: 507-513.

Silva M, Fourcade C, Fartoukh C, Lenormand B, Buchonnet G, Callat MP, et al. Lymphocyte volume and conductivity indices of the haematology analyser Coulter GEN.S in lymphoproliferative disorders and viral diseases. Clin Lab Haematol 2016; 28: 1-8.

Briggs C, Da Costa A, Freeman L, Aucamp I, Ngubeni B, Machin SJ. Development of an automated malaria discriminant factor using VCS technology. Am J Clin Pathol 2006; 126: 691-698.

Zhu Y, Cao X, Fang Y, Zhong C, Xu D. Mean monocyte volume is significantly increased in postsurgical bacterial infection. Int J Lab Hematol 2015; 37: 145-146.

Zhu Y, Cao X, Tao G, Xie W, Hu Z, Xu D. The lymph index: potential hematological parameter for viral infection. Int J Infect Dis 2013; 17: 490-493.

Gao G, Dong B. Molecular Pathology Diagnosis of Hematological Diseases. Fourth Military Medical University Press, 2016. Pp. 12.

Duan F, Ren M. Histology and Embryology. China Medical Science and Technology Press, 2016. Pp. 101.

Wang W, Xu Y, Gao R, Lu R, Han K, Wu G, et al. Detection of SARS-CoV-2 in Different Types of Clinical Specimens. JAMA 2020; 323: 1843-1844.

Cui W, Fan Y, Wu W, Zhang F, Wang JY, Ni AP. Expression of lymphocytes and 1ymphocyte subsets in patients with severe acute respiratory syndrome. Clin Infect Dis 2003; 37: 857-859.

Li T, Qiu Z, Zhang L, Han Y, He W, Liu Z, et al. Significant changes of peripheral T lymphocyte subsets in patints with severe acute respiratory syndrome. J Infect Dis 2004; 189: 648-651.

Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterization and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet 2020; 395: 565-574.

Gómez-Angelats M, Bortner CD, Cidlowski JA. Cell volume regulation in immune cell apoptosis. Cell Tissue Res 2000; 301: 33-42.

Author biographies is not available.