Red blood cell indices and erythrocyte morphology features in pregnant women with varying courses of COVID19 during the third trimester of pregnancy

Abstract

Aim. This study aimed to evaluate red blood cell indices and examine erythrocyte morphology in pregnant women with mild to moderate COVID-19 during their third trimester.Materials and methods. A total of 85 pregnant women who underwent COVID-19 in the third trimester of pregnancy were examined, of whom 44 had a mild course (Group 1) and 41 had a moderate course (Group 2) of the disease. A control group included 35 non-infected pregnant women. The total erythrocyte and hemoglobin counts were assessed, along with hematocrit levels using an automated hematology analyzer, and the morphological shapes of erythrocytes were evaluated using the "MEKOS-C2" automated microscopy system. Erythrocyte transformation indices were also calculated.Results. The COVID-19 course severity-dependent decrease in the total number of erythrocytes, hemoglobin and hematocrit in the blood of pregnant women relative to the control group was determined. Cytometric analysis of blood smears indicate a reduction in discocyte content in both the mild and moderate COVID-19 groups, both relative to the control and within the groups. Increased numbers of echinocytes and platecytes were observed in both groups compared to controls. In cases with moderate disease severity, increases in elliptocytes, dacryocytes, and degenerative erythrocyte forms were noted. These alterations led to heightened poikilocytosis indices in pregnant women with COVID-19 compared to controls and between groups. The levels of anisocytosis and polychromatophilic erythrocytes did not change significantly. The development of anisochromia was noted in the moderate disease group. Transformation indices for both reversible and irreversible changes were elevated in groups 1 and 2.Conclusion. The moderate COVID-19 in the third trimester of pregnancy compared to the mild course of the disease is associated with more pronounced changes in the red blood system, characterized by a decrease in the number of erythrocytes and hemoglobin, the development of anisochromia and poikilocytosis. indicating anemia whose severity correlates with the severity of COVID-19 among pregnant women.