1 Inonu University Adult Hematology Department, Malatya / Turkey.
2 Malatya Training and Research Hospital, Department of Infectious Diseases, Malatya / Turkey.
3 Malatya Training and Research Hospital, Chest Diseases Department, Malatya / Turkey.
4 Celal Bayar University Adult Hematology Department, Manisa / Turkey.
5 Inonu University Internal Medicine Department, Malatya / Turkey.
6 Malatya Training and Research Hospital, Department of Medical Oncology, Malatya / Turkey.
7 Inonu University Biostatistics Department, Malatya / Turkey.
8 Malatya Training and Research Hospital, Anesthesiology Department, Malatya / Turkey.
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Data about the morphological changes in peripheral blood smears during
COVID-19 infection and their clinical severity association are limited.
We aimed to examine the characteristics of the cells detected in the
pathological rate and/or appearance and whether these findings are
related to the clinical course by evaluating the peripheral blood smear
at the time of diagnosis in COVID-19 patients.
Materials and Methods
|Figure 1. Atypical lymphocytes in patients' peripheral blood smear A, B, C. There were lymphocytes with a broad cytoplasm, loose chromatin network and lobuled appearance. Lymphocytes were larger than they should be. The cytoplasm of the lymphocytes was scattered looking adherent to the erythrocytes. Their appearance was particularly similar to stimulated lymphocytes seen in viral infections, and especially "Downey" cells. D. Blast-like lymphocytes.|
Figure 2. Different degrees of abnormal maturation (Pseudo-Pelger Huet type). There may be single or double lobed neutrophils. A. Neutrophil granulocytes with unsegmented nucleus with coarsely clumped chromatin. B. Toxic granulations are suggestive of infection in the cytoplasm C. The bilobed neutrophil with vacuoles, which we are accustomed to seeing mostly in patients with myelodysplastic syndrome. D. Bilobed neutrophil with dysplasia.
|Figure 3. A. Band cell that we are accustomed to seeing in bacterial infections whose nucleus is "C" shaped. They are also known as club or stab cells. B. A dysplastic neutrophil that we see mostly in patients with myelodysplastic syndrome. Hypogranulation is at the forefront of the neutrophil's cytoplasm. C. Cell group consisting of bands and dysplastic neutrophils.|
|Figure 4. A, B.The monocytes with vacuoles that generally increased during infections. Vacuoles are often considered to be evidence of the fight against infectious agents. C. A picture to show the severity of vacuolization in patients. D. Beside a monocyte with vacuole, a neutrophil with dysplasia and vacuole.|
|Figure 5. Pyknosis, karyolysis and karyorrhexis are the death steps of the cell nucleus as a result of the cytopathic effect of the virus. A. Pyknosis is the shrinkage of the cell nucleus. Neutrophils with concentrated and basophilic nuclei showing pyknosis. Toxic granulations are suggestive of infection. B. Karyolysis is the melting of nucleus chromatin with enzymes (nucleases) released from the lysosomes of the dead cell. The nuclear membrane is preserved. C, D. Karyorrhexis is the rupture of the nuclear membrane, division of chromatin into small basophilic granules and spreading into the cytoplasm. Neutrophils that have undergone karyorrhexis are seen. Morever a dysplasic neutrophil with increased basophilic staining in one part of the cytoplasm and vacuolization in the other part.|
1. Clinical features, laboratory values, and peripheral blood smear
findings of all the patients and healthy controls.
2. Comparison of
laboratory values, peripheral blood smear findings, and clinical
features of Mild and severe stage patients.
analysis between the length of hospital stay, and baseline laboratory
characteristics, morphological findings of the patients.