Morphology of red blood cells in long-COVID-patients

Abstract

Summary. Introduction. SARS-CoV-2 COVID-19 has a wide range of consequences. There are data on changes in basic biochemical and laboratory parameters in long-COVID-patients, while information on red blood cell abnormalities is limited. Aim: to investigate the dynamic changes in clinical blood test parameters and erythrocyte morphology during COVID-19 and in the late period after recovery. Materials and Methods. An observational case-control study included 80 patients who had recovered from COVID-19 (57.5% women and 42.5% men) aged 28 to 81 years. The control group consisted of 68 healthy individuals without a history of COVID-19 (32.4% women and 67.6% men) aged 20 to 60 years. The material for the RBC study included whole blood samples stabilized with K2-EDTA. Clinical blood analysis was performed on a 5-Diff Sysmex XT1800i hematology analyzer (Sysmex Co., Japan), and an Integra Prima atomic force microscope (Russia) was used to obtain structural images of blood erythrocytes. Results. In COVID-19-patients, 6 months after recovery, there was a significant increase in parameters that indicate heterogeneity of the blood cell population by size MCV (mean corpuscular volume), RDW-SD (red blood cell distribution width, standard deviation) and RDW-CV (red cell distribution width, coefficient of variation), MPV (mean platelet volume), and P-LCR (platelet large cell count). These parameters reflected changes in cell morphology, primarily erythrocytes, detected using atomic force microscopy. Comparison of ROC curves for parameters characterizing erythrocyte changes and platelet morphology in patients with COVID-19 in the remote period showed the greatest diagnostic value of RDW-CV in predicting the development of post- COVID syndrome. Conclusion. The mechanisms of morphological changes in red blood cells in the late post-COVID period are still far from being completely clear, but their assessment can be an important tool for developing diagnostic and therapeutic options in patients with post-COVID syndrome.

For citation: Khimina M.V., Sirotkina O.V., Karonova T.L., Mikhailova A.A., Vavilova T.V. Morphology of red blood cells in long-COVID-patients. Tromboz, gemostaz i reologiya. 2026;(1):76–84. (In Russ.).

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