Leukocyte morphological changes in COVID-19, a peripheral smear study and analysis at a tertiary health care centre in India

Abstract

Context: Coronavirus disease 2019 (COVID-19) as the name depicts, a contagious disease caused by the coronavirus that emerged in the year 2019 December, at the Wuhan province in China. The knowledge on the pathogenesis of the disease at the cellular level to correlate with the clinical severity is still evolving. Various clinicopathological features and nature of the disease were gradually identified from those who were affected by the disease. Apart from the clinical presentation, certain investigations played a major role in diagnosing and assessing the severity of the disease. Morphological impact on blood cells was also caused by the severe acute respiratory syndrome-CoV-2 virus. Aim: Morphological analysis of leukocytes on blood samples of COVID19 patients. Settings and Design: Peripheral smear study of blood samples of COVID19 patients admitted at our tertiary care center. Subjects and Methods: Microscopic peripheral smear examination of leukocyte morphology on study samples. Statistical Analysis Used: All the data were recorded and analyzed statistically using Ms-Excel. Results: Our study demonstrated certain acquired pathogenic abnormalities of the leukocytes, that are acquired neutrophilic nuclear projections (ANNP), plasmacytoid lymphocytes, acquired Pelger-Huet anomaly (APHA), myeloid left shift, neutrophils with toxic granules and cytoplasmic vacuoles, and apoptotic cells. Conclusion: To summarize, in our study we observed similar features that were recorded in few studies earlier, such as APHA and plasmacytoid lymphocytes in convincing percentages among the COVID-19 patients in our population. Adding to these ANNP was one more prominent feature we encountered in majority of COVID-19 cases.