BibTex format
@article{Cidade:2026:10.1186/s40635-026-00864-x,
author = {Cidade, JP and Taccone, FS and Reyes, LF and Merson, L and Lefevre, B and Citarella, BW and fatoni, AZ and P贸voa, P and Zucman, D and Zoufaly, A and Zayyad, H and Zaynah, N and Zawadka, K and Zanella, A and Zambrano, M and Zambon, M and Zaidan, NZB and Zahid, M and Zabbe, M and Zaaqoq, A and Yuliarto, S and Yousif, O and Yonis, H and Yiaye, T and Yeoh, CH and Yelnik, C and Abdelaal, AYM and Hing, NYL and Yazdanpanah, Y and Yarad, E and Yamazaki, M and Yakop, SRBM and Xynogalas, I and Xian, LS and Wong, C and Wong, TF and Wong, YS and Wong, XC and Wittman, J and Witt, K and Wils, EJ and Williams, B and Williams, PJ and Williams, V and Wijaya, SO and Wiedemann, A and White, N and Whelan, B and Wham, M and Wesselius, S and Wen, TP and Webb, S and Walsh, L and Wainstein, M and Wahid, NA and Wahab, NH and Wahab, SA and Vuotto, F and Vongsouvath, M and Villoldo, A and Villar, J and Vijayan, D and Vieira, C and Verbon, A and Ventura, S and Veislinger, A and Veeran, S and Vauchy, C and Vasuday},
doi = {10.1186/s40635-026-00864-x},
journal = {Intensive Care Medicine Experimental},
title = {Immune dysregulation through longitudinal lymphocyte trajectories and their clinical determinants in hospitalized COVID-19 patients},
url = {http://dx.doi.org/10.1186/s40635-026-00864-x},
volume = {14},
year = {2026}
}
RIS format (EndNote, RefMan)
TY - JOUR
AB - Objective: Immune dysregulation plays a pivotal role in the pathophysiology of sepsis and COVID-19, with lymphopenia emerging as a consistent marker of severity and poor prognosis. However, most existing studies have assessed lymphocyte counts at isolated time points, limiting insights into their temporal behavior and prognostic value. The dynamics of lymphocyte recovery or persistence of lymphopenia remain largely unexplored in large populations, as well as the impact of adjunctive therapies such as corticosteroids. We hypothesized that the persistence or recovery of lymphopenia may be key to understanding disease progression and predicting outcomes. Using the multinational ISARIC cohort, we investigated longitudinal lymphocyte trajectories in hospitalized patients and the clinical determinants associated with their evolution over time. Methods: We conducted a multinational prospective observational cohort study using data from the ISARIC-WHO Clinical Characterization Protocol. Patients with confirmed SARS-CoV-2 infection and at least four lymphocyte measurements during the first 28 days of hospitalization were included. We analyzed lymphocyte trajectories, Cox regression survival analyses and multivariable linear regression modelling. We also applied multistate models and joint modeling to assess the association between lymphocyte trajectories and 28-day mortality, incorporating corticosteroid use as a time-varying covariate. Results: Of 945,317 screened patients, 231,933 hospitalized adults with confirmed COVID-19 and sufficient lymphocyte data were included, with 56.6% classified as lymphopenic. Lymphopenia was independently associated with higher rates of ICU admission, organ support, and in-hospital mortality (OR = 1.52, 95% CI 1.48–1.55), and lower absolute lymphocyte counts were strongly linked to worse survival in adjusted Cox models (HR = 1.33 per 1 × 10 cells/L decrease, 95% CI 1.28–1.38). Multistate modeling revealed that lymphope
AU - Cidade,JP
AU - Taccone,FS
AU - Reyes,LF
AU - Merson,L
AU - Lefevre,B
AU - Citarella,BW
AU - fatoni,AZ
AU - P贸voa,P
AU - Zucman,D
AU - Zoufaly,A
AU - Zayyad,H
AU - Zaynah,N
AU - Zawadka,K
AU - Zanella,A
AU - Zambrano,M
AU - Zambon,M
AU - Zaidan,NZB
AU - Zahid,M
AU - Zabbe,M
AU - Zaaqoq,A
AU - Yuliarto,S
AU - Yousif,O
AU - Yonis,H
AU - Yiaye,T
AU - Yeoh,CH
AU - Yelnik,C
AU - Abdelaal,AYM
AU - Hing,NYL
AU - Yazdanpanah,Y
AU - Yarad,E
AU - Yamazaki,M
AU - Yakop,SRBM
AU - Xynogalas,I
AU - Xian,LS
AU - Wong,C
AU - Wong,TF
AU - Wong,YS
AU - Wong,XC
AU - Wittman,J
AU - Witt,K
AU - Wils,EJ
AU - Williams,B
AU - Williams,PJ
AU - Williams,V
AU - Wijaya,SO
AU - Wiedemann,A
AU - White,N
AU - Whelan,B
AU - Wham,M
AU - Wesselius,S
AU - Wen,TP
AU - Webb,S
AU - Walsh,L
AU - Wainstein,M
AU - Wahid,NA
AU - Wahab,NH
AU - Wahab,SA
AU - Vuotto,F
AU - Vongsouvath,M
AU - Villoldo,A
AU - Villar,J
AU - Vijayan,D
AU - Vieira,C
AU - Verbon,A
AU - Ventura,S
AU - Veislinger,A
AU - Veeran,S
AU - Vauchy,C
AU - Vasudayan,SR
AU - Varrone,M
AU - Vanel,N
AU - van,Willigen H
AU - van,Twillert G
AU - van,Someren Gr茅ve F
AU - van,Netten C
AU - van,Hattem J
AU - van,Gulik L
AU - van,Gorp E
AU - Van,Der Werf S
AU - Van,der Voort P
AU - van,der Feltz M
AU - van,den Berge M
AU - Val-Flores,L
AU - Vajdovics,C
AU - Uyeki,TM
AU - Usman,A
AU - Uribe,A
AU - Ullrich,R
AU - Udy,A
AU - Udayanga,PGI
AU - Uchiyama,M
AU - Twardowski,P
AU - Tveita,A
AU - Turtle,LCW
AU - Turgeon,AF
AU - Tuite,H
AU - Tubiana,S
AU - Tual,C
AU - Truong,J
AU - Trontzas,I
DO - 10.1186/s40635-026-00864-x
PY - 2026///
TI - Immune dysregulation through longitudinal lymphocyte trajectories and their clinical determinants in hospitalized COVID-19 patients
T2 - Intensive Care Medicine Experimental
UR - http://dx.doi.org/10.1186/s40635-026-00864-x
VL - 14
ER -