{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T07:48:32Z","timestamp":1772264912136,"version":"3.50.1"},"reference-count":27,"publisher":"Associa\u00e7\u00e3o de Medicina Intensiva Brasileira","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Crit. Care Sci."],"abstract":"<jats:p>ABSTRACT  Objective  To elucidate the impact of lymphopenia on critical COVID-19 patient outcomes.  Methods  We conducted a multicenter prospective cohort study across five hospitals in Portugal and Brazil from 2020 to 2021. The study included adult patients admitted to the intensive care unit with SARS-CoV-2 pneumonia. Patients were categorized into two groups based on their lymphocyte counts within 48 hours of intensive care unit admission: the Lymphopenia Group (lymphocyte serum count &lt; 1 \u00d7 109\/L) and the Nonlymphopenia Group. Multivariate logistic regression, propensity score matching, Kaplan\u2012Meier survival curve analysis and Cox proportional hazards regression analysis were used.  Results  A total of 912 patients were enrolled, with 191 (20.9%) in the Nonlymphopenia Group and 721 (79.1%) in the Lymphopenia Group. Lymphopenia patients displayed significantly elevated disease severity indices, including Sequential Organ Failure Assessment and Simplified Acute Physiology Score 3 scores, at intensive care unit admission (p = 0.001 and p &lt; 0.001, respectively). Additionally, they presented heightened requirements for vasopressor support (p = 0.045) and prolonged intensive care unit and in-hospital stays (both p &lt; 0.001). Multivariate logistic regression analysis after propensity score matching revealed a significant contribution of lymphopenia to mortality, with an odds ratio of 1,621 (95%CI: 1,275 - 2,048; p &lt; 0.001). Interaction models revealed an increase of 8% in mortality for each decade of longevity in patients with concomitant lymphopenia. In the subanalysis utilizing three-group stratification, the Severe Lymphopenia Group had the highest mortality rate, not only in direct comparisons but also in Kaplan\u2012Meier survival analysis (log-rank test p = 0.0048).  Conclusion  Lymphopenia in COVID-19 patients is associated with increased disease severity and an increased risk of mortality, underscoring the need for prompt support for critically ill high-risk patients. These findings offer important insights into improving patient care strategies for COVID-19 patients.<\/jats:p>","DOI":"10.62675\/2965-2774.20240236-en","type":"journal-article","created":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T11:23:18Z","timestamp":1728559398000},"source":"Crossref","is-referenced-by-count":2,"title":["Advancing insights in critical COVID-19: unraveling lymphopenia through propensity score matching - Findings from the Multicenter LYMPH-COVID Study"],"prefix":"10.62675","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8359-5171","authenticated-orcid":false,"given":"Jos\u00e9 Pedro","family":"Cidade","sequence":"first","affiliation":[{"name":"Centro Hospitalar Lisboa Ocidental,  Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1865-1704","authenticated-orcid":false,"given":"Vicente C\u00eas","family":"Souza-Dantas","sequence":"additional","affiliation":[{"name":"Instituto D\u2019Or de Pesquisa e Ensino,  Brazil"}]},{"given":"Rafaela Braga","family":"Mamfrim","sequence":"additional","affiliation":[{"name":"Hospital Copa D\u2019Or,  Brazil"}]},{"given":"Renata Carnevale","family":"Miranda","sequence":"additional","affiliation":[{"name":"Hospital Copa D\u2019Or,  Brazil"}]},{"given":"Henrique Tommasi","family":"Caroli","sequence":"additional","affiliation":[{"name":"Hospital Copa D\u2019Or,  Brazil"}]},{"given":"Nat\u00e1lia Almeida","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Hospital Copa D\u2019Or,  Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9669-9391","authenticated-orcid":false,"given":"Alessandra e Figueiredo","family":"Thompson","sequence":"additional","affiliation":[{"name":"Hospital Copa D\u2019Or,  Brazil"}]},{"given":"Gabriela E.","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Hospital Copa D\u2019Or,  Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7069-7304","authenticated-orcid":false,"given":"Pedro","family":"P\u00f3voa","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Lisboa Ocidental,  Portugal"}]}],"member":"49293","published-online":{"date-parts":[[2024]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.imlet.2020.06.013","article-title":"Lymphopenia during the COVID-19 infection: what it shows and what can be learned","volume":"225","author":"Tavakolpour S","year":"2020","journal-title":"Immunol Lett"},{"key":"ref2","article-title":"Lymphopenia in Covid-19: a single center retrospective study of 589 cases","volume":"69","author":"Ghizlane EA","year":"2021","journal-title":"Ann Med Surg (Lond)"},{"issue":"3","key":"ref3","article-title":"Lymphopenia as a Predictor for adverse clinical outcomes in hospitalized patients with COVID-19: a single center retrospective study of 4485 cases","volume":"11","author":"Niu J","year":"2022","journal-title":"J Clin Med"},{"issue":"1","key":"ref4","article-title":"Lymphopenia predicts disease severity of COVID-19: a descriptive and predictive study","volume":"5","author":"Tan L","year":"2020","journal-title":"Signal Transduct Target Ther"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.ijid.2020.04.086","article-title":"Lymphopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: a systemic review and meta-analysis","volume":"96","author":"Zhao Q","year":"2020","journal-title":"Int J Infect Dis"},{"key":"ref6","doi-asserted-by":"crossref","DOI":"10.1186\/s40560-020-00453-4","article-title":"Lymphopenia in severe coronavirus disease-2019 (COVID-19): systematic review and meta-analysis","volume":"8","author":"Huang I","year":"2020","journal-title":"J Intensive Care"},{"key":"ref7","doi-asserted-by":"crossref","DOI":"10.1016\/j.intimp.2021.107586","article-title":"The contributory role of lymphocyte 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LYMPH-COVID"],"link":[{"URL":"https:\/\/criticalcarescience.org\/wp-content\/uploads\/sites\/7\/articles_xml\/2965-2774-ccsci-36-e20240236en\/2965-2774-ccsci-36-e20240236en.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T11:23:27Z","timestamp":1728559407000},"score":1,"resource":{"primary":{"URL":"https:\/\/criticalcarescience.org\/article\/advancing-insights-in-critical-covid-19-unraveling-lymphopenia-through-propensity-score-matching-findings-from-the-multicenter-lymph-covid-study\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024]]},"references-count":27,"alternative-id":["S2965-27742024000100316"],"URL":"https:\/\/doi.org\/10.62675\/2965-2774.20240236-en","relation":{"is-translation-of":[{"id-type":"doi","id":"10.62675\/2965-2774.20240236-pt","asserted-by":"subject"},{"id-type":"doi","id":"10.62675\/2965-2774.20240236-pt","asserted-by":"object"}]},"ISSN":["2965-2774"],"issn-type":[{"value":"2965-2774","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024]]},"article-number":"e20240236en"}}