ABSTRACT
Background: At the end of 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged as a novel coronavirus responsible for causing the global coronavirus disease 19 (COVID-19) pandemic. Symptoms range from asymptomatic to severe respiratory symptoms. SARS-CoV-2 infection is well known to be associated with immune dysregulation and hematologic aberrancies. Few studies have reviewed peripheral blood smears abnormalities from COVID-19 patients. In this study, we aimed to characterize the morphologic features of peripheral blood smears from COVID-19 patients. Design: Hospitalized patients with PCR-confirmed COVID-19 infection were identified. Complete Blood Count (CBC) data, clinical findings, and peripheral blood morphology were compared to control patients with confirmed negative COVID-19 PCR. Results: Twelve PCR confirmed covid 19 positive patients (male- 9, female- 3) with an age range 38 to 95 were compared to 11 control patients PCR-negative for COVID-19. Most patients presented with fever or respiratory symptoms. Among the COVID-19 positive patients absolute lymphopenia was seen in 9/12 patients. Absolute monocytosis was seen in 2/12 and monocytopenia was seen in 3/12 cases. Interestingly, large, activated monocytes with abundant gray-blue cytoplasm with prominent cytoplasmic vacuoles were seen in all the COVID-19 positive patents (see fig. 1 D-F) as compared to normal controls. These activated monocytes consist of 1-11% of leukocytes, with absolute counts ranging from 0.12-0.69 x 10∧3/microliter. Other morphologic findings found in peripheral blood smears include plasmacytoid and atypical lymphocytes (Fig 1A-C), as well as neutrophils with pseudo-Pelger-Huet nuclei (Fig 1G-I). 10/12 patients with COVID-19 infection were unvaccinated;differences between peripheral blood smears from vaccinated and unvaccinated patients were not seen. All patients recovered upon follow up. Conclusions: In conclusion, activated monocytes with distinct morphology are present in varying numbers in the peripheral blood from hospitalized COVID-19 patients. These activated monocytes are not present in non-COVID-19 patients. These findings are consistent with those found in previous studies. Some of these studies have shown the presence of activated monocytes may indicate favorable outcomes. (Figure Presented).
ABSTRACT
Background. New Jersey experienced a 64% decrease in HIV screening during the COVID-19 pandemic, hampering the Federal "End the Epidemic Initiative". From March 2020- May 2021, North Jersey Community Research Initiative, a community-based organization in Newark, NJ, noted a HIV seropositivity of 3.1% despite a decrease of 25% in testing. Qualitative interviews conducted virtually with community individuals and focus groups during that time period indicated that COVID-19 suggested clients were taking more risks due to feelings of isolation, depression and anxiety. NJCRI in collaboration with Robert Wood Johnson Medical School in Somerset, NJ and five other community-based partners in NJ wanted to assess if offering community combination COVID-19 screening and HIV screenings during the pandemic would increase community screening for HIV. Methods. CLIA Waived Screening for COVID-19 from two antigen assays, LumiraDx and BD Veritor was combined with a referenced laboratory based molecular screening from saliva Infinity Biologix under FDA emergency use authorization within CDC guidance with HIV Alere/Determine and INSTI in those individuals that identified as asymptomatic for COVID-19 but with high risk for HIV Results. NJCRI began the COVID-19 and HIV rapid screening to clients on January 4, 2021.Clients tested for COVID-19 (N=274), 3% tested positive for HIV and < 3% are self-reported HIV+ (94% of the sample tested negative for HIV). Overall, 92% of clients tested negative for COVID-19. Clients testing positive for COVID-19 (N=19), there was a 6% positivity rate utilizing COVID-19 Antigen by nasal swab. Those positive via COVID-19 Molecular (N=19) method, results indicate clients also tested positive 6% of the time using a saliva indicator. Approximately, 5% of the study sample are confirmed COVID-19 positives via both testing methods (separately 1% Antigen and < 2% Molecular). 19% of the sample (N=3) tested positive for both HIV and COVID-19. Conclusion. Newly diagnosed patients were treated the same day with antiretroviral therapy;linked to medical care, behavioral health and risk reduction services. Combining COVID-19 and HIV screening in a trusted community-based setting improved delivery of HIV care and linkage to care for newly diagnosed individuals in Newark, NJ.