Is there a link between low white blood cell counts and COVID?

A low white blood cell (WBC) count, also called leukopenia, means your body doesn’t have enough of these immune system cells to help fight infection. Many conditions and certain medications can cause low white blood cell counts.

White blood cells protect your body from foreign pathogens. As a result, a low white blood cell count puts you at higher risk for infections, including coronavirus disease 2019 (COVID-19), according to recent research. In this article, we discuss the connection between the two and how white blood cells are affected by COVID.

What are white blood cells?

White blood cells are a type of immune cell. They are produced in the bone marrow (the spongy part of bone) and can be found in the blood and tissues that support the immune system (called lymphoid tissue). There are several types of white blood cells, each of which plays a role in fighting infection and disease in the body:

  • Granulocytes, including neutrophils, eosinophils, and basophils, are released during allergic reactions and asthma
  • Monocytes, which help fight infection and promote healing
  • Lymphocytes, including T cells and B cells, also help control the immune response

Your WBC count is measured with a blood test called a complete blood count (CBC). If your WBC count is higher than normal, this may indicate infection or inflammation. A low WBC count indicates a problem with your immune system. This is a common problem for people with cancer or those taking drugs that suppress the immune system.

Typical reference ranges for WBC counts are:

  • Low: Less than 4,500 WBC per microliter
  • Normal: 4,500 to 11,000 WBCs per microliter
  • High: Over 11,000 WBCs per microliter

Overview of Leukocyte Disorders: Symptoms, Diagnosis, Treatment

The link between white blood cell counts and COVID-19

A high WBC count, also known as leukocytosis, is usually a sign that the body is fighting an infection, and so is COVID-19. Studies have shown that people who test positive for COVID-19 but are asymptomatic often have higher WBC counts, especially lymphocytes.

Lymphocytes circulate throughout your body and produce antibodies that release proteins to fight pathogens and help your immune system fight infections. B cells focus on attacking invading viruses and bacteria, while T cells destroy the body’s own cells that have been damaged by things like viruses or cancer.

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The high levels of lymphocytes observed in asymptomatic people with COVID-19 make sense. This means their immune systems are doing a good job of keeping the coronavirus under control by producing antibodies and destroying damaged cells.

Studies have shown that COVID-19 patients with high white blood cell counts have more severe disease and death. Many other studies have found that lower WBC counts or increased WBC counts, especially decreased levels of lymphocytes Linked to more severe illness and death from COVID-19.

This may be because levels of certain types of white blood cells, such as neutrophils, are higher when the body fights the virus, while the levels of lymphocytes remain low.

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Symptoms of COVID-19

The symptoms of COVID-19 and a low white blood cell count are quite different. COVID-19 symptoms may include:

  • fever
  • chills
  • cough
  • shortness of breath
  • Difficulty breathing
  • fatigue
  • Muscle pain
  • headache
  • loss of taste or smell
  • sore throat
  • stuffy or runny nose
  • nausea or vomiting
  • diarrhea

Low white blood cell counts have no actual symptoms, but people with low white blood cell counts may experience various symptoms due to infections that the body cannot fight off. People with the following conditions typically have lower WBC counts:

  • autoimmune diseases, such as rheumatoid arthritis
  • Cancer treatments such as radiation therapy
  • Infections such as HIV and hepatitis
  • antipsychotic drugs
  • Agranulocytosis, in which your body does not make enough neutrophils
  • Neutropenia, which is low levels of neutrophils in your body

But, more specifically, people with low levels of lymphocytes suffer from a condition called lymphopenia, or lymphopenia. This happens when your body doesn’t have enough of these blood cells. It can also be infected, for example in AIDS patients.

Symptoms of diseases that can cause low white blood cell counts (such as HIV, cancer treatment, and uncontrolled diabetes) may include:

  • frequent or repeated infections
  • unresolved infection
  • unusual or rare infections
  • fever
  • bladder infection
  • mouth ulcers
  • skin infection
  • sinus infection or nasal congestion
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Diagnosis and Treatment of COVID-19

A diagnosis of COVID-19 is confirmed by two tests:

  • A virus test shows if you have a current infection.
  • Antibody tests can show if you have ever been infected.

The Centers for Disease Control and Prevention (CDC) recommends testing anyone who has symptoms of COVID-19 or who has been in direct contact with someone who is positive for COVID-19.

If you test positive for an active infection, you will need to take steps to protect those around you, usually isolating yourself and letting close contacts know that you are infected.

Currently, there is only one FDA-approved drug to treat COVID-19: Veklury (remdesivir). However, it is reserved for the treatment of hospitalized patients over the age of 12. There are various other medicines with emergency use authorization, such as Actemra (tocilizumab).

Generally, if hospitalized patients with COVID-19 require supplemental oxygen, they are treated with remdesivir or dexamethasone or a similar corticosteroid. You can also use blood thinners to control blood clotting.

People who are dealing with the virus at home should monitor their symptoms and keep in touch with their doctor if they are concerned. If you have trouble breathing or your symptoms suddenly worsen, you should go to the emergency room or call 911.

Overall, you will want to:

  • Use over-the-counter medicines such as Tylenol (acetaminophen) to control fever and other symptoms.
  • Drink more water.
  • rest.
  • Wear a mask if you must come into contact with others.
  • Wash your hands often.
  • Avoid sharing utensils or personal items with others.
  • Clean shared surfaces frequently.

Ways to prevent COVID-19 or infection

There may not be many ways to prevent low blood counts. Often, a low WBC count is the result of an infection or disease or a medicine you need.

However, there are steps you can take to protect yourself from COVID-19, steps you should be extra vigilant about if you know you have a low WBC count. Often, people with low white blood cell counts are educated on how to prevent infection, and much of this guidance reflects strategies to avoid COVID-19, such as:

  • Wear a mask.
  • Wash your hands often.
  • Avoid large crowds, especially indoors.
  • Avoid sick people.
  • Clean and disinfect the area around you frequently.
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Unlike some other infections, such as HIV, you can also get a COVID-19 vaccine. The recent spike in infections has proven the vaccine’s effectiveness, with far more unvaccinated people hospitalized with the virus than vaccinated people.


A low white blood cell count means you have a higher risk of infection because white blood cells help fight pathogens in the body. Your WBC count may be low due to an illness or infection or the medicines you are taking. Recent studies have shown that people with low white blood cell counts are more likely to develop severe cases of COVID-19. If your WBC count is low, you should vigilantly practice prevention strategies for COVID-19.

VigorTip words

Your white blood cells power your immune system, and in severe infections, a low cell count can be fatal. Low white blood cell counts have been found to cause severe illness and death in COVID patients. While you may not be able to prevent a low WBC count, you can take steps to prevent COVID infection.

Frequently Asked Questions

  • What are the symptoms of a low white blood cell count?

    There are usually no symptoms associated with a low white blood cell count, but you may experience symptoms from a disorder that causes a low WBC count. These include HIV infection, uncontrolled diabetes or cancer.

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    How to manage HIV

  • Can the COVID vaccine cause blood clots?

    There have been few reports of severe blood clots and low platelet levels called cerebral venous sinus thrombosis (CVST) when using the Janssen COVID-19 vaccine. Discuss this possible side effect with your doctor.

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    What you should know about the Janssen vaccine