Is leukopenia and lymphopenia a characteristic feature of COVID-19 in children?

  • Attia Bari The Children's Hospital & The Institute of Child Health Lahore
  • Aimen CH, Dr
  • Iqbal Bano, Dr The Children's Hospital Lahore
  • Nazish Saqlain, Dr The Children's Hospital Lahore
Keywords: coronavirus disease 2019, children, acute respiratory disease, mortality, prognosis, blood picture


Objectives: To analyze whether leucopenia and lymphopenia a characteristic feature of children with COVID-19 and to find out its association with the disease severity.

Methods: This was a descriptive cross-sectional study conducted at The Children’s Hospital Lahore from March 2020 to October 2020. All confirmed cases of COVID-19 infection and post-COVID MIS-C/Kawasaki Disease diagnosed on the basis of RT-PCR and Antibody test respectively were included. Complete blood and differential counts were performed on the day of admission.

Results: Out of a total of 83 patients 60 (72%) were diagnosed as COVID-19 and 23 (28%) as post-COVID MIS-C/KD. The mean age of children was 7.0±4.3 years (95%CI: 6.07 - 8.75) with a male preponderance 51 (61%). Twenty (24%) children had an underlying comorbidity and 7 (8%) were surgical cases. Our case fatality rate was 5 (6%) and all children who died had an underlying comorbid condition. In both, COVID and MIS-C/KD the mean leukocyte count was (14.0 ± 12.5 vs 13.6 ± 6.9 x109/L), respectively (p=0.888). The mean lymphocyte count in children with COVID was (39.1 ± 21.4%). Patients with MIS-C/KD showed significantly higher levels of neutrophil count (76.5 ± 15.0%) as compared to children with COVID (52.0 ± 22.1%), absolute lymphocyte count was (5.02±4.81 vs 2.13±0.95 x109/L) in COVID and MIS-C respectively (p=<0.001). In 60 COVID-19 patients, the mean neutrophil lymphocyte ratio (NLR) in mild-moderate and severe-critical group was 2.00 and 5.08 respectively (p=0.009).

Conclusion: The blood picture of COVID-19 in children does not show leukopenia. NLR was a prognostic factor to assess the severity in COVID-19 patients. The presence of an underlying comorbid conditions is significant a risk factor for poor outcome.


How to cite this:
Bari A, Ch A, Bano I, Saqlain N. Is leukopenia and lymphopenia a characteristic feature of COVID-19 in children?. Pak J Med Sci. 2021;37(3):869-873. doi:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Author Biographies

Aimen CH, Dr

Senior Registrar 

The Children's Hospital & The ICH Lahore

Iqbal Bano, Dr, The Children's Hospital Lahore

Associate Professor Pediatric Pulmonology

The Children's Hospital Lahore

Nazish Saqlain, Dr, The Children's Hospital Lahore


Assistant Professor

Pediatric HematologyThe Children's Hospital Lahore

How to Cite
Bari, A., CH, A., Bano, I., & Saqlain, N. (2021). Is leukopenia and lymphopenia a characteristic feature of COVID-19 in children?. Pakistan Journal of Medical Sciences, 37(3).
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