有症状的 COVID-19 患者外周血粒细胞的 MDS 型形态异常

Mohammad Jafar Sharifi, Negar Gheibi, Fatemeh Panahi, S. Sharifzadeh, N. Nasiri
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摘要

背景:COVID-19 感染者的血液学异常包括量变和质变,应进一步确定其特征。骨髓增生异常综合征(MDS)的评估通常是由异常的血液学结果和增生异常形态的出现引起的。病毒感染被认为是导致形态发育不良的原因,形态学专家应加以考虑。关于 COVID-19 感染患者形态异常的报道很少。然而,这种相关性仍有待澄清。材料与方法:在本研究中,我们检测了经 RT-PCR 确诊的无症状 COVID 患者的粒细胞系形态异常。我们采集了 82 例有症状的 COVID-19 患者的外周血样本。按照标准赖特-吉氏染色法制备血涂片。形态学检查由两名实验室专家进行。结果显示血涂片检查发现了常见的骨髓增生异常综合征(MDS)类型异常,包括但不限于假性佩尔格核分叶(4.8%)、低粒化(7.3%)、Howell-Jolly样体或核片段脱落(6.0%)以及核丝拉长变细(6.0%)。此外,还发现一例不正常的未成熟粒细胞和环形核。结论我们的研究结果表明,在所有粒细胞发育不良的受试者中,都存在活动性 COVID-19 感染的可能性。这些结果对于怀疑患有骨髓增生异常综合征或与骨髓恶性肿瘤相关的疾病过程的患者具有重要的实际意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
MDS-Type Morphologic Abnormalities of Peripheral Blood Granulocytes in Symptomatic COVID-19 Patients
Background: Hematological abnormalities in COVID-19 infection included quantitative and qualitative changes and should be further characterized. Evaluation for myelodysplastic syndromes (MDS) is usually prompted by abnormal hematologic findings and the presence of dysplastic morphologies. Viral infections are considered to be the cause of dysplastic morphologies and should be considered by morphologists. There are few reports of dysplastic abnormal morphologies in patients with COVID-19 infection. However, such correlations still have to be clarified. Materials and Methods: In the present study, we examined the granulocyte lineage morphological abnormalities in symptomatic RT-PCR-confirmed COVID patients. Peripheral blood samples were collected from 82 patients with symptomatic COVID-19. Blood smears were prepared according to the standard Wright-Giemsa staining procedure. The morphological examination was carried out by two laboratory experts. Results: Blood smear examination revealed common myelodysplastic syndrome (MDS) type abnormalities including but not limited to pseudo-pelger nuclear lobulation (4.8%), hypogranulation (7.3%), Howell-Jolly-like bodies or detached nuclear segments (6.0%) and elongated and thin nuclear filaments (6.0%). One case of abnormal immature granulocyte and ring form nucleus is also evident. Conclusion: Our results accounted for the possibility of active COVID-19 infection in all subjects with granulocyte dysplasia. These results are of practical importance for patients suspected of having myelodysplastic syndromes or disease processes associated with myeloid malignancies.
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