PARAMETERS AND MORPHOLOGICAL CHANGES OF ERYTHROCYTES IN COVID-19 SUBJECTS

Objective: to assess the morphological abnormalities of red blood cells (RBC) in patients with COVID-19 and cardiovascular system (CVS) pathology.

Material and methods. The study included 142 patients who were divided into 3 groups according to the following principle: combination of COVID-19 and CVS pathology (group 1, n=56); COVID-19 without CVS pathology (group 2, n=44); patients with CVS pathology without COVID-19 (group 3, n=42). Peripheral blood erythrocytes were studied. Morphological studies were carried out in the laboratories of pathological anatomy of the State Institution “RSSPMC for surgery named after V.Vakhidov" and RSH Zangiota-1.

Results. Morphological features of peripheral blood erythrocytes in COVID-19-associated cardiovascular syndrome were revealed, characterized by an increase in the frequency of elevated erythrocyte distribution width (RDW) from 45.5% to 67.9% (p<0.05), and the average RDW from 13.1% (11, 8-15.4%) to 14.3% (12.6-15.8%) (p<0.0001); an increase in the proportion of abnormal forms from 13.6% in the isolated course of COVID-19 to 32.1% in the combination of COVID-19 with cardiovascular pathology (p<0.05), mainly due to ridged erythrocytes from 6.4+0.5% to 8.2+0.6% (p<0.001) and the proportion of irreversible forms of erythrocytes from 1.6+0.1% to 3.1+0.3% (p<0.001) increasing the risk of transferring the patient to the ICU (RR=6.0) and death (RR=4.33). Patients with more than 20% RBC abnormality had a statistically significant higher ICU admission rate (50.0%, 9 of 18; RR=6.0) than patients with less than 10% RBC abnormality (8.33%, 1 of 12, p=0.049), and patients with 10-20% abnormal RBCs (7.7%, 2 of 26, p=0.005).

Conclusion. Patients with COVID-19-associated cardiovascular syndrome have a significant morphological heterogeneity in the shape and size of erythrocytes and their relationship with the progression and outcome of the disease.