Acute Respiratory Distress Syndrome in Patients with Lymphopenia: Results from the National Inpatient Sample (2017-2021)

Authors

• Arnav Garyali
• Trishna Parikh
• Dhruv Kumar
• Ishan Gupta
• Adishwar Rao
• Akriti Agrawal
• Sabiha Armin
• Rishi Panjala
• Rohan Patil
• Nikhil Sriram
• Sruthi Parthasarathy
• Aarohi Parikh
• Bindu Akkanti

Language

English

Publication Date

7-20-2025

Journal

Journal of Clinical Medicine

DOI

10.3390/jcm14145148

PMID

40725841

PMCID

PMC12295189

PubMedCentral® Posted Date

7-20-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Background: Lymphopenia has been associated with in-hospital, early, and late mortality. We aimed to elucidate differences in baseline characteristics in patients with lymphopenia with and without acute respiratory distress syndrome (ARDS) and determine predictors of in-hospital mortality in this patient population.

Methods: Patients ≥ 18 years of age with lymphopenia were identified in the National Inpatient Sample (2017-2021) and stratified according to ARDS diagnosis. Predictors of in-hospital mortality were determined using multivariate analyses with a logistic regression model.

Results: From 183,185 patients with lymphopenia, 10,420 (5.7%) had ARDS, of which 92.8% had coronavirus disease 2019. The patients with ARDS suffered from more in-hospital mortality (47% versus 6.7%, p < 0.001). ARDS increased the odds of in-hospital mortality by eight-fold (odds ratio [OR]: 7.91 [7.06-8.86], p < 0.001). Age ≥ 65 years (OR: 4.88 [3.98-5.99]), moderate/severe liver disease (OR: 2.53 [1.87-3.42]), and metastatic cancer (OR: 2.18 [1.68-2.82]) were among the strongest positive predictors of in-hospital mortality (all p < 0.001).

Conclusions: Patients with lymphopenia who have ARDS have higher in-hospital mortality, likely due to the condition's clinical course. Lymphopenia may be a marker of immune dysregulation and systemic involvement in ARDS.

Keywords

acute respiratory distress syndrome, coronavirus disease 2019, lymphopenia, in-hospital mortality

Published Open-Access

yes

Recommended Citation

Garyali, Arnav; Parikh, Trishna; Kumar, Dhruv; et al., "Acute Respiratory Distress Syndrome in Patients with Lymphopenia: Results from the National Inpatient Sample (2017-2021)" (2025). Faculty, Staff and Student Publications. 3518.
https://digitalcommons.library.tmc.edu/uthmed_docs/3518