Morphological Changes in Red Blood Cells, White Blood Cells, and Platelets in COVID-19 Infected Patients: A Cross-sectional Study

Abstract

Introduction: Coronavirus Disease-2019 (COVID-19) is a highly infectious virus that mutates rapidly. This has led to the emergence of newer variants that can spread more easily and may be more resistant to current treatments and vaccines. It is possible that new variants could emerge in the future that could be even more dangerous than the current ones. Aim: To identify and describe characteristic changes in peripheral smears of COVID-19 patients. Materials and Methods: A cross-sectional study was conducted at Government Medical Hospital Nizamabad, Telangana, India from March 20, 2021, to June 10, 2021. A total of 600 COVID-19 patients who were tested positive via Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) were included, and blood tests were performed on the day of admission before any prior intervention. Samples were analysed using a Complete Blood Count (CBC) analyser, and peripheral smears were examined to identify the morphological changes of Red Blood Cells (RBCs), White Blood Cells (WBCs), and Platelets in COVID-19-affected patients. These changes help assess the disease process, its severity, and aid in its proper management. Results: Out of the 600 cases, 384 (64%) were males, and 216 (36%) were females. The study showed the following RBC changes: microcytic hypochromic RBCs 333 (55.5%), macrocytic RBCs 66 (11%), dimorphic picture 33 (5.5%); WBCs showed neutrophilia 535 (89.17%), lymphopenia 535 (89.17%), pseudo Pelger-Huët cells 468 (78%), smudge cells 360 (60%), reactive lymphocytes 360 (60%), large granular lymphocytes 72 (12%), and large giant platelets 444 (74%) in peripheral smears of COVID-19 patients. Conclusion: As COVID-19 patients showed specific morphological changes in RBCs, WBCs, and Platelets, CBC and peripheral smear analysis can be interpreted in conjunction with other clinical and confirmatory tests for prognostication and management of COVID-19 patients.