Red blood cell morphology in patients with COVID-19-related anaemia.
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ABSTRACT:
SUBMITTER: Berzuini A
PROVIDER: S-EPMC7850925 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Peripheral blood smear is a simple laboratory tool, which remains of invaluable help for diagnosing primary and secondary abnormalities of blood cells despite advances in automated and molecular techniques. Red blood cells (RBCs) abnormalities are known to occur in many viral infections, typically in the form of mild normo-microcytic anemia. While several hematological alterations at automated complete blood count (including neutrophilia, lymphopenia, and increased red cell distribution width-RDW) have been consistently associated with severity of COVID-19, there is scarce information on RBCs morphological abnormalities, mainly as case-reports or small series of patients, which are hardly comparable due to heterogeneity in sampling times and definition of illness severity. We report here a systematic evaluation of RBCs morphology at peripheral blood smear in COVID-19 patients within the first 72 h from hospital admission. One hundred and fifteen patients were included, with detailed collection of other clinical variables and follow-up. A certain degree of abnormalities in RBCs morphology was observed in 75 (65%) patients. Heterogenous alterations were noted, with spiculated cells being the more frequent morphology. The group with >10% RBCs abnormalities had more consistent lymphopenia and thrombocytopenia compared to those without abnormalities or <10% RBCs abnormalities (p < 0.018, and p < 0.021, respectively), thus underpinning a possible association with an overall more sustained immune-inflammatory "stress" hematopoiesis. Follow-up analysis showed a different mortality rate across groups, with the highest rate in those with more frequent RBCs morphological alterations compared to those with <10% or no abnormalities (41.9%, vs. 20.5%, vs. 12.5%, respectively, p = 0.012). Despite the inherent limitations of such simple association, our results point out towards further studies on erythropoiesis alterations in the pathophysiology of COVID-19.
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Project description:BACKGROUND AND OBJECTIVE:Guidelines suggest that red-blood-cell transfusion decisions for most hospitalized patients be based on haemoglobin (Hb) concentration and the presence of symptoms of anaemia, including fatigue. However, studies differ in whether transfusion is associated with improvements in fatigue. One explanation is that the benefit of transfusion varies by baseline fatigue levels, which existing studies have not examined. The objective of this study was to determine whether the association between transfusion during hospitalization and improvements in fatigue 30 days postdischarge varies by baseline fatigue level. METHODS:A prospective observational study of hospitalized general medicine patients with any Hb <9 g/dl. Patients with sickle cell anaemia and gastrointestinal bleeding were excluded since these diagnoses have alternative transfusion practices. Patients with depression were excluded because their fatigue is not primarily due to anaemia. Fatigue was measured during an in-person interview and a 30-day postdischarge phone interview. Hb values and receipt of a transfusion were collected from hospital administrative data. Linear regression was used to test associations between 'change in fatigue', Hb concentration and receipt of a transfusion. RESULTS:Transfusion interacted with nadir Hb was associated with reduced fatigue postdischarge for patients with higher baseline fatigue (20% most fatigued: ? = 12, P = 0·02; 10% most fatigued: ? = 17, P = 0·02). Patients <50 years old with high baseline fatigue had large reductions in fatigue from transfusion (20%: ? = 23, P = 0·02; 10%: ? = 29, P = 0·03). CONCLUSIONS:Transfusion during hospitalization is associated with reduced fatigue 30 days postdischarge in patients with higher levels of baseline fatigue.
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Project description:COVID-19 infection affects different organs of the human body, and blood cells are not an exception. Peripheral blood smear (PBS) is a simple and available method to investigate blood cells' morphologic changes. In this study, we aimed to determine the morphologic changes and abnormalities of COVID-19 patients and their relation to the patients' clinical course. In this prospective cross-sectional study, we included 89 PCR-positive COVID-19 patients. A pathologist examined the PBS findings of these patients. The patients' clinical course, including severity, outcome, intubation, and ICU admission, was extracted from their profiles. The statistical analyses were done to find out the relation between PBS findings and patients' clinical course. Results showed that smudge cells are the most frequent abnormality in our participants. Other findings were schistocyte; atypical lymphocytes; and increased large granular lymphocytes, shift to left of granulocytes, giant platelets, and leukoerythroblastic reaction. Our results did not show any statistically significant relationship between PBS findings and their clinical course. Although other studies suggested PBS as a possible predictive tool for COVID-19 disease, our study showed that these findings could not predict nor relate to the patients' clinical course.Supplementary informationThe online version contains supplementary material available at 10.1007/s12308-021-00459-3.
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Project description:A method that can rapidly quantify variations in the morphology of single red blood cells (RBCs) using light and sound is presented. When irradiated with a laser pulse, an RBC absorbs the optical energy and emits an ultrasonic pressure wave called a photoacoustic wave. The power spectrum of the resulting photoacoustic wave contains distinctive features that can be used to identify the RBC size and morphology. When particles 5-10 ?m in diameter (such as RBCs) are probed with high-frequency photoacoustics, unique periodically varying minima and maxima occur throughout the photoacoustic signal power spectrum at frequencies >100 MHz. The location and distance between spectral minima scale with the size and morphology of the RBC; these shifts can be used to quantify small changes in the morphology of RBCs. Morphological deviations from the normal biconcave RBC shape are commonly associated with disease or infection. Using a single wide-bandwidth transducer sensitive to frequencies between 100 and 500 MHz, we were able to differentiate healthy RBCs from irregularly shaped RBCs (such as echinocytes, spherocytes, and swollen RBCs) with high confidence using a sample size of just 21 RBCs. As each measurement takes only seconds, these methods could eventually be translated to an automated device for rapid characterization of RBC morphology and deployed in a clinical setting to help diagnose RBC pathology.
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Project description:High throughput sequencing is performed on mRNA isolated from whole blood of adult Covid-19 patients, bacterial coinfection with Covid-19 and healthy controls in a South Indian cohort. Samples were collected from individuals at the time of hospitalization or visit to clinic. The Covid-19 samples are categorized by severeity.
2022-02-22 | GSE196822 | GEO
Project description:ObjectiveThe mortality associated with sepsis remains unacceptably high, despite modern high-quality intensive care. Based on the results from previous studies, anaemia and its management in patients with sepsis appear to impact outcomes; however, the transfusion policy is still being debated, and the ideal approach may be extremely specific to the individual. This study aimed to investigate the long-term impact of anaemia requiring red blood cell (RBC) transfusion on mortality and disease severity in patients with sepsis. We studied a general surgical intensive care unit (ICU) population, excluding cardiac surgery patients. 435 patients were enrolled in this observational study between 2012 and 2016.ResultsPatients who received RBC transfusion between 28 days before and 28 days after the development of sepsis (n?=?302) exhibited a significantly higher 90-day mortality rate (34.1% vs 19.6%; P?=?0.004, Kaplan-Meier analysis). This association remained significant after adjusting for confounders in the multivariate Cox regression analysis (hazard ratio 1.68; 95% confidence interval 1.03-2.73; P?=?0.035). Patients who received transfusions also showed significantly higher morbidity scores, such as SOFA scores, and ICU lengths of stay compared to patients without transfusions (n?=?133). Our results indicate that anaemia and RBC transfusion are associated with unfavourable outcomes in patients with sepsis.
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Project description:In both sickle cell disease and malaria, red blood cells (RBCs) are phagocytosed in the spleen, but receptor-ligand pairs mediating uptake have not been identified. Here, we report that patches of high mannose N-glycans (Man5-9GlcNAc2), expressed on diseased or oxidized RBC surfaces, bind the mannose receptor (CD206) on phagocytes to mediate clearance. We find that extravascular hemolysis in sickle cell disease correlates with high mannose glycan levels on RBCs. Furthermore, Plasmodium falciparum-infected RBCs expose surface mannose N-glycans, which occur at significantly higher levels on infected RBCs from sickle cell trait subjects compared to those lacking hemoglobin S. The glycans are associated with high molecular weight complexes and protease-resistant, lower molecular weight fragments containing spectrin. Recognition of surface N-linked high mannose glycans as a response to cellular stress is a molecular mechanism common to both the pathogenesis of sickle cell disease and resistance to severe malaria in sickle cell trait.
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Project description:Infection with SARS-CoV-2 has highly variable clinical manifestations, ranging from asymptomatic infection through to life-threatening disease. Host whole blood transcriptomics can offer unique insights into the biological processes underpinning infection and disease, as well as severity. We performed whole blood RNA-Sequencing of individuals with varying degrees of COVID-19 severity. We used differential expression analysis and pathway enrichment analysis to explore how the blood transcriptome differs between individuals with mild, moderate, and severe COVID-19, performing pairwise comparisons between groups.
2022-07-19 | E-MTAB-10926 | biostudies-arrayexpress