Objectives: The predictive utility of lymphopenia in suspected COVID-19 cases is still poorly characterized. The primary objective of the present study was to correlate the presence of lymphopenia with CT chest at the initial triage diagnosis of COVID-19 in a sample of Egyptian patients. Methods: We conducted a single-center, observational, prospective study that recruited patients who presented with a cardiac complaint or routine cardiac follow-up and were suspected of COVID-19. Lymphopenia was defined as lymphocyte count ≤ 1100 cells/μL. Results: A total of 110 patients were included in this study. Lymphopenia was detected in 21.0% of the study cohort. Overall, 60.9% of the patients had positive CT findings. The diagnostic accuracy of lymphopenia based on CT chest diagnosis did not provide significantly accurate diagnosis of COVID-19 (p = 0.343) with sensitivity of 20.90% (11.92% - 32.57%) and specificity of 85.71% (69.74% - 95.19%). Regarding the diagnostic accuracy of CT-chest compared with PCR results as a reference standard, sensitivity raised to 68.75% (53.75% - 81.34%) and specificity of 66.67% (9.43% to 99.16%). Conclusion: In patients presenting to the diagnostic triage center with symptoms suggestive of COVID-19 infection, lymphopenia is an unreliable predictor of infection. Only in predicting suspected patients with positive CT findings did lymphopenia have a sensitivity of 20%. As a result, the presence of lymphopenia in suspected patients presenting to diagnostic triage centers should not be considered a reliable diagnostic aid.
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