PDF(Pubmed)
Abstract：
BACKGROUND: Coronavirus disease 2019 (COVID-19) caused by SARS-CoV2 can present from mild flu-like symptoms to acute respiratory distress syndrome. There is multi-organ involvement; particularly, hematopoietic system can be associated with morphological changes in blood cells of COVID-19 patients.
METHODS: We conducted a cross-sectional study on a cohort of 50 COVID-19 patients, confirmed on RT-PCR with documented cycle threshold (Ct) value. Peripheral blood sample of these patients was collected and examined for complete blood counts (CBC) on automated haematological analyser as well as Leishman-stained blood smears to look for morphological changes in blood cells. Morphological changes were evaluated with reference to clinical severity and Ct value. Additionally, association between Ct value and clinical severity was also performed. Statistical tests were performed, and P value <.05 was considered significant.
RESULTS: Mean age of our study group was 42.16 ± 15.55 years, with male preponderance. Most commonly observed peripheral blood changes were hypolobation (P value = .002) and toxic granules (P value = .005) in neutrophils, atypical granules with nucleolar prominence in lymphocytes, cytoplasmic granulation with clumped nuclear chromatin in monocytes, giant platelets and thrombocytopenia and normocytic normochromic anaemia.
CONCLUSIONS: No association was found between clinical severity and Ct value as well as peripheral blood morphological changes with Ct value. We conclude that examination of peripheral smear coupled with complete blood count (CBC) is only partially supportive of disease pathogenesis and to assess the viral load other parameters should be utilised instead of relying solely on Ct value.
METHODS: We conducted a cross-sectional study on a cohort of 50 COVID-19 patients, confirmed on RT-PCR with documented cycle threshold (Ct) value. Peripheral blood sample of these patients was collected and examined for complete blood counts (CBC) on automated haematological analyser as well as Leishman-stained blood smears to look for morphological changes in blood cells. Morphological changes were evaluated with reference to clinical severity and Ct value. Additionally, association between Ct value and clinical severity was also performed. Statistical tests were performed, and P value <.05 was considered significant.
RESULTS: Mean age of our study group was 42.16 ± 15.55 years, with male preponderance. Most commonly observed peripheral blood changes were hypolobation (P value = .002) and toxic granules (P value = .005) in neutrophils, atypical granules with nucleolar prominence in lymphocytes, cytoplasmic granulation with clumped nuclear chromatin in monocytes, giant platelets and thrombocytopenia and normocytic normochromic anaemia.
CONCLUSIONS: No association was found between clinical severity and Ct value as well as peripheral blood morphological changes with Ct value. We conclude that examination of peripheral smear coupled with complete blood count (CBC) is only partially supportive of disease pathogenesis and to assess the viral load other parameters should be utilised instead of relying solely on Ct value.
摘要：
背景：由SARS-CoV2引起的2019年冠状病毒病（COVID-19）可表现为轻度流感样症状至急性呼吸窘迫综合征。有多器官参与；特别是，造血系统可能与COVID-19患者血细胞的形态学变化有关。
方法：我们对50名COVID-19患者进行了一项横断面研究，在RT-PCR上证实，有记录的循环阈值（Ct）值。收集这些患者的外周血样本，并在自动血液学分析仪以及Leishman染色的血涂片上检查全血计数（CBC），以寻找血细胞的形态变化。参考临床严重程度和Ct值评估形态学变化。此外,同时还研究了Ct值与临床严重程度之间的相关性.进行了统计测试，P值<0.05被认为是显著的。
结果：我们研究组的平均年龄为42.16±15.55岁，男性优势。最常见的外周血变化是中性粒细胞的下叶（P值=0.002）和毒性颗粒（P值=0.005），淋巴细胞中具有核仁突出的非典型颗粒，单核细胞中具有结块核染色质的细胞质颗粒，巨大血小板和血小板减少症和正常细胞的正常色素性贫血。
结论：临床严重程度与Ct值以及外周血形态学变化与Ct值无相关性。我们得出的结论是，对外周血涂片和全血细胞计数（CBC）的检查仅部分支持疾病的发病机理，为了评估病毒载量，应使用其他参数，而不是仅依靠Ct值。
方法：我们对50名COVID-19患者进行了一项横断面研究，在RT-PCR上证实，有记录的循环阈值（Ct）值。收集这些患者的外周血样本，并在自动血液学分析仪以及Leishman染色的血涂片上检查全血计数（CBC），以寻找血细胞的形态变化。参考临床严重程度和Ct值评估形态学变化。此外,同时还研究了Ct值与临床严重程度之间的相关性.进行了统计测试，P值<0.05被认为是显著的。
结果：我们研究组的平均年龄为42.16±15.55岁，男性优势。最常见的外周血变化是中性粒细胞的下叶（P值=0.002）和毒性颗粒（P值=0.005），淋巴细胞中具有核仁突出的非典型颗粒，单核细胞中具有结块核染色质的细胞质颗粒，巨大血小板和血小板减少症和正常细胞的正常色素性贫血。
结论：临床严重程度与Ct值以及外周血形态学变化与Ct值无相关性。我们得出的结论是，对外周血涂片和全血细胞计数（CBC）的检查仅部分支持疾病的发病机理，为了评估病毒载量，应使用其他参数，而不是仅依靠Ct值。
