Comparing Absolute Eosinophil and Monocyte Counts in Critical and Non-Critical COVID-19 Patients: Comparing Eosinophil and Monocyte Counts in COVID-19 Patients

Yasir Ishaq; Muhammad Omar Malik; Yasar Mehmood Yousafzai; Maria Qubtia; Imranullah Khan; Awal Mir

doi:10.54393/pjhs.v5i09.1455

Authors

Yasir Ishaq Department of Physiology, Khyber Medical University, Peshawar, Pakistan
Muhammad Omar Malik Department of Physiology, Khyber Medical University, Peshawar, Pakistan
Yasar Mehmood Yousafzai Department of Hematology, Khyber Medical University, Peshawar, Pakistan
Maria Qubtia Department of Oncology, Shaukat Khanum Memorial Cancer Hospital, Peshawar, Pakistan
Imranullah Khan Department of Pulmonology, Rehman Medical Institute, Peshawar, Pakistan
Awal Mir Department of Hematology, Khyber Medical University, Peshawar, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v5i09.1455

Keywords:

Eosinophils, Monocytes, Lymphocytes, Platelets, Prognostic Indicators, Immune Cell Counts

Abstract

Emerging evidence suggests that variations in immune cell counts, particularly absolute eosinophil and monocyte counts may be important in predicting the clinical course and severity of the disease in COVID-19 patients. Objective: To compare the absolute eosinophil and monocyte counts ‘between critical and non-critical COVID-19 patients to elucidate potential associations with disease severity and prognosis. Methods: Between March 19th and June 6th, 2021, peripheral blood samples were taken from 26 ‘critical COVID-19 patients and 26 non-critical COVID-19 patients. Standard laboratory procedures were used to determine the immunological and haematological parameters for every participant. Whole blood samples were taken in ethylenediaminetetraacetic acid (EDTA) tubes and processed per the manufacturer's instructions using an automated haematology analyser (XN-1000, Sysmex, Japan). Results: Critical patients of COVID-19 exhibited significantly reduced absolute eosinophil, absolute monocyte, and lymphocyte count compared to non-critical patients. Additionally, critical patients were significantly older. However, there is no significant differences in the two groups' basophil counts, neutrophil counts, WBC counts, RBC counts, HCT percentage, HGB levels, MCH levels, MCV, MCHC levels, and MPV or platelet counts. Conclusions: Critical patients exhibited significantly reduced absolute eosinophil and monocyte counts suggesting a potentially weaker immune response in these subgroups. The significance of immune cell counts in assessing the severity of COVID-19 is highlighted by these results which may aid in developing targeted therapeutic interventions and prognostic indicators. Validating these results and clarifying their therapeutic significance will require more investigation.

References

Yang X, Yu Y, Xu J, Shu H, Liu H, Wu Y et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. The Lancet Respiratory Medicine. 2020 May; 8(5): 475-81. doi: 10.1016/S2213-2600(20)30079-5. DOI: https://doi.org/10.1016/S2213-2600(20)30079-5

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. The Journal of the American Medical Association. 2020 Mar; 323(11): 1061-9. doi: 10.1001/jama.2020.1585. DOI: https://doi.org/10.1001/jama.2020.1585

Del Valle DM, Kim-Schulze S, Huang HH, Beckmann ND, Nirenberg S, Wang B et al. An inflammatory cytokine signature predicts COVID-19 severity and survival. Nature Medicine. 2020 Oct; 26(10): 1636-43. doi: 10.1038/s41591-020-1051-9. DOI: https://doi.org/10.1038/s41591-020-1051-9

Zafer MM, El-Mahallawy HA, Ashour HM. Severe COVID-19 and sepsis: immune pathogenesis and laboratory markers. Microorganisms. 2021 Jan; 9(1): 159. doi: 10.3390/microorganisms9010159. DOI: https://doi.org/10.3390/microorganisms9010159

Allegra A, Di Gioacchino M, Tonacci A, Musolino C, Gangemi S. Immunopathology of SARS-CoV-2 infection: immune cells and mediators, prognostic factors, and immune-therapeutic implications. International Journal of Molecular Sciences. 2020 Jul; 21(13): 4782. doi: 10.3390/ijms21134782. DOI: https://doi.org/10.3390/ijms21134782

La Sala L, Gandini S, Bruno A, Allevi R, Gallazzi M, Senesi P et al. SARS-CoV-2 immunization orchestrates the amplification of IFNγ-producing T cell and NK cell persistence. Frontiers in Immunology. 2022 Feb; 13: 798813. doi: 10.3389/fimmu.2022.798813. DOI: https://doi.org/10.3389/fimmu.2022.798813

Gallo Marin B, Aghagoli G, Lavine K, Yang L, Siff EJ, Chiang SS et al. Predictors of COVID‐19 severity: a literature review. Reviews in Medical Virology. 2021 Jan; 31(1): 1-0. doi: 10.1002/rmv.2146. DOI: https://doi.org/10.1002/rmv.2146

Izcovich A, Ragusa MA, Tortosa F, Lavena Marzio MA, Agnoletti C, Bengolea A et al. Prognostic factors for severity and mortality in patients infected with COVID-19: A systematic review. PloS one. 2020 Nov; 15(11): e0241955. doi: 10.1371/journal.pone.0241955. DOI: https://doi.org/10.1371/journal.pone.0241955

Zhou S, Yang Y, Zhang X, Li Z, Liu X, Hu C et al. Clinical course of 195 critically ill COVID-19 patients: a retrospective multicenter study. Shock. 2020 Nov; 54(5): 644-51. doi: 10.1097/SHK.0000000000001629. DOI: https://doi.org/10.1097/SHK.0000000000001629

Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y et al. Dysregulation of immune response in patients with coronavirus 2019 (COVID-19) in Wuhan, China. Clinical Infectious Diseases. 2020 Jul; 71(15): 762-8. doi: 10.1093/cid/ciaa248. DOI: https://doi.org/10.1093/cid/ciaa248

Han PL, Diao KY, Pang T, Huang S, Yang ZG. Comparison of clinical features between critically and non-critically ill patients in SARS and COVID-19: a systematic review and meta-analysis. Available at SSRN 3566133. 2020 Mar. doi: 10.2139/ssrn.3566133. DOI: https://doi.org/10.2139/ssrn.3566133

Pallotto C, Suardi LR, Esperti S, Tarquini R, Grifoni E, Meini S et al. Increased CD4/CD8 ratio as a risk factor for critical illness in coronavirus disease 2019 (COVID-19): a retrospective multicentre study. Infectious Diseases. 2020 Sep; 52(9): 675-7. doi: 10.1080/23744235.2020.1778178. DOI: https://doi.org/10.1080/23744235.2020.1778178

Tian R, Wu W, Wang C, Pang H, Zhang Z, Xu H, et al. Clinical characteristics and survival analysis in critical and non-critical patients with COVID-19 in Wuhan, China: a single-center retrospective case control study. Scientific Reports. 2020 Oct; 10(1): 17524. doi: 10.1038/s41598-020-74465-3. DOI: https://doi.org/10.1038/s41598-020-74465-3

Zhang D, Guo R, Lei L, Liu H, Wang Y, Wang Y et al. COVID-19 infection induces readily detectable morphological and inflammation-related phenotypic changes in peripheral blood monocytes, the severity of which correlate with patient outcome. MedRxiv. 2020 Mar: 2020-03.doi: 10.1101/2020.03.24.20042655. DOI: https://doi.org/10.1101/2020.03.24.20042655

Qin S, Jiang Y, Wei X, Liu X, Guan J, Chen Y et al. Dynamic changes in monocytes subsets in COVID-19 patients. Human Immunology. 2021 Mar; 82(3): 170-6. doi: 10.1016/j.humimm.2020.12.010. DOI: https://doi.org/10.1016/j.humimm.2020.12.010

Liu J, Liu Y, Xiang P, Pu L, Xiong H, Li C et al. Neutrophil-to-lymphocyte ratio predicts severe illness patients with 2019 novel coronavirus in the early stage. MedRxiv. 2020 Jan. doi: 10.1186/s12967-020-02374-0. DOI: https://doi.org/10.1186/s12967-020-02374-0

Bairwa M, Kumar R, Beniwal K, Kalita D, Bahurupi Y. Hematological profile and biochemical markers of COVID-19 non-survivors: A retrospective analysis. Clinical Epidemiology and Global Health. 2021 Jul; 11: 100770. doi: 10.1016/j.cegh.2021.100770. DOI: https://doi.org/10.1016/j.cegh.2021.100770

Senthilnayagam b, fathima a, rajenderan k, preethi s, subrajaa k, manjani s. Complete Blood Count (CBC) and CBC derived Ratios in Early Diagnosis of COVID-19: A Retrospective Single-centre Study. Journal of Clinical & Diagnostic Research. 2022 Nov; 16(11): 12. doi: 10.7860/JCDR/2022/59495.17083. DOI: https://doi.org/10.7860/JCDR/2022/59495.17083

Cauchois R, Pietri L, Dalmas JB, Koubi M, Capron T, Cassir N et al. Eosinopenia as predictor of poor outcome in hospitalized COVID-19 adult patients from waves 1 and 2 of 2020 pandemic. Microorganisms. 2022 Dec; 10(12): 2423. doi: 10.3390/microorganisms10122423. DOI: https://doi.org/10.3390/microorganisms10122423

Javadi A, Dabiri S, Meymandi MS, Bahremani MH, Soleimantabar H, Dabiri B. Changes of routine hematological parameters in COVID-19 patients: correlation with imaging findings, RT-PCR and outcome. Iranian Journal of Pathology. 2022; 17(1): 37. doi: 10.30699/ijp.2021.533645.2675. DOI: https://doi.org/10.30699/ijp.2021.533645.2675