Introduction
The severe acute respiratory syndrome-related coronavirus 2 (SARS-Cov-2) infection may cause hematological disorders. This pathology has been studied to a lesser extent compared to the respiratory system pathology. The main purpose of this article is to investigate the general pathology of red blood cells in coronavirus infection.
Methods
In current study 74 patients suffering from SARS-Cov-2 treated at the National Center of Infectious Diseases, Ministry of Health Armenia were included. Investigated patients were classified as: 1. Regular group (fever, respiratory symptoms and radiographic evidence of pneumonia). 2. Severe group – patients manifesting shortness of breath (over 30 breaths per minute); peripheral blood oxygen saturation below 92% in rest; pneumonia affecting over 50% of tissue; and/or respiratory failure and indicated mechanical ventilation support and/or organ failure requiring intensive care unit treatment. 3. Low saturation group with peripheral blood oxygen saturation below 85% in rest. 4. Erythroblastosis group with count of erythroblasts over 0.5% among total of nucleated blood cells. Clinical laboratory investigation included all main routine studies.
Microspectrophotometry was performed on SMP-05 Opton scanning microspectrophotometer to measure the spectra of hemoglobin (Hb) in unstained erythrocytes.
Results
Erythroblasts were common (present in about 30%) finding among SARS-Cov-2 patients but predominating mainly in the severe group. Serum ferritin and C-reactive protein (CRP) levels as well as anisocytosis highly correlate with the severity of the disease. Microspectrophotometric studies showed significant changes of hemoglobin adsorption spectra in individual erythrocytes. However, in severe form of SARS-CoV-2, increase of hemoglobin absorbance occurred in within 420 nm wavelength spectrum compared with regular group.
Conclusion
Our findings suggest that the increased levels of ferritin, CRP, anisocytosis and partially increase in Hb adsorption on 420 nm wavelength may positively correlate with adverse outcomes in SARS-Cov-2 infection.