DOI: https://doi.org/10.53350/pjmhs2115102540 ORIGINAL ARTICLE 2540 P J M H S Vol. 15, No.10, OCT 2021 Lymphopenia is Associated with Severe Coronavirus Disease 2019 (COVID-19) Infections MARIA SHIREEN 1 , SARAH SHOAIB QURESHI 2 , ARSALAN NAWAZ 3 , WASIM AMIR 4 , MEHRIN FAROOQ 5 , S. KHURRAM S. KAZMI 6 1 Senior Registrar, Department of Medicine, Lahore Medical and Dental College, Lahore. 2,4 Professor of Medicine, Lahore Medical and Dental College, Lahore. 3 Assistant Professor of Medicine, University of Lahore, Lahore. 5 Associate Professor of Medicine, Lahore Medical and Dental College, Lahore. 6 Professor of Medicine, Lahore Medical and Dental College, Lahore. Correspondence to Dr Maria Shireen, Email ID: mariadoc85@yahoo.com, Phone: 0323-4930341 ABSTRACT Background: Covid-19 is a very contagious and quickly spreading viral infection, caused by a corona virus SARS-COV-2 which was originally reported in China on December 5, 2019. It was confirmed as pandemic by WHO on March 11, 2020. This disease is yet under research. It has variable severity which includes no symptoms to pneumonia. This can cause death of the patient. Aim: To evaluate the association of Lymphopenia with severity of COVID 19 in COVID-19 patients Methods: It was a retrospective observational study conducted in COVID wards of Ghurki hospital Lahore. Record of 100 COVID-19 patients that were admitted between March and July 2021 fulfilling the inclusion criteria was included in the study. A pre-structured pro forma was filled to collect the data. Results: Out of 100 patients, 30 patients were included in Non-severe group while severe group had 70 patients. The mean age of study population was 52.5±10.38 with 60% male and 40% female. 70% patients in severe group had some co-existent comorbidity. The most commonly reported symptoms were fever and cough in both groups while shortness of breath was more commonly reported in severe group. Conclusion: Lymphopenia is associated with severe Coronavirus disease 2019 (COVID-19) infections. Lymphocytes count can be used to assess the severity of COVID 19. Keywords: Lymphocytes, Lymphopenia, Coronavirus disease 2019, COVID 19. INTRODUCTION Coronavirus pandemic started in Wuhan, China in December 2019. This severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) is similar to SARS like coronaviruses previously reported in bat 1,2 . This disease is called Corona virus disease 2019 (COVID-19). As of 3rd September 2021, 218 946 836 confirmed, and 4 539 723 mortality cases were reported to the World Health Organization 3 . In Pakistan according to NCOC 1171578 cases have been reported and 260354 mortality cases were reported 4 . COVI19 is spread by respiratory droplets and contact with infected body fluids and secretions so it can spread easily from person to person 5,6 . The symptoms vary from mild illness to moderate to severe disease leading to ventilator support 1 . The symptoms of COVID-19 consist of dry cough, fever, lethargy, myalgia, pneumonia, and acute respiratory distress syndrome. There can also be diarrhea, septic shock, metabolic acidosis, coagulation profile derangement and failure of organs including heart, kidney, and liver failure 7,8,9 . Baseline examinations comprise of complete blood count, biochemical tests and coagulation profile. The biochemical tests include renal and liver function, creatinine kinase, lactate dehydrogenase, ferritin and electrolytes 8 . Out of these tests, complete blood count is the easily assessable and cost-effective. It can help in early ------------------------------------------------------------------------------ Received on 02-08-2021 Accepted on 27-09-2021 identification of severe cases, immediate treatment, and supportive care. The early identification of COVID severity helps to reduce mortality 1 . Coronaviruses are single-stranded RNA viruses. 11 12 Before the COVID-19 pandemic, in the previous two decades, two highly lethal coronaviruses causing diseases were documented named severe acute respiratory syndrome (SARS-CoV) and the Middle East respiratory syndrome (MERS-CoV) 13 . Natural killer cells and cytotoxic T cells are the main components in control of viral infection 1 . The lymphocyte count is very important in COVID 19. It has been linked with severity of COVID-19. 14 More severe cases have lower lymphocyte count than less severe cases. The recent COVID-19 investigators, have also focused on the clinical significance of lymphopenia as a prognostic marker for COVID-19 patients. While few studies have been conducted regarding lymphopenia and its association with severity of COVID 19, only a handful can be attributed to medical research professionals of Pakistan. Thus the current study was conducted. The aim of study was to evaluate the association of Lymphopenia with severity of COVID 19 in COVID-19 patients. METHODS This retrospective observational study was conducted at COVID wards Medicine Unit of Ghurki hospital Lahore treating COVID-19 patients from April 2021 to July 2021. After permission from review board, informed consent was