Peripheral blood cell anomalies in COVID-19 patients in the United Arab Emirates: A single-centered study

Introduction

In this study, we aimed at exploring the morphologic and quantitative abnormalities in the peripheral blood counts of coronavirus disease 2019 (COVID-19) patients.

Methods

A cohort of 131 COVID-19 patients was recruited at University Hospital Sharjah (UHS), UAE. Their peripheral blood smears were examined for morphological evaluation. Also, their clinical laboratory investigations and radiological findings were retrieved from the medical records. Our cohort consisted of 63 males and 68 females with an age of 63.6 ± 18.6 years.

Results

The presence of atypical lymphocytes was observed in around 80% of the recruited COVID-19 patients. Further, monocytes with toxic cytoplasmic vacuoles were identified in 55% of the cases. Neutrophil-associated changes, including pseudo-Pelger-Huët, bands, and long nuclear endoplasm, were reported in around 25-35% of the patients. RBCs associated changes such as microcytic and hypochromic RBCs, as well as targetoid, dacrocytes, ovalocytes, echinocytes/burr cells, and schistocytes, were described. According to disease severity, RBCs chromicity was found to be significantly different between stable and critical patients. COVID-19 patients with CO-RADS 5 showed a similar change in RBCs as well as a decrease in the neutrophils with hypogranular cytoplasm.

Conclusion

Peripheral blood smear assessment in COVID-19 patients could provide information about the disease state and pulmonary involvement.

Self-Report Assessment of Nurses' Risk for Infection After Exposure to Patients With Coronavirus Disease (COVID-19) in the United Arab Emirates

Purpose

Nurses have an increased risk for acquiring COVID‐19 infection. This study assessed levels of risk for exposure to COVID‐19 among nurses, and determined those at the greatest risk.

Design

A cross‐sectional design was used to assess risk for exposure to COVID‐19 in nurses from five randomly selected governmental hospitals in the United Arab Emirates. Participants completed an online survey (including the World Health Organization survey) to assess their risk for exposure to COVID‐19. Descriptive statistics were used to describe classes of risk for exposure, and logistic regression was used to identify factors associated with greater risk.

Findings

Of the 552 participants, 284 nurses (51.4%) were classified at high risk for COVID‐19 exposure as they did not report adherence to infection control and prevention (ICP) guidelines at all times during healthcare interactions and when performing aerosol procedures, or had accidental exposure to biological fluid and respiratory secretions. Compared with adherence to wearing medical masks, gloves, and hand hygiene practices, adherence to wearing face shields or goggles and disposable gowns and decontaminating high‐touch surfaces was less frequent. Shifting to work in critical care units, not having adequate critical care experience, and reporting a need for training in ICP practices were factors that contributed to high‐risk exposure (p values for Ex (Bs) = 2.60, 2.16, 1.75, ≤ 0.05, consecutively).

Conclusions

A considerable number of nurses were classified at high risk for COVID‐19 exposure. Critical care work experience and adequate evidence‐based training in ICP practices related to COVID‐19 must be considered to mitigate the risk for exposure to COVID‐19 in nurses.

Clinical Relevance

This study provided a strong message regarding protecting nurses at high risk for exposure to COVID‐19. Clinical leaders must stay vigilant to ensure nurses’ adherence to ICP practices in the context of COVID‐19, and to proactively address any related deficits.