Hematological parameters and peripheral blood morphologic abnormalities
in children with COVID-19
Abstract
Objectives: The aim of this study is to evaluate the hematologic
parameters and peripheral blood cell morphological changes in children
with COVID-19 and compare them with those of children suspected but then
confirmed to be negative for SARS-CoV-2. Methods: Thirty children were
tested to be positive for SARS-CoV-2 and the remaining 40 were negative.
Hemoglobin, leukocyte, neutrophil, lymphocyte, monocyte counts according
to age-specific intervals, platelet, large unstained cell counts, and
delta neutrophil index were recorded. Differential counts were
formulated by manual counting and morphology of the blood cells were
evaluated. Results: The mean leukocyte counts of the SARS-CoV-2 positive
and negative groups were 7.0 ± 3.7x109/L and 10.4 ± 7.1x109/L,
respectively (p<0.05). Nine (30%) children with COVID-19 had
lymphopenia. Among children with COVID-19, absolute lymphocyte count was
lower in those with pneumonia (p<0.05). Reactive lymphocytes
were noted in 77.8% and 90% in the SARS-CoV-2 test positive and
negative groups, respectively (p>0.05). Mean absolute
neutrophil counts of the SARS-CoV-2 test positive and negative groups
were 3.7±2.9 x109/L and 5.4±4.2 x109/L (p<0.05). Four patients
(13.3%) with SARS-CoV-2 test positive had neutrophilia and seven
(23.3%) had mild neutropenia. In the peripheral smear, vacuolated
monocytes and dysplastic changes in neutrophils and platelets were noted
in both groups. Conclusions: Leukocyte, neutrophil and monocyte counts
were significantly lower in children with COVID-19 compared with
symptomatic children without COVID-19. Lymphopenia, reactive
lymphocytosis and dysplasia, could be noted in children with COVID-19.
Further studies on hematological findings linked with the course of the
disease in children are warranted.