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Submitted: 01 Oct 2021
Accepted: 07 Nov 2021
ePublished: 06 Dec 2021
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Immunopathol Persa. 2022;8(2): e29303.
doi: 10.34172/ipp.2022.29303
  Abstract View: 502
  PDF Download: 516

Review

A systematic review and meta-analysis on the association between lymphocyte subsets and the severity of COVID-19

Hojat Dehghanbanadaki 1,2 ORCID logo, Hossein Aazami 3,4 ORCID logo, Mahya Shabani 5 ORCID logo, Dorsa Amighi 5, Farhad Seif 6 ORCID logo, Ali Zare Dehnavi 5 ORCID logo, Abdolkarim Hajighadery 7 ORCID logo, Mohammad-Mehdi Mehrabi Nejad 7 ORCID logo, Mohammad Ghafouri 5 ORCID logo, Nima Hajizadeh 8 ORCID logo, Fateme Abedin 5 ORCID logo, Zahra Hajizadeh 8 ORCID logo, Mehrdad Heravi 9 ORCID logo, Parsa Panahi 10 ORCID logo, Ali Kabir 11* ORCID logo

1 Metabolomics and Genomics Research Center Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
2 Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
3 Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
4 Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
5 Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
6 Department of Immunology and Allergy, Academic Center for Education, Culture, and Research (ACECR), Tehran, Iran
7 Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran
8 School of Medicine, Iran University of Medical Sciences, Tehran, Iran
9 School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
10 Student Research Committee, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
11 Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
*Corresponding Author: Correspondence to Ali Kabir, MD, MPH, PhD; Email: kabir.a@iums.ac.ir, , Email: aikabir@yahoo.com

Abstract

Introduction: Prominent prognostic parameters that reflect the severity of coronavirus disease 2019 (COVID-19) to adopt an appropriate therapeutic approach are not fully identified. This systematic review and meta-analysis aimed to explore the association between lymphocyte variation and disease severity in COVID-19 individuals.

Methods: We searched Web of Science, Scopus, PubMed, EMBASE and WHO website to retrieve studies investigating lymphocyte subset counts in non-severe and severe cases of COVID-19. The pooled standardized mean difference (SMD) between two groups and the pooled average count of each lymphocyte subset were assessed by employing a random-effect model.

Results: Thirty-nine investigations on 5087 participants, including 3578 non-severe patients and 1509 severe patients, were included. The pooled analysis showed that non-severe patients had higher total T lymphocytes (SMD = 1.01; 95% CI: 0.82, 1.20; I2 = 75.7%), T helper cells (SMD = 1.07; 95% CI: 0.85, 1.28; I2 = 85.4%), T cytotoxic cells (SMD = 1.07; 95% CI: 0.82, 1.32; I2 = 87.1%), B cells (SMD = 0.72; 95% CI: 0.45, 0.98; I2 = 79.7%), and natural killer cells (SMD = 0.65; 95% CI: 0.47, 0.84; I2 = 63.1%) than severe patients and the average count of the corresponding lymphocyte signatures in non-severe patients/severe patients were 878.88/448.40, 493.12/268.96, 311.91/158.91, 177.09/110.37, and 155.02/103.09 cells/μL, respectively.

Conclusion: Lymphopenia may be a dilemma in COVID-19 management because over-activation of lymphocytes may lead to cytokine storm or acute respiratory distress syndrome (ARDS). In contrast, lymphopenia may increase SARS-CoV-2 amplification and COVID-19 severity. Therefore, novel therapies targeting lymphocyte proliferation or contraction may counterbalance lymphocyte counts in these patients.



Citation: Dehghanbanadaki H, Aazami H, Shabani M, Amighi D, Seif F, Zare Dehnavi A, et al. A systematic review and meta-analysis on the association between lymphocyte subsets and the severity of COVID-19. Immunopathol Persa. 2022;8(2):e29303. DOI:10.34172/ ipp.2022.29303.
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