CBC parameters and morphological alterations in peripheral blood cells in COVID-19 patients: Their significance and correlation with clinical course

Abstract

Background:SARS-CoV2  infection  induces inflammatory responses and acute lung injury in human beings.CBC and its derivatives are important investigative tools in its prognosis. However very few studies highlight the importance of Peripheral blood cell morphology in this disease.Aim:To Analyze significance of the CBC,  derived parameters and peripheral blood cells morphology in Covid-19 patients,and to study their correlation with its Clinical Status of the patients at admission and at subsequent assessment during hospital stay. Material and methods: A Single center retrospective study of laboratory-confirmed 26 COVID-19 patients admitted at SSPH & PGTI, from April to July 2020., CBC, its derived parameters and Romanowsky stained peripheral blood  smears were analysed at two points of time during clinical course. Data was tabulated and analyzed using SPSS22 software.Results:On admission, 42.3% cases were mildly symptomatic and 19.2% were moderate to severely symptomatic requiring oxygen/ventilatory support. No significant statistical findings noted in CBC and its derived parameters at the  time of admission . Follow-up, revealed a significant change in WBC and platelet count. (p=0.002). 7 cases showed persistent changes in CBC parameters and blood cell morphology and 3 out of 7 had moderate to severe clinical course. Bizarre atypical mononuclear cells , 2-3 times the size of RBC with dense homogenous chromatin, nuclear  membrane irregularity and deep blue cytoplasm(?covicytes) were the most significant morphological finding. Conclusion: It is evident from our studies that a relevant number of cases having moderate to severe symptoms showed persistence of morphological changes and alteration in CBC parameters.