Quantitative and qualitative changes in blood cells associated with COVID-19
- Authors: Evtugina NG1, Sannikova SS2, Peshkova AD1, Safiullina SI1,3, Andrianova IA1, Tarasova GR1, Khismatullin RR1, Abdullaeva S.M1, Litvinov RI1
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Affiliations:
- Institute of Fundamental Medicine and Biology of Kazan (Volga Region) Federal University
- City Clinical Hospital No. 16
- Medical Center “Aibolit”
- Issue: Vol 102, No 2 (2021)
- Pages: 141-155
- Section: Theoretical and clinical medicine
- URL: https://kazanmedjournal.ru/kazanmedj/article/view/60605
- DOI: https://doi.org/10.17816/KMJ2021-141
- ID: 60605
Cite item
Open Access
Access granted
Abstract
Aim. To establish the relationship of hematological disorders with the pathogenesis, course and outcomes of COVID-19.
Methods. We examined 235 hospitalized patients with moderate and severe forms of acute COVID-19 receiving anticoagulants and immunosuppressive drugs. We studied the full blood cell counts and morphology along with the platelet function by flow cytometry in comparison with the clinical features and synthesis of inflammatory markers. To assess platelet contractility, blood clot contraction (retraction) kinetics was used in combination with scanning electron microscopy of platelets and blood clots.
Results. Hemolytic anemia, neutrophilia and lymphopenia were associated with immature erythrocytes and leukocytes, indicating activation of hematopoiesis. Contraction of blood clots in COVID-19 was impaired, especially in severe and lethal cases, as well as in the presence of comorbidities, including myeloproliferative and coronary heart diseases and acute cerebrovascular disease. In male patients, the changes in clot contraction were more pronounced. Suppression of clot contraction correlated directly with anemia and coagulopathy, including a high D-dimer level, which confirms the pathogenetic significance of blood clot contraction in COVID-19. A decrease in platelet contractility was due to moderate thrombocytopenia in combination with chronic platelet activation and secondary platelet dysfunction. The structure and cellular composition of blood clots depended on the extent of contraction; clots with impaired contraction were porous, had a low content of deformed polyhedral erythrocytes (polyhedrocytes) and an even distribution of fibrin.
Conclusion. Blood cells undergoing both quantitative and qualitative changes are involved in the pathogenesis of COVID-19; the suppressed platelet-driven contraction of intravital blood clots may be a part of the prothrombotic mechanisms.
Keywords
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About the authors
N G Evtugina
Institute of Fundamental Medicine and Biology of Kazan (Volga Region) Federal University
Author for correspondence.
Email: natalja.evtugyna@gmail.com
Russian Federation, Kazan, Russia
S S Sannikova
City Clinical Hospital No. 16
Email: natalja.evtugyna@gmail.com
Russian Federation, Kazan, Russia
A D Peshkova
Institute of Fundamental Medicine and Biology of Kazan (Volga Region) Federal University
Email: natalja.evtugyna@gmail.com
Russian Federation, Kazan, Russia
S I Safiullina
Institute of Fundamental Medicine and Biology of Kazan (Volga Region) Federal University; Medical Center “Aibolit”
Email: natalja.evtugyna@gmail.com
Russian Federation, Kazan, Russia; Kazan, Russia
I A Andrianova
Institute of Fundamental Medicine and Biology of Kazan (Volga Region) Federal University
Email: natalja.evtugyna@gmail.com
Russian Federation, Kazan, Russia
G R Tarasova
Institute of Fundamental Medicine and Biology of Kazan (Volga Region) Federal University
Email: natalja.evtugyna@gmail.com
Russian Federation, Kazan, Russia
R R Khismatullin
Institute of Fundamental Medicine and Biology of Kazan (Volga Region) Federal University
Email: natalja.evtugyna@gmail.com
Russian Federation, Kazan, Russia
Sh M Abdullaeva
Institute of Fundamental Medicine and Biology of Kazan (Volga Region) Federal University
Email: natalja.evtugyna@gmail.com
Russian Federation, Kazan, Russia
R I Litvinov
Institute of Fundamental Medicine and Biology of Kazan (Volga Region) Federal University
Email: natalja.evtugyna@gmail.com
Russian Federation, Kazan, Russia
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