Hematological Parameters and Morphologicalalterations in Leucocytes of Covid-19 Patients

Abstract

World Health Organization (WHO) announced COVID-19 outbreak as a pandemic on 11th March 2020. COVID-19 caused its impact globally with a substantial morbidity and mortality in people across the world especially in those at a higher age group with comorbidities. Most of the organ systems are affected including hematopoietic system. We studied the hematological profile of 196 confirmed COVID-19 positive patients at our tertiary care center from 22nd March 2020 to 15th June 2020. Various hematological parameters including Haemoglobin(Hb), Total Leucocyte Count(TLC), Absolute Neutrophil count(ANC), Absolute Lymphocyte Count(ALC), Absolute Monocyte Count(AMC), Absolute Eosinophil Count(AEC), Platelet Count(PC), Neutrophil to Lymphocyte Ratio(NLR), Erythrocyte Sedimentation Rate(ESR) and Peripheral blood smears were studied. We found Hb levels were decreasing in the patients with more severe disease. Leucopenia, lymphopenia, eosinopenia, neutrophilia, raised ESR and increasing NLR was seen in patients with more severe disease and those who succumbed to death. We also observed various morphological abnormalities in leucocytes in peripheral blood films of these patients. These parameters prove their prognostic significance in risk stratification in the COVID-19 positive patients for early intervention and deciding treatment regimens which may help to alleviate the morbidity and mortality. As these tests are easily available even at low resource settings, in developing country like India this study may help the patients who are being treated at peripheral centers to get referred to a higher center and get better treatment to reduce the morbidity and mortality.