Myriad of hematological manifestations in COVID-19 infected paediatric age group: our experience

Abstract

Background: The incidence of COVID-19 is remarkably less in pediatric population compared to the adult population. Little information on the association of various hematological abnormalities with disease severity, clinical course and age exists in children. There is also paucity of data regarding peripheral smear findings in children with SARS-CoV-2 infection.Methods: A retrospective-cum-prospective review of the hematological parameters and peripheral smear findings of children diagnosed with COVID-19 infection admitted in tertiary care hospital over a period of two months was conducted. The study was conducted after obtaining approval from the Institute’s Ethics committee. Data was recorded in a pre-designed form and analyzed anonymously.Results: A total of 72 SARS-CoV-2 positive cases were included. Age of patients ranged from 2 days-18 years with male to female ratio of 1.6:1. Patients were grouped, based on age, into <1 year (21%), 1-5 years (15%) and 5-18 years (64%). Mild disease was noted in 82.1% cases. Anemia was the commonest hematological abnormality noted in 62.5% cases followed by leucopenia in 21% cases. Neutrophil to lymphocyte ratio (NLR) ranged from 0.1-11 and was raised in 40% cases of <1 year of age, 27% of 1-5 years and 28% of 5-18 years age group. Abnormalities in RBC and WBC morphology on peripheral smear were noted in 45.8% and 41.6% each. Peculiar finding was the presence of covicytes on peripheral smear showing Sandglass pattern in WBC scattergram.Conclusions: The present study showed that the majority of children with COVID-19 had a mild disease with absence of significant lymphopenia.