Infection and Drug Resistance (Mar 2023)

Parameters and Morphological Changes of Erythrocytes and Platelets of COVID-19 Subjects: A Longitudinal Cohort Study

  • Shen L,
  • Chen L,
  • Chi H,
  • Luo L,
  • Ruan J,
  • Zhao X,
  • Jiang Y,
  • Tung TH,
  • Zhu H,
  • Zhou K,
  • Shen B,
  • Xu J

Journal volume & issue
Vol. Volume 16
pp. 1657 – 1668

Abstract

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Liping Shen,1,* Linping Chen,1,* Hongbo Chi,1 Lifei Luo,1 Jinsu Ruan,1 Xinzhuan Zhao,1 Yi Jiang,1 Tao-Hsin Tung,2 Hongguo Zhu,1 Kai Zhou,1 Bo Shen,1 Jiaqin Xu1 1Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, People’s Republic of China; 2Evidence-Based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jiaqin Xu; Bo Shen, Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, People’s Republic of China, Tel +86-13968607148 ; +86 13586121278, Email [email protected]; [email protected]: Information about dynamic changes occurring in the parameters and morphology of erythrocytes and platelets during the coronavirus disease 2019 (COVID-19) infection and convalescence is scarce. To explore potential associations between dynamic erythrocyte and platelet parameters, morphological changes, and the course or severity of the disease is essential.Patients and Methods: From January 17th, 2020, to February 20th, 2022, we followed up on 35 patients with non-severe and 11 patients with severe COVID-19 following their discharge. We collected clinical features, dynamic complete blood count (CBC), and peripheral blood smears (PBS) and analyzed parameter and morphological changes of erythrocytes and platelets depending on the course or severity of the disease. The course of the disease included four periods, namely onset (T1), discharge (T2), 1-year follow-up (T3), and 2-year follow-up (T4).Results: Red blood cell (RBC) counts and hemoglobin were the lowest in T2, followed by T1, and lower in T1 and T2 than in T3 and T4. Inversely, the red blood cell distribution width (RDW) was the highest in T2, followed by T1, and higher than in T3 and T4. Compared to non-severe patients, the platelet of severe patients was lower in T1 and T2. In contrast, the mean platelet volume (MPV) and platelet distribution width (PDW) tended to be higher in severe patients. Similarly, anisocytosis was more common in peripheral blood smears at early stages and in severe patients. Finally, large platelets were more common in severe patients.Conclusion: Anisocytosis of erythrocytes and large platelets are found in patients with severe COVID-19, these changes may help primary hospitals to identify patients with a high risk of severe COVID-19 at an early stage.Keywords: erythrocytes, blood platelets, COVID-19

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