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Category: Volume 10 Issue 06 June 2022
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Title: Haematological and morphological alterations in peripheral blood cells of patients with COVID -19 infections

Authors: Monika Pangotra, Rashmi Aithmia, Isha Sharma

 DOI: https://dx.doi.org/10.18535/jmscr/v10i6.12

Abstract

Introduction: COVID-19 infection is a highly communicable disease caused due to Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It is responsible for a widespread pandemic with millions of confirmed cases and numerous deaths, which are reported in almost all countries. Peripheral blood smears shows changes in the morphology and count of white blood cells (WBCs), as well as abnormalities of platelets. The most common hematological abnormalities seen in these patients include decreased lymphocytes, increased neutrophils, low eosinophils, as well as changes in the platelets.

Aims: The objective of this study was to evaluate changes in blood smears of COVID-19 patients which can help in the diagnosis and to a certain extent in the patient’s prognosis.

Materials and Methods: This study was performed on 52 patients diagnosed with COVID‐19 infection in district hospital Udhampur between April 2021 to June 2021. Blood samples were collected from the patients and examined for the estimation of hematological parameters and blood cell morphology.

Results: A total of 52 patients who were diagnosed with COVID-19 infection were enrolled in the study.WBC count was normal in 59.6% of the patients and leukocytosis was observed in 38.4%cases. In addition, differential WBC count indicated that 30.7% of cases had neutrophilia. Lymphopenia was found in 21.1% and 61.5 % had a low eosinophil count. The most notable morphologic changes were neutrophils with clumped chromatin, multiple abnormal nuclear shapes, pseudo-Pelger-Huet deformity, and smudged neutrophils’-shaped, fetus-like nuclei were noted with aberrant nuclear projections referred to as COVID nuclei. Atypical lymphocytes with deeply basophilic cytoplasm were seen in 19.8% of the cases. Activated monocytes were observed that demonstrated marked anisocytosis with significant cytoplasmic vacuolization and few granules.

Conclusion: The understanding of the hematological manifestations of SARS-CoV-2 is still evolving. This research identifies and describes a summary of morphological changes in peripheral blood cells of patients suffering fromCOVID-19. Knowledge of such morphologic changes in peripheral blood of affected leucocytes, if substantiated with larger studies, may help physicians diagnose in the absence of a negative RT-PCR or antibody results.

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Corresponding Author

Rashmi Aithmia

Resident, Department of Pathology GMC Jammu