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Cureus Feb 2021Objective Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, many studies have described the quantitative peripheral blood findings seen in...
Objective Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, many studies have described the quantitative peripheral blood findings seen in COVID-19 patients. However, morphologic changes have been described by only a few studies. We report morphologic and quantitative changes in peripheral blood of COVID-19 patients. Design We reviewed electronic medical records, complete blood counts, and peripheral blood smears of 20 patients who were COVID-19 positive by reverse transcriptase-polymerase chain reaction (RT-PCR), from March 1, 2020, through May 31, 2020. The peripheral blood smears of all 20 patients were retrieved and morphological features of white blood cells, red blood cells, and platelets were reviewed and documented. Appropriate pictures were taken. Results Of the 20 patients reviewed, 13 were males and seven were females. The average age of the patients was 65.1 years. The most common quantitative hematologic abnormalities noted on complete blood count (CBC) were anemia followed by neutrophilia, neutrophilic left shift, and lymphopenia. The most significant morphologic changes noted were neutrophils with clumped chromatin, multiple abnormal nuclear shapes, pseudo-Pelger-Huet deformity, and smudged neutrophils. Lymphocytes showed abundant blue cytoplasm and/or lymphoplasmacytoid morphology and monocytes were activated with abnormal shapes and vacuolization. Platelets were adequate in number in the majority of patients and platelet clumping was the most significant finding noted. The red blood cells were normocytic and normochromic with few nucleated red blood cells and coarse basophilic stippling. Conclusion Our study identifies and describes significant morphologic changes in the peripheral blood cells of COVID-19 patients. An understanding of these morphologic changes in addition to established hematologic parameters can aid in the diagnosis of COVID-19 and serial CBC and peripheral smear review may help with management decisions in COVID-19 patients.
PubMed: 33758711
DOI: 10.7759/cureus.13416 -
Open Veterinary Journal Jun 2023Ovine and caprine theileriosis is a tick-borne hemoprotozoan disease, caused by spp., responsible for heavy economic losses in terms of high mortality and morbidity...
BACKGROUND
Ovine and caprine theileriosis is a tick-borne hemoprotozoan disease, caused by spp., responsible for heavy economic losses in terms of high mortality and morbidity rates. Diagnosis of ovine theileriosis is primarily based on clinical symptoms, microscopic screening of stained blood smears, and lymph node biopsy smears, but the limitations of these detection methods against spp. infection limits their specificity.
AIM
To overcome these limitations, the current study reports the differential diagnosis of theileriosis through a blood smear examination and polymerase chain reaction (PCR) in small ruminants from Pakistan.
METHODS
The study was conducted on 1,200 apparently healthy small ruminants (737 sheep and 463 goats). First, blood smears were screened for the presence of piroplasms in red blood cells. Second, PCR amplification based on 18S rRNA gene was performed by using primers specific to spp.
RESULTS
Out of the 1,200 samples of examined blood smears, 100 animals (8.33%) were found positive for species, which showed intra-erythrocytic bodies in the form of dot and comma shapes. Amplification of the isolated DNA from randomly collected blood samples of 737 sheep and 463 goats showed that an amplicon size of 1,098 bp was positive for spp. In total, 315 out of the 1,200 small ruminants examined in this study were found positive for spp. DNA through PCR amplification. Notably, out of the 885 blood samples negative by PCR amplification, only 15 blood samples were found positive by the blood smear test. Conversely, 230 blood samples that tested negative in the smear technique produced a specific band through PCR amplification. Overall, the sensitivity and specificity rates were 26.98% and 98.31% for the blood smear method and 73.01% and 100% for the PCR assay, respectively.
CONCLUSION
Our finding suggests that PCR is the gold standard method compared to the conventional method of smear examination for the diagnosis of ovine and caprine theileriosis in Pakistan.
Topics: Cattle; Animals; Sheep; Theileriasis; Goats; Diagnosis, Differential; Pakistan; Theileria; Ruminants; Polymerase Chain Reaction; Cattle Diseases; Goat Diseases; Sheep Diseases
PubMed: 37545708
DOI: 10.5455/OVJ.2023.v13.i6.4 -
Hematology Reports Jul 2022This review summarizes data from patients with COVID-19 requiring intensive care unit (ICU) admission. The goals of this study are to showcase some morphological...
INTRODUCTION
This review summarizes data from patients with COVID-19 requiring intensive care unit (ICU) admission. The goals of this study are to showcase some morphological anomalies found in peripheral blood smears from COVID-19 patients and to bring attention to how some hematologic abnormalities in COVID-19 that correspond to disease severity and mortality.
METHODS
We performed a retrospective analysis of hematologic parameters using peripheral blood smear analysis from 31 COVID-19 patients hospitalized between April 2021 and January 2022.
RESULTS
We found abnormal morphology that has not been previously reported. We also report that severe lymphopenia, neutrophilia, acute hemolysis, hematologic malignancies, and increased LDH are associated with ICU admissions, respiratory failure requiring intubation, and poor clinical outcome.
CONCLUSION
We propose these recommendations in the management of COVID-19 patients: 1. Early diagnosis and follow-up of DIC; 2. Optimization of thromboprophylaxis regimen.
PubMed: 35893155
DOI: 10.3390/hematolrep14030031 -
Hematology, Transfusion and Cell Therapy 2022We evaluated the relevance of using the smudge cell percentage in the blood smear as a prognostic marker in CLL.
OBJECTIVE
We evaluated the relevance of using the smudge cell percentage in the blood smear as a prognostic marker in CLL.
METHODS
In this prospective study, 42 untreated Senegalese patients with CLL were enrolled. The diagnosis was established, based on the peripheral blood count and flow cytometry using the Matutes score. Cytogenetic aberrations, assessed by fluorescence in situ hybridization (FISH), were available for 30 patients, while the immunoglobulin heavy chain genes (IGVH) mutation status was performed by next-generation sequencing (NGS) in 24 patients. The SC percentage was determined in the blood smear, as previously described. Statistical analyses were executed using the GraphPad Prism 8.
RESULTS
The mean age was 63 years (48 - 85) and the male: female sex ratio was 4.66. A low SC (< 30%) percentage was correlated with Binet stage B/C (p = 0.0009), CD38 expression (p = 0.039), unmutated IGVH status (p = 0.0009) and presence of cytogenetic abnormalities (for del 13q, p = 0.0012, while for other cytogenetic aberrations, p = 0.016). An inverse correlation was found between the SC percentage and the absolute lymphocyte count (r = -0.51) and patients with higher percentage of SCs had a prolonged survival. However, there was no correlation between the SC percentage and age (p = 0.41) or gender (median, 19% for males vs. 20% for females; p = 0.76).
CONCLUSION
When less than 30%, the SC was associated with a poor prognosis in CLL. Easy and affordable, the percentage of SCs in a blood smear could be a reliable prognostic marker, accessible to all CLL patients, mainly those in developing countries.
PubMed: 34116931
DOI: 10.1016/j.htct.2021.04.002 -
Scientific Reports Jan 2022Accurate and early detection of anomalies in peripheral white blood cells plays a crucial role in the evaluation of well-being in individuals and the diagnosis and... (Observational Study)
Observational Study
Accurate and early detection of anomalies in peripheral white blood cells plays a crucial role in the evaluation of well-being in individuals and the diagnosis and prognosis of hematologic diseases. For example, some blood disorders and immune system-related diseases are diagnosed by the differential count of white blood cells, which is one of the common laboratory tests. Data is one of the most important ingredients in the development and testing of many commercial and successful automatic or semi-automatic systems. To this end, this study introduces a free access dataset of normal peripheral white blood cells called Raabin-WBC containing about 40,000 images of white blood cells and color spots. For ensuring the validity of the data, a significant number of cells were labeled by two experts. Also, the ground truths of the nuclei and cytoplasm are extracted for 1145 selected cells. To provide the necessary diversity, various smears have been imaged, and two different cameras and two different microscopes were used. We did some preliminary deep learning experiments on Raabin-WBC to demonstrate how the generalization power of machine learning methods, especially deep neural networks, can be affected by the mentioned diversity. Raabin-WBC as a public data in the field of health can be used for the model development and testing in different machine learning tasks including classification, detection, segmentation, and localization.
Topics: Adolescent; Adult; Aged; Cell Nucleus; Child; Cytoplasm; Datasets as Topic; Deep Learning; Elementary Particles; Female; Hematologic Diseases; Humans; Image Processing, Computer-Assisted; Leukocytes; Male; Middle Aged; Prognosis; Young Adult
PubMed: 35064165
DOI: 10.1038/s41598-021-04426-x -
Clinical Chemistry and Laboratory... Jul 2023Extracellular histone levels are associated with the severity of many human pathologies, including sepsis and COVID-19. This study aimed to investigate the role of...
OBJECTIVES
Extracellular histone levels are associated with the severity of many human pathologies, including sepsis and COVID-19. This study aimed to investigate the role of extracellular histones on monocyte distribution width (MDW), and their effect on the release of cytokines by blood cells.
METHODS
Peripheral venous blood was collected from healthy subjects and treated with different doses of a histone mixture (range 0-200 μg/mL) to analyze MDW modifications up-to 3 h and digital microscopy of blood smears. Plasma obtained after 3 h of histone treatment were assayed to evaluate a panel of 24 inflammatory cytokines.
RESULTS
MDW values significantly increased in a time- and dose-dependent manner. These findings are associated with the histone-induced modifications of cell volume, cytoplasmic granularity, vacuolization, and nuclear structure of monocytes, promoting their heterogeneity without affecting their count. After 3 h of treatment almost all cytokines significantly increased in a dose-dependent manner. The most relevant response was shown by the significantly increased G-CSF levels, and by the increase of IL-1β, IL-6, MIP-1β, and IL-8 at the histone doses of 50, 100, and 200 µg/mL. VEGF, IP-10, GM-CSF, TNF-α, Eotaxin, and IL-2 were also up-regulated, and a lower but significant increase was observed for IL-15, IL-5, IL-17, bFGF, IL-10, IFN-γ, MCP-1, and IL-9.
CONCLUSIONS
Circulating histones critically induce functional alterations of monocytes mirrored by MDW, monocyte anisocytosis, and hyperinflammation/cytokine storm in sepsis and COVID-19. MDW and circulating histones may be useful tools to predict higher risks of worst outcomes.
Topics: Humans; Histones; Monocytes; Cytokine Release Syndrome; COVID-19; Cytokines; Sepsis
PubMed: 36847604
DOI: 10.1515/cclm-2023-0093 -
Determinants of external and blood parasite load in African penguins () admitted for rehabilitation.Parasitology Apr 2020We investigate the factors associated with the occurrence and abundance of external and blood parasites in African penguins (Spheniscus demersus), an endangered seabird...
We investigate the factors associated with the occurrence and abundance of external and blood parasites in African penguins (Spheniscus demersus), an endangered seabird that breeds exclusively on the coasts of Namibia and South Africa. External parasites were collected using the dust-ruffling method from 171 African Penguins admitted at a rehabilitation facility in the Western Cape, South Africa. Additionally, blood smears were obtained upon admission and weekly during rehabilitation and examined for blood parasites. Fleas Parapsyllus longicornis humboldti, ticks Ornithodoros capensis and lice Austrogoniodes demersus were recovered from 93, 63 and 40%, respectively, of the penguins upon admission to the centre. Rescue location and age group were identified as significant determinants of flea abundance, whereas month of admission was a significant determinant of tick abundance. Blood parasites were also common on admission, with Babesia being the most frequent (46% prevalence) whereas Borrelia was recorded sporadically (1.2%) and Plasmodium was recorded once. The prevalence and abundance of ticks on admission was positively associated with Babesia infection on admission. Our findings demonstrate the variability and contributing factor of parasite infections in an endangered species of penguin, and highlight the need for additional research on the parasite-host dynamics involving these potential disease vectors.
Topics: Animals; Arthropod Vectors; Babesia; Babesiosis; Bird Diseases; Blood; Borrelia; Ectoparasitic Infestations; Endangered Species; Insect Vectors; Parasite Load; Plasmodium; Prevalence; Siphonaptera; South Africa; Spheniscidae; Ticks; Vector Borne Diseases
PubMed: 31992371
DOI: 10.1017/S0031182020000141 -
Malaria Journal Mar 2022Progress towards malaria elimination has stagnated, partly because infections persisting at low parasite densities comprise a large reservoir contributing to ongoing...
Diagnostic performance and comparison of ultrasensitive and conventional rapid diagnostic test, thick blood smear and quantitative PCR for detection of low-density Plasmodium falciparum infections during a controlled human malaria infection study in Equatorial Guinea.
BACKGROUND
Progress towards malaria elimination has stagnated, partly because infections persisting at low parasite densities comprise a large reservoir contributing to ongoing malaria transmission and are difficult to detect. This study compared the performance of an ultrasensitive rapid diagnostic test (uRDT) designed to detect low density infections to a conventional RDT (cRDT), expert microscopy using Giemsa-stained thick blood smears (TBS), and quantitative polymerase chain reaction (qPCR) during a controlled human malaria infection (CHMI) study conducted in malaria exposed adults (NCT03590340).
METHODS
Blood samples were collected from healthy Equatoguineans aged 18-35 years beginning on day 8 after CHMI with 3.2 × 10 cryopreserved, infectious Plasmodium falciparum sporozoites (PfSPZ Challenge, strain NF54) administered by direct venous inoculation. qPCR (18s ribosomal DNA), uRDT (Alere™ Malaria Ag P.f.), cRDT [Carestart Malaria Pf/PAN (PfHRP2/pLDH)], and TBS were performed daily until the volunteer became TBS positive and treatment was administered. qPCR was the reference for the presence of Plasmodium falciparum parasites.
RESULTS
279 samples were collected from 24 participants; 123 were positive by qPCR. TBS detected 24/123 (19.5% sensitivity [95% CI 13.1-27.8%]), uRDT 21/123 (17.1% sensitivity [95% CI 11.1-25.1%]), cRDT 10/123 (8.1% sensitivity [95% CI 4.2-14.8%]); all were 100% specific and did not detect any positive samples not detected by qPCR. TBS and uRDT were more sensitive than cRDT (TBS vs. cRDT p = 0.015; uRDT vs. cRDT p = 0.053), detecting parasitaemias as low as 3.7 parasites/µL (p/µL) (TBS and uRDT) compared to 5.6 p/µL (cRDT) based on TBS density measurements. TBS, uRDT and cRDT did not detect any of the 70/123 samples positive by qPCR below 5.86 p/µL, the qPCR density corresponding to 3.7 p/µL by TBS. The median prepatent periods in days (ranges) were 14.5 (10-20), 18.0 (15-28), 18.0 (15-20) and 18.0 (16-24) for qPCR, TBS, uRDT and cRDT, respectively; qPCR detected parasitaemia significantly earlier (3.5 days) than the other tests.
CONCLUSIONS
TBS and uRDT had similar sensitivities, both were more sensitive than cRDT, and neither matched qPCR for detecting low density parasitaemia. uRDT could be considered an alternative to TBS in selected applications, such as CHMI or field diagnosis, where qualitative, dichotomous results for malaria infection might be sufficient.
Topics: Adolescent; Adult; Diagnostic Tests, Routine; Equatorial Guinea; Humans; Malaria; Plasmodium falciparum; Real-Time Polymerase Chain Reaction; Young Adult
PubMed: 35331251
DOI: 10.1186/s12936-022-04103-y -
CytoJournal 2022Fluids are one the most common specimens received in cytology laboratories. The presence of erythrocytes may obscure the cells in the smears, making the diagnosis, and...
OBJECTIVES
Fluids are one the most common specimens received in cytology laboratories. The presence of erythrocytes may obscure the cells in the smears, making the diagnosis, and identification of cells difficult. Many techniques are being used by laboratories to eliminate these erythrocytes. The present study was undertaken to improve the quality of cytology smears of hemorrhagic samples by comparing three different techniques, namely, Carnoy's fixative (CF), modified CF, and normal saline rehydration technique (NSRT) to hemolysis red blood cells (RBC) present in the smear background for better cytological assessment. The present study was a prospective study done over 1 year 6 months from November 2012 to March 2014, in the Department of Pathology in a Tertiary Care Rural Medical College.
MATERIALS AND METHODS
All hemorrhagic effusions received in the department of pathology were processed using CF, modified CF, and NSRT. The background of the smear and cytomorphological details with two different stains was analyzed. The Chi-square test was used to find out the association of different techniques in the reduction of RBC.
RESULTS
More than 60% reduction of RBCs in the smear was noted in 85.40%, 14.60%, and 15.60% by NSRT, modified CF, and CF, respectively. Staining was better and nuclear features were best preserved in NSRT.
CONCLUSION
NSRT is the best, simple, and cheaper technique to lyse RBC in the hemorrhagic fluid. It also shows better staining and well-preserved cytomorphological features of the cell.
PubMed: 35928534
DOI: 10.25259/Cytojournal_14_2021 -
Frontiers in Cellular and Infection... 2020Leishmaniasis is a vector-borne disease caused by . Although the incidence of leishmaniasis in China is currently low, it has not been completely eradicated. In 2019,...
Leishmaniasis is a vector-borne disease caused by . Although the incidence of leishmaniasis in China is currently low, it has not been completely eradicated. In 2019, visceral leishmaniasis was diagnosed in three patients using bone marrow microscopic examination and metagenomic next-generation sequencing (mNGS). The bone marrow mNGS results from the three patients indicated that 99.9, 99.6, and 30.3% of non-human reads matched the genome, and plasma mNGS results from one of the patients revealed that 46.2% of non-human reads matched the genome. In the second patient's plasma, no sequences were detected by plasma mNGS, and the third patient's plasma was unavailable. The pathogen in all three patients was identified as . amastigotes were observed by microscopic examination of bone marrow smears in all three patients, but were not found in peripheral blood smears. This indicates that the sensitivity of mNGS is higher than that of smear microscopy and that mNGS can be used to identify at the species level. All three patients were elderly male farmers, two from Shanxi and one from Beijing. All three patients had splenomegaly and pancytopenia. Originally, these patients were misdiagnosed and treated for extended periods in other hospitals. Diagnoses of visceral leishmaniasis took place 6, 2, and 2 months after the onset of symptoms in the three patients. In conclusion, this study confirms that bone marrow mNGS can be used to quickly and accurately confirm a diagnosis in patients with suspected leishmaniasis.
Topics: Aged; China; High-Throughput Nucleotide Sequencing; Humans; Leishmania infantum; Leishmaniasis; Leishmaniasis, Visceral; Male
PubMed: 33072623
DOI: 10.3389/fcimb.2020.528884