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A Review of the Hematological Picture of Severe COVID-19 Infection
Dominga Amoroso1, Stefania Bongo1, Anna Copponi1
1Department of Experimental Medicine, Faculty of Medicine, University of Rome Tor Vergata, Rome, ITA.
Insights
COVID-19 survivors and non-survivors show distinct blood cell changes. Neutrophilia, lymphopenia, and thrombocytopenia are key indicators, with severe cases revealing specific microscopic and scattergram patterns.
Area of Science:
- Hematology
- Infectious Diseases
- COVID-19 Research
Background:
- COVID-19 is associated with various hematological abnormalities.
- Understanding these changes is crucial for assessing disease severity.
Purpose of the Study:
- To review and analyze hematological characteristics in COVID-19 survivors and non-survivors.
- To identify key hematological indicators of disease severity.
Main Methods:
- Systematic review of 82 PubMed articles.
- Analysis of hematological findings in moderate (survivors) and severe (non-survivors) COVID-19 cases.
- Microscopic and scattergram analysis of blood cells.
Main Results:
- Neutrophilia, lymphopenia, and thrombocytopenia are hallmark features.
- Severe cases show neutrophil abnormalities (granularity, vacuolization), altered lymphocytes and monocytes, platelet aggregation, and red blood cell basophilic stippling.
- Scattergram analysis reveals increased neutrophils and a "sandglass pattern".
Conclusions:
- Hematochemical and cytomorphological blood cell analysis are vital for COVID-19 patient management.
- These analyses aid in recognizing indicators of disease severity and prognosis.
Abstract:
Numerous hematological abnormalities have been documented in COVID-19 patients. We conducted an analysis of 82 articles from PubMed, focusing on the hematological characteristics observed in survivors (S) and non-survivors (NS) with moderate and severe COVID-19 symptoms, respectively. Our review underlines neutrophilia, lymphopenia, and thrombocytopenia as hallmark features of the disease. In severe cases, blood cell microscopy revealed the following abnormalities: i) an increased number of neutrophils, often displaying granularity, toxic granulation, and vacuolization; ii) lymphocytes with a notably blue cytoplasm; iii) several monocytes that contain vacuoles; iv) platelet aggregation; and v) basophilic stippling in red blood cells. Furthermore, scattergram analysis of COVID-19 patients revealed two common features: i) an increased neutrophil population and ii) the presence of a distinctive "sandglass pattern". This review underscores the critical role of hematochemical and cytomorphological blood cell analysis in COVID-19 patients, aiding clinicians in better recognizing and understanding the indicators of disease severity.
