Peripheral Blood Smear Demonstration of Lymphocyte Changes in Severe COVID-19

Lee, Chun Tsu; Teo, Winnie Z.Y.

doi:10.4269/ajtmh.20-0721

Cited by 10 publications

(17 citation statements)

References 5 publications

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“…Yue Ping Lee et al reports lower incidence of plasmacytoid lymphocytes when compared to monocytoid lymphocytes which was in correlation with our study [15]. However our study showed increased incidence of plasmacytoid lymphocytes in stage 3 disease which was also in correlation with a study by Chun Tsu lee [9].…”

Section: Discussionsupporting

confidence: 90%

“…In a study by Aminder Singh the various morphological changes of RBC, WBC and Platelets in Covid 19 positive patients have been described and correlated with clinical ndings [8].They have described that morphological changes in monocytes played a signi cant role in clinical presentation. In a study by Chun Tsu Lee the various morphological changes of lymphocytes in Covid 19 positive patients have been described [9].…”

Section: Introductionmentioning

confidence: 99%

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Morphological Changes in Blood Cells as Indicators for Disease Progression in COVID 19

A¹,

KARTHIKEYN

2021

Preprint

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A novel highly pathogenic human corona virus (COVID19) has been recently recognised in Wuhan, China as the cause of corona disease outbreak. It has rapidly spread from China to various countries across the world evolving as a pandemic. In our study we have categorized the covid positive patients into mild, moderate and severe based on the clinical criteria suggested by WHO. The coagulation parameters of the patients were analysed and documented. A peripheral smear was made for every patient and the morphological changes in blood cells were documented. The peripheral smear findings were then correlated with the disease stage and coagulation parameters. There were significant differences in the total WBC count and the differential WBC count between stages 1 &2 and stages 1 & 3 (p<0.005). Leucocytosis, neutrophilia and toxic changes in neutrophils were seen in severe stage of the disease and in covid coagulopathy suggesting these are important indicators of disease severity. Schistocytes an important finding in any other coagulopathy was not present in covid associated coagulopathy. Activated lymphocytes was found to be the most common morphological presentation seen in all covid patients irrespective of the disease stage whereas plasmacytoid lymphocytes was an important finding in severe stage disease. Monocyte cytoplasmic vacuoles, large/giant platelets were other morphological findings observed but these findings did not have any significant correlation with disease stage. Since follow up smears of the same patient were not analysed during disease progression and also post recovery, additional research in this field will provide further insights.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Morphological Changes in Blood Cells as Indicators for Disease Progression in COVID 19

A¹,

KARTHIKEYN

2021

Preprint

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“…Therefore, further evaluations my show the reduced number of CD4-positive and CD8-positive T cells, B cells, and natural killer cells. A favorable clinical outcome has also been correlated with increased lymphocyte count, and lymphocytosis was present in 9.1% of the patients in the current research (1,15,17,18).…”

Section: Discussionsupporting

confidence: 61%

Hematological and Morphological Changes in the Peripheral Blood Smear of Patients with COVID-19

Ahmed

Mohammed

2021

J Kermanshah Univ Med Sci

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Background: The novel coronavirus is responsible for a widespread pandemic, causing multiple clinical manifestations. Peripheral blood films have shown changes in white blood cell (WBC) morphology and counts, as well as platelet abnormalities. Atypical and reactive lymphocytes may also be observed in the blood film, which suggests mild leukoerythroblastosis. Objectives: The present study aimed to evaluate the hematological and morphological changes in the peripheral blood smear of patients with COVID-19. Methods: This study was conducted on 175 patients diagnosed with COVID‐19 infection. Blood samples were collected from the patients and examined for the estimation of blood parameters, differential cell count, and presence of atypical lymphocytes. Results: The mean age of the patients was 53.73 years, and males constituted 52.6% of the patients. The majority had normal hemoglobin levels. WBC count was normal in 60.6% of the patients, while 74.3% had normal platelet count, and thrombocytopenia was detected in 23.4%. In addition, differential WBC count indicated that 56.6% of the patients had normal neutrophils, while lymphopenia was detected in 28 and 77.7% had a low eosinophil count. The peripheral blood smears showed atypical lymphocytes with deeply basophilic cytoplasm in 21.14% of the patients. Conclusions: Blood film examination may show multiple abnormal findings in patients with COVID-19 infection. Neutrophilia and lymphopenia with the presence of atypical lymphocytes are frequently observed as well. Low eosinophil count is also highly common. Although platelets showed changes, they were normal or reduced in most cases.

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“…Os linfócitos plasmocitóides (Figura 2), descritos na primeira categoria, foram relatados por diversos estudos (Chong et al, 2020;Foldes et al, 2020;Jamal et al, 2020;Kaur et al, 2021;Lee & Teo, 2020;Lüke et al, 2020;Nazarullah et al, 2020;Pozdnyakova et al, 2020;Sadigh et al, 2020;Schapkaitz, Jager & Levy, 2020;Weinberg, Behdad & Ji, 2020) revelando presença frequente no sangue periférico dos pacientes.…”

Section: Linfócitosunclassified

“…Os linfócitos reativos semelhantes às células de Downey (Figura 3), que mimetizam morfologicamente as células observadas nos pacientes infectados pelo vírus Epstein-Barr ou infecção por citomegalovírus (Gérard, Henry & Thomas, 2020), foram observados com menos frequência (Berber et al, 2020;Chong et al, 2020;Gérard, Henry & Thomas, 2020;Jamal et al, 2020;Lee & Teo, 2020;Lüke et al, 2020;Nazarullah et al, 2020;Schapkaitz, Jager & Levy, 2020). Outras morfologias citadas com menos frequência incluem a presença ocasional de grânulos citoplasmáticos (Gérard, Henry & Thomas, 2020;Jamal et al, 2020;Kaur et al, 2021;Nazarullah et al, 2020;Schapkaitz, Jager & Levy, 2020;Singh et al, 2020; e linfócitos reativos com grandes inclusões citoplasmáticas, semelhantes às células de Mott (Foldes et al, 2020;Lee & Teo, 2020;Lüke et al, 2020). Singh et al (2020), relatou várias anomalias.…”

Section: Linfócitosunclassified

Alterações leucocitárias em pacientes com COVID-19 observadas em extensão de sangue periférico

Coradi

Vieira

2021

RSD

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O objetivo do estudo foi verificar as principais alterações na linhagem leucocitária causadas pela infecção pelo SARS-CoV-2, vírus de origem zoonótica responsável pela doença conhecida como COVID-19. O SARS-CoV-2 afeta vários sistemas, incluindo o sistema hematopoiético, o que ocasiona alterações nas linhagens dos leucócitos. Os pacientes infectados pelo vírus SARS-CoV-2 apresentavam alterações numéricas e morfológicas na linhagem de leucócitos, sendo mais significativo a linfopenia e a neutrofilia. Quanto à morfologia, foram observadas várias anomalias. Os linfócitos reativos plasmocitóides e os semelhantes às células de Downey foram observados com frequência. Monócitos displásicos e neutrófilos com hipolobulação, classificados como anomalia Pseudo Pelger-Huet adquirida, também estavam presentes. Essas anormalidades foram correlacionadas com maior chance de admissão na UTI e evolução para óbito. Houve correspondência entre a contagem normal de eosinófilos com a progressão positiva da doença, o que sugere que, a regeneração dos eosinófilos esteja relacionada com a recuperação da doença. Esse conjunto de alterações não foi observado em nenhuma outra pneumonia de origem viral. A contagem diferencial de leucócitos é um exame rápido e de fácil realização, que pode auxiliar a equipe médica na classificação de pacientes graves ou não graves, e fornecer direcionamento da evolução da doença.

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Peripheral Blood Smear Demonstration of Lymphocyte Changes in Severe COVID-19

Cited by 10 publications

References 5 publications

Morphological Changes in Blood Cells as Indicators for Disease Progression in COVID 19

Morphological Changes in Blood Cells as Indicators for Disease Progression in COVID 19

Hematological and Morphological Changes in the Peripheral Blood Smear of Patients with COVID-19

Alterações leucocitárias em pacientes com COVID-19 observadas em extensão de sangue periférico

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