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Study of Morphological Spectrum of Peripheral Blood Smear Changes in Coronavirus Disease 2019 (COVID-19) Positive Patients and its Correlation with Clinical Severity
Indian Journal of Hematology and Blood Transfusion ; 37(SUPPL 1):S125, 2021.
Article in English | EMBASE | ID: covidwho-1635355
ABSTRACT

Introduction:

Peripheral blood changes in Coronavirus disease 19(COVID-19) are diverse and have been reported in literature in theform of brief communications and case series with relatively smallersample size and with a handful of studies showing associationbetween peripheral blood smear (PBS) and clinical severity of thedisease.Aims &

Objectives:

To highlight the numerical and morphologicalchanges in COVID-19 patients and to compare the same in IntensiveCare Unit (ICU) and non-ICU settings as well as between COVID-19survivors and deceased patients.Materials &

Methods:

This cross-sectional study included 80COVID-19 positive (41 ICU and 39 non-ICU) patients and 32COVID-19 negative ICU patients, done in Department of Pathology,ABVIMS &Dr RML Hospital, New Delhi from December 2020 toFebruary 2021. Complete blood counts (CBC) and PBS findings werestudied and scored by two pathologists blindfoldedly.

Result:

Among CBC parameters, absolute lymphocyte count (ALC)and absolute eosinophil count (AEC) were significantly lower inCOVID-19 positive cases as compared to COVID-19 negative group(p = 0.001 &p = 0.001). On PBS, COVID-19 positive group showedsignificant left myeloid shift (p = 0.021), Dohle bodies (p = 0.025)with significant prominence of acquired pseudo pelger-huet anomaly,ring shaped neutrophils, monolobulate neutrophils and plasmacytoidlymphocytes as compared to control group (p = 0.000, p = 0.009,p = 0.046 &p = 0.011 resp). The overall mean White blood cell(WBC) counts were higher in COVID-19 positive ICU patients ascompared to non-ICU COVID positive patients with significant shiftto left (p = 0.017). Ring shaped neutrophils, monocyte vacuolationand large granular lymphocyte (LGL) were significantly higher inCOVID-19 positive ICU patients as compared to non-ICU patients(p = 0.007, p = 0.008 &p = 0.004 resp). Deceased group (14/39 ICUCOVID positive cases) showed significantly high WBC count(p = 0.018) with marked neutrophilia (p = 0.024) and toxic granulation (p = 0.01) and prominence of monocyte vacuolization, ringshaped neutrophils, large granular lymphocytes and reactive lymphocytes as compared to survivor.

Conclusions:

Morphological parameters like myeloid left shift, ringshaped neutrophils, monocyte vacuolation, LGLs and reactive lymphocytes emerged as highly sensitive markers of COVID-19 diseaseseverity. Therefore, serial CBC with comprehensive PBS analysisshould be done in every newly diagnosed hospitalized COVID-19patients to potentially predicts the course of disease and its clinicaloutcome.
Keywords

Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Prognostic study Language: English Journal: Indian Journal of Hematology and Blood Transfusion Year: 2021 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Prognostic study Language: English Journal: Indian Journal of Hematology and Blood Transfusion Year: 2021 Document Type: Article