Correlation between white blood cell count at admission and mortality in COVID-19 patients: a retrospective study

BMC Infect Dis. 2021 Jun 14;21(1):574. doi: 10.1186/s12879-021-06277-3.

Abstract

Background: Coronavirus disease-19 (COVID-19) has become a world health threaten. Its risk factors with death were still not known. White blood cells (WBC) count as a reflection of inflammation has played a vital role in COVID-19, however its level with death is not yet investigated.

Methods: In this retrospective, single-center study, all confirmed patients with COVID-19 at West Branch of Union Hospital from Jan 29 to Feb 28, 2020 were collected and analyzed. Demographic and clinical data including laboratory examinations were analyzed and compared between recovery and death patients.

Results: A total of 163 patients including 33 death cases were included in this study. Significant association was found between WBC count and death (HR = 1.14, 95%CI: 1.09-1.20, p < 0.001). The regression analysis results showed there was a significant association between WBC count and death (HR = 5.72, 95%CI: 2.21-14.82, p < 0.001) when use the second quartile as a cutoff value (> 6.16 × 10^9/L). The difference was still exist after adjusting for confounding factors (HR = 6.26, 95%CI: 1.72-22.77, p = 0.005). In addition, Kaplan-meier survival analysis showed that there was a significant decline of the cumulative survival rate (p < 0.001) in those with WBC count ≥6.16 × 10^9/L.

Conclusion: WBC count at admission is significantly corelated with death in COVID-19 patients. Higher level of WBC count should be given more attention in the treatment of COVID-19.

Keywords: Coronavirus disease-19; Death; Second quartile; Survival rate; White blood cells.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • COVID-19 / blood*
  • COVID-19 / epidemiology
  • COVID-19 / mortality*
  • COVID-19 / virology
  • China / epidemiology
  • Female
  • Humans
  • Inflammation / blood
  • Inflammation / virology
  • Kaplan-Meier Estimate
  • Leukocyte Count
  • Leukocytes*
  • Male
  • Middle Aged
  • Patient Admission*
  • Real-Time Polymerase Chain Reaction
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2 / genetics*
  • Survival Rate