Publication date: Jul 20, 2025

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.

Open Access PDF

Semantics

Original Article