Iranian Journal of Pathology

Hematocytological Clues of Peripheral Blood in Different Clinical Presentations of COVID-19

Document Type : Original Research

Authors

Fakhri Mohaghegh Zahed 1
Shahriar Dabiri 1
Abdolreza Javadi 2
Sajjadeh Movahedinia 1
Manzumeh Shamsi Meymandi Pharm 1
Bahram Dabiri 3
Parisa khorasani Esmaili 2
Mitra Sadat Rezaei 2, 4
Mehrdad Farokhniya 5

1 Pathology and Stem Cells Research Centers, Pathology Department, Afzalipour Medical School, Kerman Medical Sciences University, Kerman, Iran

2 Department of Pathology, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Department of Pathology, NYU Long Island School of Medicine, NYU Langone Hospital, New York, United States of America

4 Virology Research Center, National Research Institute of Tuberculosis and Lung Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran

5 Infectious Branch, Internal Medicine Department, Afzalipour Hospital, Kerman Medical Sciences University, Kerman, Iran

https://doi.org/10.30699/ijp.2023.561331.2963
Abstract
Background: To gain insight into the pathogenesis and clinical course of COVID-19 from a historical perspective, we reviewed paraclinical diagnostic tools of this disease and prioritized the patients with a more severe form of disease admitted to intensive care units (ICUs). The objective was to better predict the course and severity of the disease by collecting more paraclinical data, specifically by examining the relationship between hematological findings and cytological variation of blood neutrophils and monocytes.
Methods: This retrospective study was conducted on 112 patients with confirmed COVID-19 admitted to Imam Hossein Hospital (Tehran, Iran) from August to September 2020. Peripheral blood smears of these patients were differentiated according to several cytological variations of neutrophils and monocytes, and the correlation to the severity of the disease was specified.
Results: The mean percentages of degenerated monocytes, degenerated granulocytes, and spiky biky neutrophils were significantly different among critical and non-critical patients (P<0.05). Degenerated monocytes and granulocytes were higher in critical patients as opposed to spiky biky neutrophils, which were higher among non-critical ones. Comparing the peripheral blood smears of COVID-19 patients (regarding pulmonary involvement in chest computed tomography [CT] scans [subtle, mild, moderate, and severe groups]), the twisted form of neutrophils was significantly higher in the subtle group than in the mild and moderate groups (P=0.003).
Conclusion: Different cytological morphologies of neutrophils and monocytes, including degenerated monocytes, degenerated granulocytes, and spiky biky and twisted neutrophils, could help to predict the course and severity of the disease.

Keywords

COVID-19
Critical state
Cytogenesis Cytological variants
Monocytes
Neutrophils
Peripheral blood smear

Subjects

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Iranian Journal of Pathology
Volume 18, Issue 3
Summer 2023
Pages 270-278

  • Receive Date 22 December 2022
  • Revise Date 04 February 2023
  • Accept Date 30 June 2023

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