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Am J Clin Pathol . Peripheral Blood Examination Findings in SARS-CoV-2 Infection

tetano

Editor, Senior Moderator
Am J Clin Pathol


. 2020 Aug 5;154(3):319-329.
doi: 10.1093/ajcp/aqaa108.
Peripheral Blood Examination Findings in SARS-CoV-2 Infection


Alia Nazarullah[SUP] 1 [/SUP], Christine Liang[SUP] 1 [/SUP], Andrew Villarreal[SUP] 2 [/SUP], Russell A Higgins[SUP] 1 [/SUP], Daniel D Mais[SUP] 1 [/SUP]



Affiliations

Abstract

Objectives: Peripheral blood abnormalities in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have not been fully elucidated. We report qualitative and quantitative peripheral blood findings in coronavirus disease 2019 (COVID-19) patients and compare them with a control group.
Methods: We reviewed electronic medical records, complete blood counts, peripheral blood smears, and flow cytometry data in 12 patients with SARS-CoV-2. These were compared with 10 control patients with symptoms suspicious for SARS-CoV-2 but who tested negative.
Results: No significant differences were noted in blood counts, except that absolute lymphopenia was present frequently in the control group (P < .05). Acquired Pelger-Hu?t anomaly (APHA) was noted in all COVID-19 cases, in most cases affecting over 5% of granulocytes. This contrasted with APHA in only 50% of control cases, affecting fewer than 5% of granulocytes in all cases (P < .05). Monolobate neutrophils were exclusive to COVID-19 cases. COVID-19 patients had greater frequency of plasmacytoid lymphocytes (P < .05). Flow cytometry data revealed absolute CD3+ T-cell count reduction in 6 of 7 patients; all of them required mechanical ventilation.
Conclusions: Lymphopenia was infrequent in our COVID-19 cohort; however, flow cytometric analysis revealed absolute T-cell count reduction in most cases. COVID-19 cases had significant APHA with monolobate neutrophils and plasmacytoid lymphocytes as compared to controls.

Keywords: COVID-19; Coronavirus; Hematologic; Peripheral blood; Peripheral smear; SARS-CoV-2.
 
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