Clinical Research
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COVID-19'LU GEBE KADINLARDA PERİFERİK YAYMA BULGULARI VE KLİNİK ÖNEMİ

Year 2025, Volume: 35 Issue: 1, 181 - 188, 28.02.2025
https://doi.org/10.54005/geneltip.1598358

Abstract

ÖZ
Amaç: Periferik kan yayma analizi hematolojide temel bir tanı aracıdır. COVID-19'lu gebe kadınlarda, bu tanı tekniği daha da önem kazanmaktadır. Çalışmamız COVID-19'lu gebe kadınlarda periferik yayma bulgularını açıklamayı amaçlamaktadır.
Materyal ve Yöntemler: Çalışmamızın katılımcıları COVID-19 tanısı almış 50 gebe kadın ve 50 kontrolden oluşmaktadır. Klinik bulgular ilaçlar, periferik kan yayması ve tam kan sayımı parametreleri incelenen değişkenlerden bazılarıdır. Kategorik ölçümleri karşılaştırmak için Ki-Kare testleri kullanıldı. Sayısal ölçümler için Örnek T-Testi kullanıldı. Gruplar tam kan sayımı parametreleri açısından karşılaştırıldı. Gruplar arasında anlamlı farklılıklar belirlendi.
Bulgular: Ferritin, CRP, prokalsitonin, D-dimer, APTT ve fibrinojen değerleri gruplar arasında anlamlı farklılıklar gösterdi. COVID-19 grubunda lenfosit oranı kontrol grubuna göre daha düşüktür. Bant hücreleri, lenfositler, monositler, nötrofiller, vakuollü monositler ve hipersegmente nötrofillerin oranları gruplar arasında istatistiksel olarak anlamlı farklılıklar göstermektedir. Periferik kan anormallikleri mikrobiyal enfeksiyonlarda, özellikle viral enfeksiyonlarda yaygındır.
Sonuçlar: Bu anormallikler altta yatan patofizyolojik değişikliklere dair içgörüler sağlayabilir. COVID-19 hastalarında trombositlerde ve eritrositlerde herhangi bir anormallik gözlemlenmemiştir. Ancak kontrollerle karşılaştırıldığında atipik monositler ve nötrofil hipersegmentasyonu COVID-19 hastalarında önemli ölçüde yüksektir.

Project Number

yok

References

  • 1. Chase ML, Drews R, Zumberg MS, Ellis LR, Reid EG, Gerds AT, et al. Consensus recommendations on peripheral blood smear review: defining curricular standards and fellow competency. Blood Adv. 2023;7(13):3244–52.
  • 2. Surekha M V, Suneetha N, Balakrishna N, Putcha UK, Satyanarayana K, Geddam JJB, et al. Impact of COVID-19 during pregnancy on placental pathology, maternal and neonatal outcome - A cross-sectional study on anemic term pregnant women from a tertiary care hospital in southern India. Front Endocrinol (Lausanne). 2023;14:1092104.
  • 3. Chandra S, Tripathi AK, Mishra S, Amzarul M, Vaish AK. Physiological changes in hematological parameters during pregnancy. Indian J Hematol Blood Transfus Off J Indian Soc Hematol Blood Transfus. 2012;28(3):144–6.
  • 4. Gajendra S. Spectrum of hematological changes in COVID-19. Am J Blood Res. 2022;12(1):43–53.
  • 5. Erol Koç EM, Fındık RB, Akkaya H, Karadağ I, Tokalıoğlu EÖ, Tekin ÖM. Comparison of hematological parameters and perinatal outcomes between COVID-19 pregnancies and healthy pregnancy cohort. 2021;49(2):141–7.
  • 6. Ghizlane EA, Manal M, Abderrahim EK, Abdelilah E, Mohammed M, Rajae A, et al. Lymphopenia in Covid-19: A single-center retrospective study of 589 cases. Ann Med Surg. 2021;69:102816.
  • 7. Nasif WA, El-Moursy Ali AS, Hasan Mukhtar M, Alhuzali AMH, Yahya Alnashri YA, Ahmed Gadah ZI, et al. Elucidating the Correlation of D-Dimer Levels with COVID-19 Severity: A Scoping Review. Anemia. 2022;2022:9104209.
  • 8. Singhania N, Bansal S, Nimmatoori DP, Ejaz AA, McCullough PA, Singhania G. Current Overview on Hypercoagulability in COVID-19. Am J Cardiovasc Drugs [Internet]. 2020;20(5):393–403.
  • 9. Elemam NM, Talaat IM, Bayoumi FA, Zein D, Georgy R, Altamimi A, et al. Peripheral blood cell anomalies in COVID-19 patients in the United Arab Emirates: A single-centered study. Front Med. 2022;9:1072427.
  • 10. Aminimoghaddam S, Afrooz N, Nasiri S, Motaghi Nejad O, Mahmoudzadeh F. A COVID-19 pregnant patient with thrombotic thrombocytopenic purpura: A case report. J Med Case Rep. 2021;15(1):104.
  • 11. Patel P, Balanchivadze N. Hematologic Findings in Pregnancy: A Guide for the Internist. Cureus. 2021;13(5):e15149.
  • 12. Alimohamadi Y, Sepandi M, Taghdir M, Hosamirudsari H. Determine the most common clinical symptoms in COVID-19 patients: a systematic review and meta-analysis. J Prev Med Hyg. 2020;61(3):E304–12.
  • 13. Cajanding R. Oxygen use and saturation targets in patients with COVID-19: Are we giving too much or aiming too low? Nurs Crit Care. 2022;27(2):282–5.
  • 14. Inada-Kim M, Chmiel FP, Boniface M, Burns D, Pocock H, Black J, et al. Validation of oxygen saturations measured in the community by emergency medical services as a marker of clinical deterioration in patients with confirmed COVID-19: a retrospective cohort study. BMJ Open. 2024;14(1):e067378.
  • 15. Galwankar SC, Paladino L, Gaieski DF, Nanayakkara KDPWB, Somma S Di, Grover J, et al. Management Algorithm for Subclinical Hypoxemia in Coronavirus Disease-2019 Patients: Intercepting the “Silent Killer”. J Emerg Trauma Shock. 2020;13(2):110–3.
  • 16. You J-S, Faner R, Sibila O, Sellarés J. COVID-19 and lung involvement. Vol. 17, Handbook of Systemic Autoimmune Diseases. 2022. p. 189–211.
  • 17. Mehta OP, Bhandari P, Raut A, Kacimi SEO, Huy NT. Coronavirus Disease (COVID-19): Comprehensive Review of Clinical Presentation. Front public Heal. 2020;8:582932.
  • 18. Swenson KE, Hardin CC. Pathophysiology of Hypoxemia in COVID-19 Lung Disease. Clin Chest Med. 2023;44(2):239–48.
  • 19. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet (London, England). 2020;395(10223):497–506.
  • 20. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet (London, England). 2020;395(10223):507–13.
  • 21. Rodriguez-Morales AJ, Cardona-Ospina JA, Gutiérrez-Ocampo E, Villamizar-Peña R, Holguin-Rivera Y, Escalera-Antezana JP, et al. Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis. Travel Med Infect Dis. 2020;34:101623.
  • 22. Toori KU, Qureshi MA, Chaudhry A. Lymphopenia: A useful predictor of COVID-19 disease severity and mortality. Pakistan J Med Sci. 2021;37(7):1984–8.
  • 23. Shen X-R, Geng R, Li Q, Chen Y, Li S-F, Wang Q, et al. ACE2-independent infection of T lymphocytes by SARS-CoV-2. Signal Transduct Target Ther. 2022;7(1):83.
  • 24. Tan L, Wang Q, Zhang D, Ding J, Huang Q, Tang Y-Q, et al. Lymphopenia predicts disease severity of COVID-19: A descriptive and predictive study. Vol. 5, Signal transduction and targeted therapy. England; 2020. p. 33.
  • 25. Wang F, Nie J, Wang H, Zhao Q, Xiong Y, Deng L, et al. Characteristics of Peripheral Lymphocyte Subset Alteration in COVID-19 Pneumonia. J Infect Dis. 2020;221(11):1762–9.
  • 26. Kurian SJ, Mathews SP, Paul A, Viswam SK, Kaniyoor Nagri S, Miraj SS, et al. Association of serum ferritin with severity and clinical outcome in COVID-19 patients: An observational study in a tertiary healthcare facility. Clin Epidemiol Glob Heal. 2023 May-Jun;21:101295.
  • 27. Bal A, Agrawal R, Vaideeswar P, Arava S, Jain A. COVID-19: An up-to-date review - from morphology to pathogenesis. Indian J Pathol Microbiol. 2020;63(3):358–66.
  • 28. Catanzaro M, Fagiani F, Racchi M, Corsini E, Govoni S, Lanni C. Immune response in COVID-19: addressing a pharmacological challenge by targeting pathways triggered by SARS-CoV-2. Signal Transduct Target Ther. 2020;5(1):84.
  • 29. D’Ardes D, Boccatonda A, Rossi I, Guagnano MT, Santilli F, Cipollone F, et al. COVID-19 and RAS: Unravelling an Unclear Relationship. Int J Mol Sci. 2020;21(8):3003.
  • 30. Guan W-J, Ni Z-Y, Hu Y, Liang W-H, Ou C-Q, He J-X, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382(18):1708–20.
  • 31. Yitbarek GY, Walle Ayehu G, Asnakew S, Ayele FY, Bariso Gare M, Mulu AT, et al. The role of C-reactive protein in predicting the severity of COVID-19 disease: A systematic review. SAGE open Med. 2021;9:20503121211050756.
  • 32. Zhao Y, Qin L, Zhang P, Li K, Liang L, Sun J, et al. Longitudinal COVID-19 profiling associates IL-1RA and IL-10 with disease severity and RANTES with mild disease. JCI insight. 2020;5(13): e139834.
  • 33. Zini G, Bellesi S, Ramundo F, d’Onofrio G. Morphological anomalies of circulating blood cells in COVID-19. Am J Hematol. 2020;95(7):870–2.
  • 34. Adewoyin AS, Nwogoh B. Peripheral blood film - a review. Ann Ibadan Postgrad Med. 2014;12(2):71–9.
  • 35. Okazaki Y, Watabu T, Endo K, Oiwa H. Hypersegmented Neutrophils in Methotrexate Toxicity. Intern Med. 2018;57(7):1055–6.
  • 36. Abuga KM, Muriuki JM, Williams TN, Atkinson SH. How Severe Anaemia Might Influence the Risk of Invasive Bacterial Infections in African Children. Int J Mol Sci. 2020;21(18):6976.
  • 37. Salib C, Khattar P, Cheng J, Teruya-Feldstein J. Atypical Peripheral Blood Cell Morphology in COVID-19 (Sars-CoV-2) Patients from Mount Sinai Health System in New York City. Blood. 2020;136:26–7.

PERIPHERAL BLOOD SMEAR FINDINGS AND CLINICAL SIGNIFICANCE IN PREGNANT WOMEN WITH COVID-19

Year 2025, Volume: 35 Issue: 1, 181 - 188, 28.02.2025
https://doi.org/10.54005/geneltip.1598358

Abstract

ABSTRACT
Aim: Peripheral blood smear analysis is a cornerstone diagnostic tool in hematology. Pregnant women with COVID-19, this diagnostic technique assumes heightened significance. Our study aims to elucidate the peripheral smear findings in pregnant women with COVID-19.
Material and Methods: Our study's participants comprise 50 pregnant women diagnosed with COVID-19 and 50 controls. Clinical findings medications, peripheral blood smear and complete blood count parameters some of examined variables. The Chi-Square tests were employed to compare categorical measurements. Samples T-Test was used for numerical measurements. The groups were compared in terms of complete blood count parameters. Significant differences were identified between the groups.
Results: The values of ferritin, CRP, procalcitonin, D-dimer, APTT, and fibrinogen exhibited significant differences among the groups. The lymphocyte ratio in the COVID-19 group is lower compared to the control group. The proportions of band cells, lymphocytes, monocytes, neutrophils, vacuolated monocytes, and hypersegmented neutrophils exhibit statistically significant differences between the groups. Peripheral blood abnormalities are prevalent in microbial infections, particularly in viral infections.
Conclusions: These abnormalities can provide insights into the underlying pathophysiological changes. In patients with COVID-19, no abnormalities have been observed in platelets and erythrocytes. However, compared to controls, atypical monocytes and neutrophil hypersegmentation are significantly elevated in COVID-19 patients.

Project Number

yok

References

  • 1. Chase ML, Drews R, Zumberg MS, Ellis LR, Reid EG, Gerds AT, et al. Consensus recommendations on peripheral blood smear review: defining curricular standards and fellow competency. Blood Adv. 2023;7(13):3244–52.
  • 2. Surekha M V, Suneetha N, Balakrishna N, Putcha UK, Satyanarayana K, Geddam JJB, et al. Impact of COVID-19 during pregnancy on placental pathology, maternal and neonatal outcome - A cross-sectional study on anemic term pregnant women from a tertiary care hospital in southern India. Front Endocrinol (Lausanne). 2023;14:1092104.
  • 3. Chandra S, Tripathi AK, Mishra S, Amzarul M, Vaish AK. Physiological changes in hematological parameters during pregnancy. Indian J Hematol Blood Transfus Off J Indian Soc Hematol Blood Transfus. 2012;28(3):144–6.
  • 4. Gajendra S. Spectrum of hematological changes in COVID-19. Am J Blood Res. 2022;12(1):43–53.
  • 5. Erol Koç EM, Fındık RB, Akkaya H, Karadağ I, Tokalıoğlu EÖ, Tekin ÖM. Comparison of hematological parameters and perinatal outcomes between COVID-19 pregnancies and healthy pregnancy cohort. 2021;49(2):141–7.
  • 6. Ghizlane EA, Manal M, Abderrahim EK, Abdelilah E, Mohammed M, Rajae A, et al. Lymphopenia in Covid-19: A single-center retrospective study of 589 cases. Ann Med Surg. 2021;69:102816.
  • 7. Nasif WA, El-Moursy Ali AS, Hasan Mukhtar M, Alhuzali AMH, Yahya Alnashri YA, Ahmed Gadah ZI, et al. Elucidating the Correlation of D-Dimer Levels with COVID-19 Severity: A Scoping Review. Anemia. 2022;2022:9104209.
  • 8. Singhania N, Bansal S, Nimmatoori DP, Ejaz AA, McCullough PA, Singhania G. Current Overview on Hypercoagulability in COVID-19. Am J Cardiovasc Drugs [Internet]. 2020;20(5):393–403.
  • 9. Elemam NM, Talaat IM, Bayoumi FA, Zein D, Georgy R, Altamimi A, et al. Peripheral blood cell anomalies in COVID-19 patients in the United Arab Emirates: A single-centered study. Front Med. 2022;9:1072427.
  • 10. Aminimoghaddam S, Afrooz N, Nasiri S, Motaghi Nejad O, Mahmoudzadeh F. A COVID-19 pregnant patient with thrombotic thrombocytopenic purpura: A case report. J Med Case Rep. 2021;15(1):104.
  • 11. Patel P, Balanchivadze N. Hematologic Findings in Pregnancy: A Guide for the Internist. Cureus. 2021;13(5):e15149.
  • 12. Alimohamadi Y, Sepandi M, Taghdir M, Hosamirudsari H. Determine the most common clinical symptoms in COVID-19 patients: a systematic review and meta-analysis. J Prev Med Hyg. 2020;61(3):E304–12.
  • 13. Cajanding R. Oxygen use and saturation targets in patients with COVID-19: Are we giving too much or aiming too low? Nurs Crit Care. 2022;27(2):282–5.
  • 14. Inada-Kim M, Chmiel FP, Boniface M, Burns D, Pocock H, Black J, et al. Validation of oxygen saturations measured in the community by emergency medical services as a marker of clinical deterioration in patients with confirmed COVID-19: a retrospective cohort study. BMJ Open. 2024;14(1):e067378.
  • 15. Galwankar SC, Paladino L, Gaieski DF, Nanayakkara KDPWB, Somma S Di, Grover J, et al. Management Algorithm for Subclinical Hypoxemia in Coronavirus Disease-2019 Patients: Intercepting the “Silent Killer”. J Emerg Trauma Shock. 2020;13(2):110–3.
  • 16. You J-S, Faner R, Sibila O, Sellarés J. COVID-19 and lung involvement. Vol. 17, Handbook of Systemic Autoimmune Diseases. 2022. p. 189–211.
  • 17. Mehta OP, Bhandari P, Raut A, Kacimi SEO, Huy NT. Coronavirus Disease (COVID-19): Comprehensive Review of Clinical Presentation. Front public Heal. 2020;8:582932.
  • 18. Swenson KE, Hardin CC. Pathophysiology of Hypoxemia in COVID-19 Lung Disease. Clin Chest Med. 2023;44(2):239–48.
  • 19. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet (London, England). 2020;395(10223):497–506.
  • 20. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet (London, England). 2020;395(10223):507–13.
  • 21. Rodriguez-Morales AJ, Cardona-Ospina JA, Gutiérrez-Ocampo E, Villamizar-Peña R, Holguin-Rivera Y, Escalera-Antezana JP, et al. Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis. Travel Med Infect Dis. 2020;34:101623.
  • 22. Toori KU, Qureshi MA, Chaudhry A. Lymphopenia: A useful predictor of COVID-19 disease severity and mortality. Pakistan J Med Sci. 2021;37(7):1984–8.
  • 23. Shen X-R, Geng R, Li Q, Chen Y, Li S-F, Wang Q, et al. ACE2-independent infection of T lymphocytes by SARS-CoV-2. Signal Transduct Target Ther. 2022;7(1):83.
  • 24. Tan L, Wang Q, Zhang D, Ding J, Huang Q, Tang Y-Q, et al. Lymphopenia predicts disease severity of COVID-19: A descriptive and predictive study. Vol. 5, Signal transduction and targeted therapy. England; 2020. p. 33.
  • 25. Wang F, Nie J, Wang H, Zhao Q, Xiong Y, Deng L, et al. Characteristics of Peripheral Lymphocyte Subset Alteration in COVID-19 Pneumonia. J Infect Dis. 2020;221(11):1762–9.
  • 26. Kurian SJ, Mathews SP, Paul A, Viswam SK, Kaniyoor Nagri S, Miraj SS, et al. Association of serum ferritin with severity and clinical outcome in COVID-19 patients: An observational study in a tertiary healthcare facility. Clin Epidemiol Glob Heal. 2023 May-Jun;21:101295.
  • 27. Bal A, Agrawal R, Vaideeswar P, Arava S, Jain A. COVID-19: An up-to-date review - from morphology to pathogenesis. Indian J Pathol Microbiol. 2020;63(3):358–66.
  • 28. Catanzaro M, Fagiani F, Racchi M, Corsini E, Govoni S, Lanni C. Immune response in COVID-19: addressing a pharmacological challenge by targeting pathways triggered by SARS-CoV-2. Signal Transduct Target Ther. 2020;5(1):84.
  • 29. D’Ardes D, Boccatonda A, Rossi I, Guagnano MT, Santilli F, Cipollone F, et al. COVID-19 and RAS: Unravelling an Unclear Relationship. Int J Mol Sci. 2020;21(8):3003.
  • 30. Guan W-J, Ni Z-Y, Hu Y, Liang W-H, Ou C-Q, He J-X, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382(18):1708–20.
  • 31. Yitbarek GY, Walle Ayehu G, Asnakew S, Ayele FY, Bariso Gare M, Mulu AT, et al. The role of C-reactive protein in predicting the severity of COVID-19 disease: A systematic review. SAGE open Med. 2021;9:20503121211050756.
  • 32. Zhao Y, Qin L, Zhang P, Li K, Liang L, Sun J, et al. Longitudinal COVID-19 profiling associates IL-1RA and IL-10 with disease severity and RANTES with mild disease. JCI insight. 2020;5(13): e139834.
  • 33. Zini G, Bellesi S, Ramundo F, d’Onofrio G. Morphological anomalies of circulating blood cells in COVID-19. Am J Hematol. 2020;95(7):870–2.
  • 34. Adewoyin AS, Nwogoh B. Peripheral blood film - a review. Ann Ibadan Postgrad Med. 2014;12(2):71–9.
  • 35. Okazaki Y, Watabu T, Endo K, Oiwa H. Hypersegmented Neutrophils in Methotrexate Toxicity. Intern Med. 2018;57(7):1055–6.
  • 36. Abuga KM, Muriuki JM, Williams TN, Atkinson SH. How Severe Anaemia Might Influence the Risk of Invasive Bacterial Infections in African Children. Int J Mol Sci. 2020;21(18):6976.
  • 37. Salib C, Khattar P, Cheng J, Teruya-Feldstein J. Atypical Peripheral Blood Cell Morphology in COVID-19 (Sars-CoV-2) Patients from Mount Sinai Health System in New York City. Blood. 2020;136:26–7.
There are 37 citations in total.

Details

Primary Language English
Subjects Infectious Diseases
Journal Section Original Article
Authors

Defne Ay Tuncel 0000-0002-1262-8271

Raziye Narin 0000-0001-5352-878X

Turkan Muhlis 0009-0007-2191-6949

Ayşe Yiğit Sönmez 0000-0002-1868-838X

Project Number yok
Publication Date February 28, 2025
Submission Date December 9, 2024
Acceptance Date February 10, 2025
Published in Issue Year 2025 Volume: 35 Issue: 1

Cite

Vancouver Ay Tuncel D, Narin R, Muhlis T, Yiğit Sönmez A. PERIPHERAL BLOOD SMEAR FINDINGS AND CLINICAL SIGNIFICANCE IN PREGNANT WOMEN WITH COVID-19. Genel Tıp Derg. 2025;35(1):181-8.

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