Howell-Jolly Body-Like Inclusions in Coronavirus Disease 2019 (COVID-19): Possible Novel Findings.

IF 2.1 Q3 HEMATOLOGY
Amaylia Oehadian, Ian Huang, Andini Kartikasari, Bachti Alisjahbana, Delita Prihatni
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引用次数: 0

Abstract

Background: During COVID-19 pandemic, it is difficult to distinguish febrile patient infected by SARS-CoV-2 or bacterial causes. Howell-Jolly bodies are a well-known entity found in red blood cells. They are nuclear fragments, composed of deoxyribonucleic acid, commonly observed in the peripheral blood smears of hyposplenic or asplenic patients. Recently, similar inclusions often referred to as Howell-Jolly body-like inclusions (HJBLIs) have been reported in the neutrophils of patients with acquired immune deficiency syndrome (AIDS) and COVID-19 patient.

Aim: To explore whether HJBLIs in peripheral blood smear could differentiate between patients with confirmed SARS-CoV-2 and bacterial pneumonia.

Methods: We performed cross-sectional study using secondary data from COVID-19 database and re-evaluated peripheral blood smears to identify HJBLIs. We included confirmed COVID-19 adults age >18 years who were hospitalized in Dr. Hasan Sadikin General Hospital, Bandung, Indonesia from March 1st 2020-May 31st 2020. We also examined peripheral blood smears in patients with confirmed bacterial pneumonia as a control group. Clinical characteristics including disease severity, CURB-65 score, comorbidity, and the present of HJBLIs in peripheral blood smears were evaluated.

Results: Overall, 33 patients were included: 22 were confirmed COVID-19 and 11 were confirmed bacterial pneumonia. The median (interquartile range) age in COVID-19 and patients with bacterial pneumonia were 53 years (40-64) vs 57 years (53-71), respectively. Compared with patients with bacterial pneumonia, HJBLIs were significantly higher in COVID-19 patients [21/22 (80.8%) vs 5/11 (45.5%), p 0.001].

Conclusion: Howell-Jolly body-like inclusions could be a potential feature to help differentiate between COVID-19 and bacterial pneumonia.

Abstract Image

2019冠状病毒病(COVID-19)中的豪威尔-乔利体样内含物:可能的新发现
背景:在COVID-19大流行期间,很难区分发热患者是由SARS-CoV-2感染还是细菌感染。豪厄尔-乔利体是在红细胞中发现的一种众所周知的实体。它们是核片段,由脱氧核糖核酸组成,常见于脾功能低下或脾功能缺失患者的外周血涂片。最近,在获得性免疫缺陷综合征(AIDS)患者和COVID-19患者的中性粒细胞中发现了类似的包涵体,通常被称为Howell-Jolly体样包涵体(HJBLIs)。目的:探讨外周血涂片HJBLIs能否区分确诊的SARS-CoV-2与细菌性肺炎。方法:利用COVID-19数据库的二次数据进行横断面研究,并重新评估外周血涂片以确定HJBLIs。我们纳入了2020年3月1日至2020年5月31日在印度尼西亚万隆哈桑·萨迪金医生总医院住院的确诊COVID-19成年人,年龄>18岁。我们还检查了确诊细菌性肺炎患者的外周血涂片作为对照组。评估临床特征,包括疾病严重程度、CURB-65评分、合并症以及外周血涂片中是否存在HJBLIs。结果:共纳入33例患者,其中确诊COVID-19 22例,确诊细菌性肺炎11例。COVID-19和细菌性肺炎患者的年龄中位数(四分位数范围)分别为53岁(40-64岁)和57岁(53-71岁)。与细菌性肺炎患者相比,新冠肺炎患者HJBLIs明显高于细菌性肺炎患者[21/22 (80.8%)vs 5/11 (45.5%), p 0.001]。结论:Howell-Jolly体样包涵体可能是帮助区分COVID-19和细菌性肺炎的潜在特征。
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来源期刊
CiteScore
3.50
自引率
0.00%
发文量
94
审稿时长
16 weeks
期刊介绍: The Journal of Blood Medicine is an international, peer-reviewed, open access, online journal publishing laboratory, experimental and clinical aspects of all topics pertaining to blood based medicine including but not limited to: Transfusion Medicine (blood components, stem cell transplantation, apheresis, gene based therapeutics), Blood collection, Donor issues, Transmittable diseases, and Blood banking logistics, Immunohematology, Artificial and alternative blood based therapeutics, Hematology including disorders/pathology related to leukocytes/immunology, red cells, platelets and hemostasis, Biotechnology/nanotechnology of blood related medicine, Legal aspects of blood medicine, Historical perspectives. Original research, short reports, reviews, case reports and commentaries are invited.
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