{"id":18555,"date":"2020-12-08T13:07:55","date_gmt":"2020-12-08T13:07:55","guid":{"rendered":"http:\/\/evaggelatos.com\/?p=18555"},"modified":"2020-12-08T13:07:55","modified_gmt":"2020-12-08T13:07:55","slug":"h-%ce%bc%ce%b5%ce%af%cf%89%cf%83%ce%b7-%ce%b5%cf%80%ce%af-%cf%84%ce%bf%ce%b9%cf%82-%cf%84%cf%89%ce%bd-%ce%bb%ce%b5%ce%bc%cf%86%ce%bf%ce%ba%cf%85%cf%84%cf%84%ce%ac%cf%81%cf%89%ce%bd-%ce%b1%cf%80%ce%bf","status":"publish","type":"post","link":"https:\/\/evaggelatos.com\/?p=18555","title":{"rendered":"H \u03bc\u03b5\u03af\u03c9\u03c3\u03b7 \u03b5\u03c0\u03af \u03c4\u03bf\u03b9\u03c2 % \u03c4\u03c9\u03bd \u03bb\u03b5\u03bc\u03c6\u03bf\u03ba\u03c5\u03c4\u03c4\u03ac\u03c1\u03c9\u03bd \u03b1\u03c0\u03bf\u03c4\u03b5\u03bb\u03b5\u03af \u03c0\u03c1\u03bf\u03b3\u03bd\u03c9\u03c3\u03c4\u03b9\u03ba\u03cc \u03c3\u03c4\u03bf\u03b9\u03c7\u03b5\u03af\u03bf \u03c4\u03b7\u03c2 \u03c3\u03bf\u03b2\u03b1\u03c1\u03cc\u03c4\u03b7\u03c4\u03b1\u03c2 \u03c4\u03b7\u03c2 COVID_19. (LYM% indicates disease severity of COVID-19 patients)"},"content":{"rendered":"<div class=\"c-article-header\">\n<header>\n<h1 class=\"c-article-title\" data-test=\"article-title\" data-article-title=\"\">Lymphopenia predicts disease severity of COVID-19: a descriptive and predictive study<\/h1>\n<ul class=\"c-author-list js-etal-collapsed js-no-scroll\" data-etal=\"25\" data-etal-small=\"3\" data-test=\"authors-list\" data-component-authors-activator=\"authors-list\">\n<li class=\"c-author-list__item\"><a data-test=\"author-name\" data-track=\"click\" data-track-action=\"open author\" data-track-label=\"link\" data-author-popup=\"auth-Li-Tan\" aria-pressed=\"false\" aria-expanded=\"false\">Li Tan<\/a>,<\/li>\n<li class=\"c-author-list__item\"><a data-test=\"author-name\" data-track=\"click\" data-track-action=\"open author\" data-track-label=\"link\" data-author-popup=\"auth-Qi-Wang\" aria-pressed=\"false\" aria-expanded=\"false\">Qi Wang<\/a>,<\/li>\n<li class=\"c-author-list__item js-smaller-author-etal\"><a data-test=\"author-name\" data-track=\"click\" data-track-action=\"open author\" data-track-label=\"link\" data-author-popup=\"auth-Duanyang-Zhang\" aria-pressed=\"false\" aria-expanded=\"false\">Duanyang Zhang<\/a>,<\/li>\n<li class=\"c-author-list__item js-smaller-author-etal\"><a data-test=\"author-name\" data-track=\"click\" data-track-action=\"open author\" data-track-label=\"link\" data-author-popup=\"auth-Jinya-Ding\" aria-pressed=\"false\" aria-expanded=\"false\">Jinya Ding<\/a>,<\/li>\n<li class=\"c-author-list__item js-smaller-author-etal\"><a data-test=\"author-name\" data-track=\"click\" data-track-action=\"open author\" data-track-label=\"link\" data-author-popup=\"auth-Qianchuan-Huang\" aria-pressed=\"false\" aria-expanded=\"false\">Qianchuan Huang<\/a>,<\/li>\n<li class=\"c-author-list__item js-smaller-author-etal\"><a data-test=\"author-name\" data-track=\"click\" data-track-action=\"open author\" data-track-label=\"link\" data-author-popup=\"auth-Yi_Quan-Tang\" aria-pressed=\"false\" aria-expanded=\"false\">Yi-Quan Tang<\/a>,<\/li>\n<li class=\"c-author-list__item js-smaller-author-etal\"><a data-test=\"author-name\" data-track=\"click\" data-track-action=\"open author\" data-track-label=\"link\" data-author-popup=\"auth-Qiongshu-Wang\" data-corresp-id=\"c1\" aria-pressed=\"false\" aria-expanded=\"false\">Qiongshu Wang<\/a> &amp;<\/li>\n<li class=\"c-author-list__item\"><a data-test=\"author-name\" data-track=\"click\" data-track-action=\"open author\" data-track-label=\"link\" data-author-popup=\"auth-Hongming-Miao\" data-corresp-id=\"c2\" aria-pressed=\"false\" aria-expanded=\"false\">Hongming Miao<\/a><\/li>\n<\/ul>\n<p class=\"c-article-info-details\" data-container-section=\"info\"><a href=\"https:\/\/www.nature.com\/sigtrans\" data-test=\"journal-link\"><i data-test=\"journal-title\">Signal Transduction and Targeted Therapy<\/i><\/a> <b data-test=\"journal-volume\"><span class=\"u-visually-hidden\">volume<\/span>\u00a05<\/b>, Article\u00a0number:\u00a0<span data-test=\"article-number\">33<\/span> (<span data-test=\"article-publication-year\">2020<\/span>) <a class=\"c-article-info-details__cite-as u-hide-print\" href=\"https:\/\/www.nature.com\/articles\/s41392-020-0148-4#citeas\" data-track=\"click\" data-track-action=\"cite this article\" data-track-label=\"link\">Cite this article<\/a><\/p>\n<\/header>\n<div class=\"u-mb-8 c-status-message c-status-message--boxed c-status-message--info\">\n<p>An <a class=\"relation-link\" href=\"https:\/\/www.nature.com\/articles\/s41392-020-0159-1\" data-track=\"click\" data-track-action=\"view linked article\" data-track-label=\"link\">Author Correction<\/a> to this article was published on 29 April 2020<\/p>\n<\/div>\n<div class=\"u-mb-8 c-status-message c-status-message--boxed c-status-message--info\">\n<p>This article has been <a href=\"https:\/\/www.nature.com\/articles\/s41392-020-0148-4#change-history\">updated<\/a><\/p>\n<\/div>\n<\/div>\n<div class=\"c-article-body\">\n<div class=\"c-article-section__content\">\n<p><b>Dear Editor<\/b>,<\/p>\n<\/div>\n<div class=\"c-article-section__content\">\n<p>An outbreak of an unknown infectious pneumonia has recently occurred in Wuhan, China.<sup><a id=\"ref-link-section-d49976e480\" title=\"Chen, N. et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 395, 507\u2013513 (2020).\" href=\"https:\/\/www.nature.com\/articles\/s41392-020-0148-4#ref-CR1\" data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 1\">1<\/a><\/sup> The pathogen of the disease was quickly identified as a novel coronavirus (SARS-CoV-2, severe acute respiratory syndrome coronavirus 2), and the disease was named coronavirus disease-19 (COVID-19).<sup><a id=\"ref-link-section-d49976e484\" title=\"Zhu, N. et al. A novel coronavirus from patients with pneumonia in China, 2019. N. Engl. J. Med. 382, 727\u2013733 (2020).\" href=\"https:\/\/www.nature.com\/articles\/s41392-020-0148-4#ref-CR2\" data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 2\">2<\/a><\/sup> The virus has so far caused 78,959 confirmed cases and 2791 deaths in China according to the reports of government. COVID-19 has been spreading in many countries such as Japan, Korea, Singapore, Iran, and Italia. The clinical manifestation of COVID-19 include fever, cough, fatigue, muscle pain, diarrhea, and pneumonia, which can develop to acute respiratory distress syndrome, metabolic acidosis, septic shock, coagulation dysfunction, and organ failure such as liver, kidney, and heart failure.<sup><a id=\"ref-link-section-d49976e488\" title=\"Chen, N. et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 395, 507\u2013513 (2020).\" href=\"https:\/\/www.nature.com\/articles\/s41392-020-0148-4#ref-CR1\" data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 1\">1<\/a>,<a id=\"ref-link-section-d49976e491\" title=\"Wang, D. et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 323, 1061\u20131069 (2020).\" href=\"https:\/\/www.nature.com\/articles\/s41392-020-0148-4#ref-CR3\" data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 3\">3<\/a>,<a id=\"ref-link-section-d49976e494\" title=\"Huang, C. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 395, 497\u2013506 (2020).\" href=\"https:\/\/www.nature.com\/articles\/s41392-020-0148-4#ref-CR4\" data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 4\">4<\/a><\/sup> Unfortunately, there is no effective medication other than comprehensive support. However, the mild type of COVID-19 patients can recover shortly after appropriate clinical intervention. The moderate type patients, especially the elderly or the ones with comorbidity, can worsen and became severe, indicating high mortality rate.<sup><a id=\"ref-link-section-d49976e498\" title=\"Wang, D. et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 323, 1061\u20131069 (2020).\" href=\"https:\/\/www.nature.com\/articles\/s41392-020-0148-4#ref-CR3\" data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 3\">3<\/a>,<a id=\"ref-link-section-d49976e501\" title=\"Huang, C. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 395, 497\u2013506 (2020).\" href=\"https:\/\/www.nature.com\/articles\/s41392-020-0148-4#ref-CR4\" data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 4\">4<\/a><\/sup> However, efficient indicators for the disease severity, therapeutic response and disease outcome have not been fully investigated. Once such indicators are present, reasonable medication and care can be inclined, which is believed to significantly reduce the mortality rate of severe patients.<\/p>\n<\/div>\n<div class=\"c-article-section__content\">\n<p>Routine examinations include complete blood count, coagulation profile, and serum biochemical test (including renal and liver function, creatine kinase, lactate dehydrogenase, and electrolytes). Complete blood count is the most available, efficient and economic examination. This study aims to retrospect and analyze the time-courses of complete blood count of cured and dead patients, in order to obtain key indicators of disease progression and outcome and to provide guidance for subsequent clinical practice.<\/p>\n<\/div>\n<section aria-labelledby=\"Sec1\" data-title=\"Low LYM% is a predictor of prognosis in COVID-19 patients\">\n<div id=\"Sec1-section\" class=\"c-article-section\">\n<h2 id=\"Sec1\" class=\"c-article-section__title js-section-title js-c-reading-companion-sections-item\">Low LYM% is a predictor of prognosis in COVID-19 patients<\/h2>\n<div id=\"Sec1-content\" class=\"c-article-section__content\">\n<p>We first randomly selected five death cases and monitored dynamic changes in blood tests for each patient from disease onset to death. Although course of disease in each patient was different, inter-day variations of most parameters studied are fairly constant among all five patients (Supplementary Fig. <a href=\"https:\/\/www.nature.com\/articles\/s41392-020-0148-4#MOESM1\" data-track=\"click\" data-track-label=\"link\" data-track-action=\"supplementary material anchor\">S1a\u2013f<\/a>). Among all parameters<strong>, blood lymphocyte percentage (LYM%) showed the most significant and consistent trend (Supplementary Fig. <a href=\"https:\/\/www.nature.com\/articles\/s41392-020-0148-4#MOESM1\" data-track=\"click\" data-track-label=\"link\" data-track-action=\"supplementary material anchor\">S1f<\/a>), suggesting that this indicator might reflect the disease progression.<\/strong> To further confirm the relationship between blood LYM% and patient\u2019s condition, we increased our sample size to 12 death cases (mean age: 76 years; average therapeutic time: 20 days) (Supplementary Table <a href=\"https:\/\/www.nature.com\/articles\/s41392-020-0148-4#MOESM1\" data-track=\"click\" data-track-label=\"link\" data-track-action=\"supplementary material anchor\">S1<\/a>). <strong>Most cases showed that LYM% was reduced to lower than 5% within 2 weeks after disease onset<\/strong> (Supplementary Fig. <a href=\"https:\/\/www.nature.com\/articles\/s41392-020-0148-4#MOESM1\" data-track=\"click\" data-track-label=\"link\" data-track-action=\"supplementary material anchor\">S2a<\/a>). We also randomly selected seven cases (mean age: 35 years, average therapeutic time: 35 days) with severe symptoms and treatment outcomes (Supplementary Table <a href=\"https:\/\/www.nature.com\/articles\/s41392-020-0148-4#MOESM1\" data-track=\"click\" data-track-label=\"link\" data-track-action=\"supplementary material anchor\">S2<\/a>) and 11 cases (mean age: 49; average therapeutic time: 26 days) with moderate symptoms and treatment outcomes (Supplementary Table <a href=\"https:\/\/www.nature.com\/articles\/s41392-020-0148-4#MOESM1\" data-track=\"click\" data-track-label=\"link\" data-track-action=\"supplementary material anchor\">S3<\/a>). LYM% of severe patients decreased initially and then increased to higher than 10% until discharged (Supplementary Fig. <a href=\"https:\/\/www.nature.com\/articles\/s41392-020-0148-4#MOESM1\" data-track=\"click\" data-track-label=\"link\" data-track-action=\"supplementary material anchor\">S2b<\/a>). In contrast, LYM% of moderate patients fluctuated very little after disease onset and was higher than 20% when discharged (Supplementary Fig. <a href=\"https:\/\/www.nature.com\/articles\/s41392-020-0148-4#MOESM1\" data-track=\"click\" data-track-label=\"link\" data-track-action=\"supplementary material anchor\">S2c<\/a>).<strong> These results suggest that lymphopenia is a predictor of prognosis in COVID-19 patients.<\/strong><\/p>\n<\/div>\n<\/div>\n<\/section>\n<section aria-labelledby=\"Sec2\" data-title=\"Establishment of a Time-LYM% model from discharged COVID-19 patients\">\n<div id=\"Sec2-section\" class=\"c-article-section\">\n<h2 id=\"Sec2\" class=\"c-article-section__title js-section-title js-c-reading-companion-sections-item\">Establishment of a Time-LYM% model from discharged COVID-19 patients<\/h2>\n<div id=\"Sec2-content\" class=\"c-article-section__content\">\n<p>By summarizing all the death and cured cases in our hospital to depict the time-LYM% curve (Fig. <a href=\"https:\/\/www.nature.com\/articles\/s41392-020-0148-4#Fig1\" data-track=\"click\" data-track-label=\"link\" data-track-action=\"figure anchor\">1a<\/a>), we established a Time-LYM% model (TLM) for disease classification and prognosis prediction (Fig. <a href=\"https:\/\/www.nature.com\/articles\/s41392-020-0148-4#Fig1\" data-track=\"click\" data-track-label=\"link\" data-track-action=\"figure anchor\">1b<\/a>). We defined TLM as follows: patients have varying LYM% after the onset of COVID-19. At the 1st time point (TLM-1) of 10\u201312 days after symptom onset, patients with LYM% &gt;\u200920% are classified as moderate type and can recover quickly. Patients with LYM% &lt;\u200920% are initially classified as severe type. At the 2nd time point (TLM-2) of 17\u201319 days after symptom onset, patients with LYM% &gt;\u200920% are in recovery; patients with 5% &lt;\u2009LYM% &lt;\u200920% are still in danger and in need of supervision; patients with LYM% &lt;\u20095% become critically ill with high mortality rate and need intensive care.<\/p>\n<div id=\"figure-1\" class=\"c-article-section__figure js-c-reading-companion-figures-item\" data-test=\"figure\" data-container-section=\"figure\" data-title=\"Fig. 1\">\n<figure><figcaption><b id=\"Fig1\" class=\"c-article-section__figure-caption\" data-test=\"figure-caption-text\">Fig. 1<\/b><\/figcaption><div class=\"c-article-section__figure-content\">\n<div class=\"c-article-section__figure-item\"><a class=\"c-article-section__figure-link\" href=\"https:\/\/www.nature.com\/articles\/s41392-020-0148-4\/figures\/1\" rel=\"nofollow\" data-test=\"img-link\" data-track=\"click\" data-track-label=\"image\" data-track-action=\"view figure\"><picture><source srcset=\"\/\/media.springernature.com\/lw685\/springer-static\/image\/art%3A10.1038%2Fs41392-020-0148-4\/MediaObjects\/41392_2020_148_Fig1_HTML.png?as=webp\" type=\"image\/webp\" \/><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/media.springernature.com\/lw685\/springer-static\/image\/art%3A10.1038%2Fs41392-020-0148-4\/MediaObjects\/41392_2020_148_Fig1_HTML.png\" alt=\"figure1\" width=\"685\" height=\"406\" aria-describedby=\"figure-1-desc\" \/><\/picture><\/a><\/div>\n<div id=\"figure-1-desc\" class=\"c-article-section__figure-description\" data-test=\"bottom-caption\">\n<p>Establishment and validation of Time-LYM% model (TLM) in patients with COVID-19. <b>a<\/b> Dynamic changes of LYM% in the death cases (<i>n<\/i>\u2009=\u200915), severe-cured cases (<i>n<\/i>\u2009=\u200915), and moderate-cured cases (<i>n<\/i>\u2009=\u200940). Data are showen as means\u2009\u00b1\u2009s.e.ms. Two cutoff time points of these three curves were set as 1st time point (day 10\u201312) and 2nd time point (day 17\u201319). <b>b<\/b> Description of TLM: 1st time point (TLM-1) and 2nd time point (TLM-2) are defined as day 10\u201312 and day 17\u201319 from symptom onset, respectively. The confirmed COVID-19 patients with LYM% &gt;\u200920% at TLM-1 are classified as moderate type and the ones with LYM% &lt;\u200920% at TLM-1 are suggested as pre-severe type, which need to be further distinguished at TLM-2. If LYM% &gt;\u200920% at TLM-2, those pre-severe patients are reclassified as moderate. If 5% &lt;\u2009LYM% &lt;\u200920% at TLM-2, the pre-severe patients are indeed typed as severe.<strong> If LYM% &lt;\u20095% at TLM-2, those patients are suggested as critically ill.<\/strong> The moderate and severe types are curable, while the critically ill types need intensive care has a poor prognosis. <b>c<\/b> Ninety COVID-19 patients were currently hospitalized in light of the classification criteria of the New Coronavirus Pneumonia Diagnosis Program (5th edition): 55 patients with moderate type, 24 patients with severe type and 11 patients with critically ill type. At TLM-1, LYM% in 24 out of 55 moderate cases was lower than 20%; At TLM-2, LYM% in all 24 patients was above 5%, indicating that these patients would be curable. Regarding other 24 patients with severe symptoms, LYM% at TLM-1 was lower than 20% in 20 out of 24 cases. LYM% at TLM-2 in 6 cases was &lt;5%, indicating a poor prognosis. In 11 out of 11 critically ill patients, LYM% at TLM-1 was lower than 20%. LYM% at TLM-2 in six cases was lower than 5%, suggesting a poor prognosis. <b>d<\/b> The consistency between Guideline and TLM-based disease classification in <b>c<\/b> was tested using kappa statistic. Kappa\u2009=\u20090.48; <i>P<\/i>\u2009&lt;\u20090.005<\/p>\n<\/div>\n<\/div>\n<div class=\"u-text-right u-hide-print\"><a class=\"c-article__pill-button\" href=\"https:\/\/www.nature.com\/articles\/s41392-020-0148-4\/figures\/1\" rel=\"nofollow\" data-test=\"article-link\" data-track=\"click\" data-track-label=\"button\" data-track-action=\"view figure\" data-track-dest=\"link:Figure1 Full size image\">Full size image<\/a><\/div>\n<\/figure>\n<\/div>\n<\/div>\n<\/div>\n<\/section>\n<section aria-labelledby=\"Sec3\" data-title=\"Validation of TLM in disease classification in hospitalized COVID-19 patients\">\n<div id=\"Sec3-section\" class=\"c-article-section\">\n<h2 id=\"Sec3\" class=\"c-article-section__title js-section-title js-c-reading-companion-sections-item\">Validation of TLM in disease classification in hospitalized COVID-19 patients<\/h2>\n<div id=\"Sec3-content\" class=\"c-article-section__content\">\n<p>To validate the reliability of TLM, 90 hospitalized COVID-19 patients typed by the latest classification guideline (5th edition) were redefined with TLM. LYM% in 24 out of 55 moderate cases was lower than 20% at TLM-1; LYM% of all these patients was above 5% at TLM-2, indicating that these patients would recover soon. LYM% at TLM-1 was lower than 20% in 20 out of 24 severe cases; LYM% at TLM-2 was &lt;5% in six cases, indicating a poor prognosis. LYM% at TLM-1 in 11 out of 11 critically ill patients was lower than 20%; LYM% of these patients at TLM-2 was lower than 5% in six cases, suggesting a poor outcome (Fig. <a href=\"https:\/\/www.nature.com\/articles\/s41392-020-0148-4#Fig1\" data-track=\"click\" data-track-label=\"link\" data-track-action=\"figure anchor\">1c<\/a>). Furthermore, with kappa statistic test, we verified the consistency between TLM and the existing guideline in disease typing (Fig. <a href=\"https:\/\/www.nature.com\/articles\/s41392-020-0148-4#Fig1\" data-track=\"click\" data-track-label=\"link\" data-track-action=\"figure anchor\">1d<\/a>).<\/p>\n<\/div>\n<\/div>\n<\/section>\n<section aria-labelledby=\"Sec4\" data-title=\"LYM% indicates disease severity of COVID-19 patients\">\n<div id=\"Sec4-section\" class=\"c-article-section\">\n<h2 id=\"Sec4\" class=\"c-article-section__title js-section-title js-c-reading-companion-sections-item\">LYM% indicates disease severity of COVID-19 patients<\/h2>\n<div id=\"Sec4-content\" class=\"c-article-section__content\">\n<p>The classification of disease severity in COVID-19 is very important for the grading treatment of patients. In particular, when the outbreak of an epidemic occurs and medical resources are relatively scarce, it is necessary to conduct grading severity and treatment, thereby optimize the allocation of rescue resources and prevent the occurrence of overtreatment or undertreatment. According to the latest 5th edition of the national treatment guideline, COVID-19 can be classified into four types. Pulmonary imaging is the main basis of classification, and other auxiliary examinations are used to distinguish the severity. Blood tests are easy, fast, and cost-effective. However, none of the indicators in blood tests were included in the classification criteria. This study suggested that LYM% can be used as a reliable indicator to classify the moderate, severe, and critical ill types independent of any other auxiliary indicators.<\/p>\n<\/div>\n<\/div>\n<\/section>\n<section aria-labelledby=\"Sec5\" data-title=\"Analysis of possible reasons for lymphopenia in COVID-19 patients\">\n<div id=\"Sec5-section\" class=\"c-article-section\">\n<h2 id=\"Sec5\" class=\"c-article-section__title js-section-title js-c-reading-companion-sections-item\">Analysis of possible reasons for lymphopenia in COVID-19 patients<\/h2>\n<div id=\"Sec5-content\" class=\"c-article-section__content\">\n<p>Lymphocytes play a decisive role in maintaining immune homeostasis and inflammatory response throughout the body. Understanding the mechanism of reduced blood lymphocyte levels is expected to provide an effective strategy for the treatment of COVID-19. We speculated four potential mechanisms leading to lymphocyte deficiency. (1) The virus might directly infect lymphocytes, resulting in lymphocyte death. Lymphocytes express the coronavirus receptor ACE2 and may be a direct target of viruses.<sup><a id=\"ref-link-section-d49976e621\" title=\"Xu, H. et al. High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. Int J. Oral. Sci. 12, 8 (2020).\" href=\"https:\/\/www.nature.com\/articles\/s41392-020-0148-4#ref-CR5\" data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 5\">5<\/a><\/sup> (2) The virus might directly destroy lymphatic organs. Acute lymphocyte decline might be related to lymphocytic dysfunction, and the direct damage of novel coronavirus virus to organs such as thymus and spleen cannot be ruled out. This hypothesis needs to be confirmed by pathological dissection in the future. (3) Inflammatory cytokines continued to be disordered, perhaps leading to lymphocyte apoptosis. Basic researches confirmed that tumour necrosis factor (TNF)\u03b1, interleukin (IL)-6, and other pro-inflammatory cytokines could induce lymphocyte deficiency.<sup><a id=\"ref-link-section-d49976e625\" title=\"Liao, Y. C. et al. IL-19 induces production of IL-6 and TNF-alpha and results in cell apoptosis through TNF-alpha. J. Immunol. 169, 4288\u20134297 (2002).\" href=\"https:\/\/www.nature.com\/articles\/s41392-020-0148-4#ref-CR6\" data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 6\">6<\/a><\/sup> (4) Inhibition of lymphocytes by metabolic molecules produced by metabolic disorders, such as hyperlactic acidemia. The severe type of COVID-19 patients had elevated blood lactic acid levels, which might suppress the proliferation of lymphocytes.<sup><a id=\"ref-link-section-d49976e629\" title=\"Fischer, K. et al. Inhibitory effect of tumor cell-derived lactic acid on human T cells. Blood 109, 3812\u20133819 (2007).\" href=\"https:\/\/www.nature.com\/articles\/s41392-020-0148-4#ref-CR7\" data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 7\">7<\/a><\/sup> Multiple mechanisms mentioned above or beyond might work together to cause lymphopenia, and further research is needed.<\/p>\n<p>In conclusion, lymphopenia is an effective and reliable indicator of the severity and hospitalization in COVID-19 patients. We suggest that TLM should be included in the diagnosis and therapeutic guidelines of COVID-19.<\/p>\n<\/div>\n<\/div>\n<\/section>\n<section aria-labelledby=\"change-history\" data-title=\"Change history\">\n<div id=\"change-history-section\" class=\"c-article-section\">\n<div id=\"change-history-content\" class=\"c-article-section__content\">\n<p><ins datetime=\"2020-04-29\"><\/p>\n<h3 class=\"c-article-change-list__heading u-h3\">29 April 2020<\/h3>\n<div class=\"c-article-change-list__details\">\n<p>An amendment to this paper has been published and can be accessed via a link at the top of the paper.<\/p>\n<\/div>\n<p><\/ins><\/p>\n<\/div>\n<\/div>\n<\/section>\n<section aria-labelledby=\"Bib1\" data-title=\"References\">\n<div id=\"Bib1-section\" class=\"c-article-section\">\n<h2 id=\"Bib1\" class=\"c-article-section__title js-section-title js-c-reading-companion-sections-item\">References<\/h2>\n<div id=\"Bib1-content\" class=\"c-article-section__content\">\n<div data-container-section=\"references\">\n<ol class=\"c-article-references\">\n<li class=\"c-article-references__item js-c-reading-companion-references-item\"><span class=\"c-article-references__counter\">1.<\/span>\n<p id=\"ref-CR1\" class=\"c-article-references__text\">Chen, N. et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. <i>Lancet<\/i> <b>395<\/b>, 507\u2013513 (2020).<\/p>\n<p class=\"c-article-references__links u-hide-print\"><a href=\"https:\/\/www.nature.com\/articles\/cas-redirect\/1%3ACAS%3A528%3ADC%252BB3cXhvFOmsb8%253D\" data-track=\"click\" data-track-action=\"outbound reference\" data-track-label=\"link\" aria-label=\"View reference 1 on CAS\">CAS<\/a>\u00a0 <a href=\"https:\/\/doi.org\/10.1016%2FS0140-6736%2820%2930211-7\" data-track=\"click\" data-track-action=\"outbound reference\" data-track-label=\"link\" aria-label=\"View reference 1\">Article<\/a>\u00a0 <a href=\"http:\/\/scholar.google.com\/scholar_lookup?&amp;title=Epidemiological%20and%20clinical%20characteristics%20of%2099%20cases%20of%202019%20novel%20coronavirus%20pneumonia%20in%20Wuhan%2C%20China%3A%20a%20descriptive%20study&amp;journal=Lancet&amp;volume=395&amp;pages=507-513&amp;publication_year=2020&amp;author=Chen%2CN\" data-track=\"click\" data-track-action=\"outbound reference\" data-track-label=\"link\" aria-label=\"Search for reference 1 on Google Scholar\"> Google Scholar<\/a><\/p>\n<\/li>\n<li class=\"c-article-references__item js-c-reading-companion-references-item\"><span class=\"c-article-references__counter\">2.<\/span>\n<p id=\"ref-CR2\" class=\"c-article-references__text\">Zhu, N. et al. A novel coronavirus from patients with pneumonia in China, 2019. <i>N. Engl. J. Med.<\/i> <b>382<\/b>, 727\u2013733 (2020).<\/p>\n<p class=\"c-article-references__links u-hide-print\"><a href=\"https:\/\/www.nature.com\/articles\/cas-redirect\/1%3ACAS%3A528%3ADC%252BB3cXjslGmsrc%253D\" data-track=\"click\" data-track-action=\"outbound reference\" data-track-label=\"link\" aria-label=\"View reference 2 on CAS\">CAS<\/a>\u00a0 <a href=\"https:\/\/doi.org\/10.1056%2FNEJMoa2001017\" data-track=\"click\" data-track-action=\"outbound reference\" data-track-label=\"link\" aria-label=\"View reference 2\">Article<\/a>\u00a0 <a href=\"http:\/\/scholar.google.com\/scholar_lookup?&amp;title=A%20novel%20coronavirus%20from%20patients%20with%20pneumonia%20in%20China%2C%202019&amp;journal=N.%20Engl.%20J.%20Med.&amp;volume=382&amp;pages=727-733&amp;publication_year=2020&amp;author=Zhu%2CN\" data-track=\"click\" data-track-action=\"outbound reference\" data-track-label=\"link\" aria-label=\"Search for reference 2 on Google Scholar\"> Google Scholar<\/a><\/p>\n<\/li>\n<li class=\"c-article-references__item js-c-reading-companion-references-item\"><span class=\"c-article-references__counter\">3.<\/span>\n<p id=\"ref-CR3\" class=\"c-article-references__text\">Wang, D. et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. <i>JAMA<\/i> <b>323<\/b>, 1061\u20131069 (2020).<\/p>\n<p class=\"c-article-references__links u-hide-print\"><a href=\"https:\/\/www.nature.com\/articles\/cas-redirect\/1%3ACAS%3A528%3ADC%252BB3cXlvVSqtbY%253D\" data-track=\"click\" data-track-action=\"outbound reference\" data-track-label=\"link\" aria-label=\"View reference 3 on CAS\">CAS<\/a>\u00a0 <a href=\"https:\/\/doi.org\/10.1001%2Fjama.2020.1585\" data-track=\"click\" data-track-action=\"outbound reference\" data-track-label=\"link\" aria-label=\"View reference 3\">Article<\/a>\u00a0 <a href=\"http:\/\/scholar.google.com\/scholar_lookup?&amp;title=Clinical%20characteristics%20of%20138%20hospitalized%20patients%20with%202019%20novel%20coronavirus-infected%20pneumonia%20in%20Wuhan%2C%20China&amp;journal=JAMA&amp;volume=323&amp;pages=1061-1069&amp;publication_year=2020&amp;author=Wang%2CD\" data-track=\"click\" data-track-action=\"outbound reference\" data-track-label=\"link\" aria-label=\"Search for reference 3 on Google Scholar\"> Google Scholar<\/a><\/p>\n<\/li>\n<li class=\"c-article-references__item js-c-reading-companion-references-item\"><span class=\"c-article-references__counter\">4.<\/span>\n<p id=\"ref-CR4\" class=\"c-article-references__text\">Huang, C. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. <i>Lancet<\/i> <b>395<\/b>, 497\u2013506 (2020).<\/p>\n<p class=\"c-article-references__links u-hide-print\"><a href=\"https:\/\/www.nature.com\/articles\/cas-redirect\/1%3ACAS%3A528%3ADC%252BB3cXhs1Kqu7c%253D\" data-track=\"click\" data-track-action=\"outbound reference\" data-track-label=\"link\" aria-label=\"View reference 4 on CAS\">CAS<\/a>\u00a0 <a href=\"https:\/\/doi.org\/10.1016%2FS0140-6736%2820%2930183-5\" data-track=\"click\" data-track-action=\"outbound reference\" data-track-label=\"link\" aria-label=\"View reference 4\">Article<\/a>\u00a0 <a href=\"http:\/\/scholar.google.com\/scholar_lookup?&amp;title=Clinical%20features%20of%20patients%20infected%20with%202019%20novel%20coronavirus%20in%20Wuhan%2C%20China&amp;journal=Lancet&amp;volume=395&amp;pages=497-506&amp;publication_year=2020&amp;author=Huang%2CC\" data-track=\"click\" data-track-action=\"outbound reference\" data-track-label=\"link\" aria-label=\"Search for reference 4 on Google Scholar\"> Google Scholar<\/a><\/p>\n<\/li>\n<li class=\"c-article-references__item js-c-reading-companion-references-item\"><span class=\"c-article-references__counter\">5.<\/span>\n<p id=\"ref-CR5\" class=\"c-article-references__text\">Xu, H. et al. High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. <i>Int J. Oral. Sci.<\/i> <b>12<\/b>, 8 (2020).<\/p>\n<p class=\"c-article-references__links u-hide-print\"><a href=\"https:\/\/www.nature.com\/articles\/cas-redirect\/1%3ACAS%3A528%3ADC%252BB3cXksVWnsL4%253D\" data-track=\"click\" data-track-action=\"outbound reference\" data-track-label=\"link\" aria-label=\"View reference 5 on CAS\">CAS<\/a>\u00a0 <a href=\"https:\/\/doi.org\/10.1038%2Fs41368-020-0074-x\" data-track=\"click\" data-track-action=\"outbound reference\" data-track-label=\"link\" aria-label=\"View reference 5\">Article<\/a>\u00a0 <a href=\"http:\/\/scholar.google.com\/scholar_lookup?&amp;title=High%20expression%20of%20ACE2%20receptor%20of%202019-nCoV%20on%20the%20epithelial%20cells%20of%20oral%20mucosa&amp;journal=Int%20J.%20Oral.%20Sci.&amp;volume=12&amp;publication_year=2020&amp;author=Xu%2CH\" data-track=\"click\" data-track-action=\"outbound reference\" data-track-label=\"link\" aria-label=\"Search for reference 5 on Google Scholar\"> Google Scholar<\/a><\/p>\n<\/li>\n<li class=\"c-article-references__item js-c-reading-companion-references-item\"><span class=\"c-article-references__counter\">6.<\/span>\n<p id=\"ref-CR6\" class=\"c-article-references__text\">Liao, Y. C. et al. IL-19 induces production of IL-6 and TNF-alpha and results in cell apoptosis through TNF-alpha. <i>J. Immunol.<\/i> <b>169<\/b>, 4288\u20134297 (2002).<\/p>\n<p class=\"c-article-references__links u-hide-print\"><a href=\"https:\/\/www.nature.com\/articles\/cas-redirect\/1%3ACAS%3A528%3ADC%252BD38XnvFGntbc%253D\" data-track=\"click\" data-track-action=\"outbound reference\" data-track-label=\"link\" aria-label=\"View reference 6 on CAS\">CAS<\/a>\u00a0 <a href=\"https:\/\/doi.org\/10.4049%2Fjimmunol.169.8.4288\" data-track=\"click\" data-track-action=\"outbound reference\" data-track-label=\"link\" aria-label=\"View reference 6\">Article<\/a>\u00a0 <a href=\"http:\/\/scholar.google.com\/scholar_lookup?&amp;title=IL-19%20induces%20production%20of%20IL-6%20and%20TNF-alpha%20and%20results%20in%20cell%20apoptosis%20through%20TNF-alpha&amp;journal=J.%20Immunol.&amp;volume=169&amp;pages=4288-4297&amp;publication_year=2002&amp;author=Liao%2CYC\" data-track=\"click\" data-track-action=\"outbound reference\" data-track-label=\"link\" aria-label=\"Search for reference 6 on Google Scholar\"> Google Scholar<\/a><\/p>\n<\/li>\n<li class=\"c-article-references__item js-c-reading-companion-references-item\"><span class=\"c-article-references__counter\">7.<\/span>\n<p id=\"ref-CR7\" class=\"c-article-references__text\">Fischer, K. et al. Inhibitory effect of tumor cell-derived lactic acid on human T cells. <i>Blood<\/i> <b>109<\/b>, 3812\u20133819 (2007).<\/p>\n<p class=\"c-article-references__links u-hide-print\"><a href=\"https:\/\/www.nature.com\/articles\/cas-redirect\/1%3ACAS%3A528%3ADC%252BD2sXkvFCitLs%253D\" data-track=\"click\" data-track-action=\"outbound reference\" data-track-label=\"link\" aria-label=\"View reference 7 on CAS\">CAS<\/a>\u00a0 <a href=\"https:\/\/doi.org\/10.1182%2Fblood-2006-07-035972\" data-track=\"click\" data-track-action=\"outbound reference\" data-track-label=\"link\" aria-label=\"View reference 7\">Article<\/a>\u00a0 <a href=\"http:\/\/scholar.google.com\/scholar_lookup?&amp;title=Inhibitory%20effect%20of%20tumor%20cell-derived%20lactic%20acid%20on%20human%20T%20cells&amp;journal=Blood&amp;volume=109&amp;pages=3812-3819&amp;publication_year=2007&amp;author=Fischer%2CK\" data-track=\"click\" data-track-action=\"outbound reference\" data-track-label=\"link\" aria-label=\"Search for reference 7 on Google Scholar\"> Google Scholar<\/a><\/p>\n<\/li>\n<\/ol>\n<p class=\"c-article-references__download u-hide-print\"><a href=\"https:\/\/www.nature.com\/articles\/s41392-020-0148-4-references.ris\" data-track=\"click\" data-track-action=\"download citation references\" data-track-label=\"link\">Download references<\/a><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/section>\n<section aria-labelledby=\"Ack1\" data-title=\"Acknowledgements\">\n<div id=\"Ack1-section\" class=\"c-article-section\">\n<h2 id=\"Ack1\" class=\"c-article-section__title js-section-title js-c-reading-companion-sections-item\">Acknowledgements<\/h2>\n<div id=\"Ack1-content\" class=\"c-article-section__content\">\n<p>We thank all the doctors, nurses, public health workers, and researchers for the braveness in fighting against SARS-CoV-2 and the efforts to save the life of COVID-19 patients. This work was supported in part by award numbers 81872028 and 81672693 (H.M.) from the National Natural Science Foundation of China, cstc2017jcyjBX0071 (H.M.) from the Foundation and Frontier Research Project of Chongqing and T04010019 (H.M.) from the Chongqing Youth Top Talent Project.<\/p>\n<\/div>\n<\/div>\n<\/section>\n<section aria-labelledby=\"author-information\" data-title=\"Author information\">\n<div id=\"author-information-section\" class=\"c-article-section\">\n<h2 id=\"author-information\" class=\"c-article-section__title js-section-title js-c-reading-companion-sections-item\">Author information<\/h2>\n<div id=\"author-information-content\" class=\"c-article-section__content\"><span id=\"author-notes\" class=\"c-article-author-information__subtitle u-visually-hidden\">Author notes<\/span><\/p>\n<ol class=\"c-article-author-information__list\">\n<li id=\"na1\" class=\"c-article-author-information__item\">These authors contributed equally: Li Tan, Qi Wang<\/li>\n<\/ol>\n<h3 id=\"affiliations\" class=\"c-article__sub-heading\">Affiliations<\/h3>\n<ol class=\"c-article-author-affiliation__list\">\n<li id=\"Aff1\">\n<p class=\"c-article-author-affiliation__address\">Department of Disease Control and Prevention, General Hospital of Central Theater Command, 430015, Wuhan, Hubei province, People\u2019s Republic of China<\/p>\n<p class=\"c-article-author-affiliation__authors-list\">Li Tan,\u00a0Qi Wang,\u00a0Duanyang Zhang\u00a0&amp;\u00a0Qiongshu Wang<\/p>\n<\/li>\n<li id=\"Aff2\">\n<p class=\"c-article-author-affiliation__address\">Department of Laboratory, General Hospital of Central Theater Command, 430015, Wuhan, Hubei province, People\u2019s Republic of China<\/p>\n<p class=\"c-article-author-affiliation__authors-list\">Jinya Ding\u00a0&amp;\u00a0Qianchuan Huang<\/p>\n<\/li>\n<li id=\"Aff3\">\n<p class=\"c-article-author-affiliation__address\">MRC Laboratory of Molecular Biology, Cambridge Biomedical Campus, Cambridge, CB2 0QH, UK<\/p>\n<p class=\"c-article-author-affiliation__authors-list\">Yi-Quan Tang<\/p>\n<\/li>\n<li id=\"Aff4\">\n<p class=\"c-article-author-affiliation__address\">Department of Biochemistry and Molecular Biology, Third Military Medical University (Army Medical University), 400038, Chongqing, People\u2019s Republic of China<\/p>\n<p class=\"c-article-author-affiliation__authors-list\">Hongming Miao<\/p>\n<\/li>\n<\/ol>\n<h3 id=\"contributions\" class=\"c-article__sub-heading\">Contributions<\/h3>\n<p>L.T., Q.W., Q.W. were responsible for the collection and summary of clinical cases. D.Z., J.D., Q.H. and Y.-Q.T. participated in discussion. Y.-Q.T. and Q.W. contributed to language polishing. H.M. was responsible for conceptual design, data analysis, manuscript writing, and submission.<\/p>\n<h3 id=\"corresponding-author\" class=\"c-article__sub-heading\">Corresponding authors<\/h3>\n<p id=\"corresponding-author-list\">Correspondence to <a id=\"corresp-c1\" href=\"https:\/\/www.nature.com\/articles\/s41392-020-0148-4\/email\/correspondent\/c1\/new\" rel=\"nofollow\">Qiongshu Wang<\/a> or <a id=\"corresp-c2\" href=\"https:\/\/www.nature.com\/articles\/s41392-020-0148-4\/email\/correspondent\/c2\/new\" rel=\"nofollow\">Hongming Miao<\/a>.<\/p>\n<\/div>\n<\/div>\n<\/section>\n<section aria-labelledby=\"ethics\" data-title=\"Ethics declarations\">\n<div id=\"ethics-section\" class=\"c-article-section\">\n<h2 id=\"ethics\" class=\"c-article-section__title js-section-title js-c-reading-companion-sections-item\">Ethics declarations<\/h2>\n<div id=\"ethics-content\" class=\"c-article-section__content\">\n<h3 id=\"FPar1\" class=\"c-article__sub-heading\">Competing interests<\/h3>\n<p>The authors declare no competing interests.<\/p>\n<\/div>\n<\/div>\n<\/section>\n<section aria-labelledby=\"Sec6\" data-title=\"Supplementary information\">\n<div id=\"Sec6-section\" class=\"c-article-section\">\n<h2 id=\"Sec6\" class=\"c-article-section__title js-section-title js-c-reading-companion-sections-item\">Supplementary information<\/h2>\n<div id=\"Sec6-content\" class=\"c-article-section__content\">\n<div data-test=\"supplementary-info\">\n<div id=\"figshareContainer\" class=\"c-article-figshare-container\" data-test=\"figshare-container\"><\/div>\n<div id=\"MOESM1\" class=\"c-article-supplementary__item\" data-test=\"supp-item\">\n<h3 class=\"c-article-supplementary__title u-h3\"><a class=\"print-link\" href=\"https:\/\/static-content.springer.com\/esm\/art%3A10.1038%2Fs41392-020-0148-4\/MediaObjects\/41392_2020_148_MOESM1_ESM.docx\" data-track=\"click\" data-track-action=\"view supplementary info\" data-track-label=\"link\" data-test=\"supp-info-link\" data-supp-info-image=\"\">Supplementary information<\/a><\/h3>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/section>\n<section aria-labelledby=\"rightslink\" data-title=\"Rights and permissions\">\n<div id=\"rightslink-section\" class=\"c-article-section\">\n<h2 id=\"rightslink\" class=\"c-article-section__title js-section-title js-c-reading-companion-sections-item\">Rights and permissions<\/h2>\n<div id=\"rightslink-content\" class=\"c-article-section__content\">\n<p><b>Open Access<\/b> This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article\u2019s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article\u2019s Creative Commons license and your intended use is not permitted by statutory reg<\/p>\n<\/div>\n<\/div>\n<\/section>\n<\/div>\n<p><main class=\"c-article-main-column u-float-left js-main-column\" data-track-component=\"article body\"><\/p>\n<article lang=\"en\">\n<div class=\"c-article-body\">\n<section aria-labelledby=\"article-info\" data-title=\"About this article\">\n<div id=\"article-info-section\" class=\"c-article-section\">\n<div id=\"article-info-content\" class=\"c-article-section__content\">\n<div class=\"c-bibliographic-information\">\n<div class=\"c-bibliographic-information__column\">\n<div data-component=\"share-box\">\n<div class=\"c-article-share-box\">\n<p class=\"js-c-article-share-box__additional-info c-article-share-box__additional-info\">Provided by the Springer Nature SharedIt content-sharing initiative<\/p>\n<\/div>\n<\/div>\n<div data-component=\"article-info-list\"><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/section>\n<\/div>\n<\/article>\n<p><\/main><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Lymphopenia predicts disease severity of COVID-19: a descriptive and predictive study Li Tan, Qi Wang, Duanyang Zhang, Jinya Ding, Qianchuan Huang, Yi-Quan Tang, Qiongshu Wang &amp; Hongming Miao Signal Transduction and Targeted Therapy volume\u00a05, Article\u00a0number:\u00a033 (2020) Cite this article An Author Correction to this article was published on 29 April 2020 This article has been &hellip; <\/p>\n<p><a class=\"more-link btn\" href=\"https:\/\/evaggelatos.com\/?p=18555\">\u03a3\u03c5\u03bd\u03ad\u03c7\u03b5\u03b9\u03b1 \u03b1\u03bd\u03ac\u03b3\u03bd\u03c9\u03c3\u03b7\u03c2<\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[85,41,10],"tags":[90],"class_list":["post-18555","post","type-post","status-publish","format-standard","hentry","category-85","category-41","category-10","tag-90","item-wrap"],"_links":{"self":[{"href":"https:\/\/evaggelatos.com\/index.php?rest_route=\/wp\/v2\/posts\/18555","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/evaggelatos.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/evaggelatos.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/evaggelatos.com\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/evaggelatos.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=18555"}],"version-history":[{"count":1,"href":"https:\/\/evaggelatos.com\/index.php?rest_route=\/wp\/v2\/posts\/18555\/revisions"}],"predecessor-version":[{"id":18556,"href":"https:\/\/evaggelatos.com\/index.php?rest_route=\/wp\/v2\/posts\/18555\/revisions\/18556"}],"wp:attachment":[{"href":"https:\/\/evaggelatos.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=18555"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/evaggelatos.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=18555"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/evaggelatos.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=18555"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}