ALTERACIONES MIELODISPLÁSICAS EN PACIENTES CON COVID-19 EN ESTADIO SEVERO
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Rev. Méd. La Paz
Abstract
Introducción. Las alteraciones hematológicas observadas en pacientes con COVID-19 en estadio severo suelen albergar leucocitosis o leucopenia, plaquetopenia, hipersegmentación de neutrófilos, hemofagocitosis y reacción leucemoide. También se ha reportado presencia de citopenias y características mielodisplásicas, lo cual implica alteraciones en la hematopoyesis que requieren ser elucidadas. Objetivo. Identificar alteraciones citomorfológicas en las células progenitoras de médula ósea de pacientes con COVID-19 en estadio severo. Métodos. Estudio observacional descriptivo de corte transversal. Se realizó análisis citomorfológicos en muestras de aspirado de médula ósea de pacientes con COVID-19 en estadio III (n=6) que fueron ingresados a la Unidad de Terapia Intensiva. Resultados. Se evidenció presencia de grumos medulares e hipercelulares con caracteristicas compatibles con alteraciones mielodisplásicas que abarcaron todas las series de la hematopoyesis. Se observó diseritropoyesis, disgranulopoyesis, así como, alteraciones en monocitos, linfocitos, plasmacélulas y plaquetas. Conclusiones. El SARS-CoV-2 puede promover cambios hematológicos compatibles con alteraciones mielodisplásicas y presencia de microtrombos en la médula ósea de pacientes con COVID-19 severo.
Introduction. Hematologic alterations have been seen in patients with severe COVID-19 characterized by leukocytosis or leukopenia, thrombocytopenia, neutrophil hypersegmentation, hemophagocytosis, and leukemoid reaction. Likewise, presence of cytopenias and myelodysplastic features has been reported, which implies alterations in the hematopoiesis requiring to be elucidated. Objective. To identify cytomorphological changes in bone marrow progenitor cells of patients with severe COVID-19. Methods. Descriptive cross-sectional observational study. Cytomorphological analyses were performed on bone marrow aspirate samples from intensive care unit (ICU) patients with severe COVID-19 (n = 6). Results. A hypercellular bone marrow with myelodysplastic disorders compatible features that involved all hematopoietic cell lineages was evidenced. Dyserythropoiesis, dysgranulopoiesis, as well as alterations in monocytes, lymphocytes, plasma cells and platelets were observed. Conclusions. SARS-CoV-2 can promote hematological changes consistent with myelodysplastic alterations and presence of microthrombs in patients with severe COVID19.
Introduction. Hematologic alterations have been seen in patients with severe COVID-19 characterized by leukocytosis or leukopenia, thrombocytopenia, neutrophil hypersegmentation, hemophagocytosis, and leukemoid reaction. Likewise, presence of cytopenias and myelodysplastic features has been reported, which implies alterations in the hematopoiesis requiring to be elucidated. Objective. To identify cytomorphological changes in bone marrow progenitor cells of patients with severe COVID-19. Methods. Descriptive cross-sectional observational study. Cytomorphological analyses were performed on bone marrow aspirate samples from intensive care unit (ICU) patients with severe COVID-19 (n = 6). Results. A hypercellular bone marrow with myelodysplastic disorders compatible features that involved all hematopoietic cell lineages was evidenced. Dyserythropoiesis, dysgranulopoiesis, as well as alterations in monocytes, lymphocytes, plasma cells and platelets were observed. Conclusions. SARS-CoV-2 can promote hematological changes consistent with myelodysplastic alterations and presence of microthrombs in patients with severe COVID19.
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Vol. 27, No. 2