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Peripheral Red Blood Cells Morphology in COVID-19 Patients

Tyseer AM Barri, Nihad Babiker, Altaf Taaha, Nedal Soliman, Renad Abdalla, Riham Ahmed, Mawahib Aledrissy, Safa Hamid, Mohamed Arbab, Alsadig Gassoum, Sawsan AH Aldeaf

COVID-19 pandemic has resulted in global health disaster and posed a great challenge to the suitable measures to contain the disease. The pathogenesis of the disease is still evolving. In the search for the pathogenesis of the virus, little attention has been made to the peripheral blood picture in COVID-19 patients. This study has focused on the morphology of the red blood cells as stained with Geimsa. The results showed distinct RBCs morphological changes including rouleaux formation, Significant finding of ring-like stained bodies were seen within the RBCs in 98.3%of the patients. No such ring bodies were detected in any of the control smears. In a number of smears stained particles were seen on the RBCs cell wall. Macrocytosis with central polar stomatocytes and tear shape RBCs were seen. Nuclei of neutrophils with fetus like structure and anisocytosisand mild poikilocytosis were reported the number of reticulocytes and platelets is scanty in the COVID-19 patients compared to controls. All patients’ blood smears showed marked lymphocytopenia, thrombocytopenia and slight neutrophilia with nuclei fetus like structure. Direct Coombs test was listed to be positive in 15% of the patients. In conclusion peripheral blood picture seems to be easy and predictable tool to diagnose COVID-19 patients.