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. 2023 Oct 26;11(11):2902.
doi: 10.3390/biomedicines11112902.

SARS-CoV-2 Impact on Red Blood Cell Morphology

Kirill A Kondratov  1   2   3 , Alexander A Artamonov  2 , Vladimir Yu Mikhailovskii  3 , Anastasiya A Velmiskina  1   3 , Sergey V Mosenko  1   3 , Evgeniy A Grigoryev  3 , Anna Yu Anisenkova  1   3 , Yuri V Nikitin  2 , Svetlana V Apalko  1   3 , Natalya N Sushentseva  1 , Andrey M Ivanov  2 , Sergey G Scherbak  1   3
Affiliations

SARS-CoV-2 Impact on Red Blood Cell Morphology

Kirill A Kondratov et al. Biomedicines. .

Abstract

Severe COVID-19 alters the biochemical and morphological characteristics of blood cells in a wide variety of ways. To date, however, the vast majority of research has been devoted to the study of leukocytes, while erythrocyte morphological changes have received significantly less attention. The aim of this research was to identify erythrocyte morphology abnormalities that occur in COVID-19, compare the number of different poikilocyte types, and measure erythrocyte sizes to provide data on size dispersion. Red blood cells obtained from 6 control donors (800-2200 cells per donor) and 5 COVID-19 patients (800-1900 cells per patient) were examined using low-voltage scanning electron microscopy. We did not discover any forms of erythrocyte morphology abnormalities that would be specific to COVID-19. Among COVID-19 patients, we observed an increase in the number of acanthocytes (p = 0.01) and a decrease in the number of spherocytes (p = 0.03). In addition, our research demonstrates that COVID-19 causes an increase in the median (p = 0.004) and interquartile range (p = 0.009) when assessing erythrocyte size. The limitation of our study is a small number of participants.

Keywords: COVID-19; cytokine storm; erythrocyte; erythrocyte size; low-voltage scanning electron microscopy; red blood cells; severe COVID-19.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Morphological types of erythrocytes of six control donors. Images obtained by LVSEM. Scale bar is equal to 3 µm.
Figure 2
Figure 2
Morphological types of erythrocytes of five patients with severe COVID-19. Images obtained by LVSEM. Scale bar is equal to 3 µm.
Figure 3
Figure 3
Comparison of the proportions of distinct morphological erythrocyte types (normocytes and other forms of poikilocytes) in control donors and patients with severe COVID-19.
Figure 4
Figure 4
Comparison of erythrocyte sizes from six control donors and five patients with severe COVID-19 (Panel A). Erythrocyte size distribution (Panel B). Comparison of median and interquartile range of RBC size.
See this image and copyright information in PMC

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