Red blood cells injuries and hypersegmented neutrophils in COVID-19 peripheral blood film

Abstract

In the current investigation, peripheral blood films of 15 COVID-19 patients (44.78±16.55 years), proven by computed tomographic imaging and RT-PCR for coronavirus SARS-CoV-2, were analyzed at the moment of hospital admission. Blood tests showed raised inflammatory markers (C-reactive protein 58.2±61.2 mg/L) with normal values for hemoglobin (126.2±2.6 g/L), WBC (6.8±18.74 109/L) RBC (4.55±0.99 1012/L) platelets (262.4±41.8, 109/L) MCV (79.84±8.2 fL) MCH (28±3.31 pg) and MCHC (350.3±1.15 g/L). The results revealed the presence of hypersegmented neutrophils in 66.66%% of the patients. The percentages of neutrophils with 4 and 5 lobes were 46.25±4.83% and 31.5±14.84%, respectively. Three major red blood cells morphological alteration were observed: (1) erythrocytes in double primerouleauxdouble prime formation represented by linear erythrocytes aggregation, (2) spherocytes with the disappearance of the usual biconcave disk, and (3) echinocytes showing spiky projections. Apparent reorganization of hemoglobin is found in the majority of the analyzed erythrocytes. Rouleaux formation is observed in 33.33% of patients and spherocytes and echinocytes are present at variable levels in the all analyzed patients. The current results revealed erythrocytes injuries in COVID-19 peripheral blood, in association with hypersegmented neutrophils, alterations that could be involved in the respiratory syndrome.

Evidence for a connection between COVID-19 and exposure to radiofrequency radiation from wireless communications including 5G

“…Similar red blood cell changes have been described in peripheral blood of COVID-19 patients (Lakhdari et al, 2020). Rouleaux formation is observed in 1/3 of COVID-19 patients, whereas spherocytes and echinocytes have been observed at variable levels.…”

A Deadly Embrace: Hemagglutination Mediated by SARS-CoV-2 Spike Protein at Its 22 N-Glycosylation Sites, Red Blood Cell Surface Sialoglycoproteins, and Antibody

“…The interlaced attachments of RBCs with SARS-CoV-2 virions as observed in vitro in the hemadsorption assay [ 35 ] may well define the mechanism by which clumps (rouleaux) of RBCs form in the blood of COVID-19 patients [ 112 , 113 , 114 ], as shown in Figure 2 . These clumps would present vascular obstructive potential, given that an RBC of average disk diameter 8 µm [ 115 , 116 ] traverses through an alveolar capillary of smaller average cross-sectional diameter [ 117 ], achieved only by a distortion of the RBC’s shape to press against the capillary wall [ 116 , 118 ].…”

“… Images of RBC rouleaux (clumps) from the blood of COVID-19 patients, obtained using light (( A ) [ 112 ], ( B ) [ 113 ]) and electron microscopy (( C ) [ 114 ]). The first study ( A ) found huge rouleaux formation by RBCs in 85% of COVID-19 patients studied [ 112 ]; the second ( B ) found these in 33% of patients [ 113 ]; and the third ( C ) found these prevalent in its series of 31 patients, all with mild COVID-19 [ 114 ]. Reproduced with permission from ( A ) SIMTIPRO Srl; ( B ) CC-BY 4.0; ( C ) Georg Thieme Verlag KG.…”

Comparison of hematologic abnormalities between hospitalized coronavirus disease 2019 positive and negative patients with correlation to disease severity and outcome

“…Salib et al reported hypersegmented neutrophils in 88% of the COVID‐19 patients while Lakhdari N et al reported them in 66.66% of the COVID‐19 patients. 20 , 21 Previous studies have reported hypersegmented neutrophils in cases of acute respiratory distress syndrome, inflammation, and severe viral respiratory infection. 22 , 23 Since, the control group in the current study was of ICU settings therefore no significant difference was noted between the two groups.…”