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Osman J, Gonnin C, Lambert J, Behier C, Chapuis N, Chevalier S, Debus J, Delaval A, Depoorter M, Dumas C, Dumesges A, Dussert P, Vacher CF, Dubois-Galopin F, Gerard D, Bollotte PG, Guignedoux G, Mayeur-Rousse C, Mercier-Bataille D, Ronez E, Trichet C, Wiber M, Raggueneau V. White blood cells scattergram as a valuable tool for COVID-19 screening: A multicentric study. Int J Lab Hematol 2024. [PMID: 38439664 DOI: 10.1111/ijlh.14257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 02/14/2024] [Indexed: 03/06/2024]
Abstract
INTRODUCTION New tools have been developed to distinguish the COVID-19 diagnosis from other viral infections presenting similar symptomatology and mitigate the lack of sensitivity of molecular testing. We previously identified a specific "sandglass" aspect on the white blood cells (WBC) scattergram of COVID-19 patients, as a highly reliable COVID-19 screening test (sensitivity: 85.9%, specificity: 83.5% and positive predictive value: 94.3%). We then decided to validate our previous data in a multicentric study. METHODS This retrospective study involved 817 patients with flu-like illness, among 20 centers, using the same CBC instrument (XN analyzer, SYSMEX, Japan). After training, one specialist per center independently evaluated, under the same conditions, the presence of the "sandglass" aspect of the WDF scattergram, likely representing plasmacytoid lymphocytes. RESULTS Overall, this approach showed sensitivity: 59.0%, specificity: 72.9% and positive predictive value: 77.7%. Sensitivity improved with subgroup analysis, including in patients with lymphopenia (65.2%), patients presenting symptoms for more than 5 days (72.3%) and in patients with ARDS (70.1%). COVID-19 patients with larger plasmacytoid lymphocyte cluster (>15 cells) more often have severe outcomes (70% vs. 15% in the control group). CONCLUSION Our findings confirm that the WBC scattergram analysis could be added to a diagnostic algorithm for screening and quickly categorizing symptomatic patients as either COVID-19 probable or improbable, especially during COVID-19 resurgence and overlapping with future influenza epidemics. The observed large size of the plasmacytoid lymphocytes cluster appears to be a hallmark of COVID-19 patients and was indicative of a severe outcome. Furthers studies are ongoing to evaluate the value of the new hematological parameters in combination with WDF analysis.
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Affiliation(s)
- Jennifer Osman
- Department of Hematobiology, CH Versailles, Le Chesnay, France
| | - Cécile Gonnin
- Department of Hematobiology, CH Versailles, Le Chesnay, France
| | - Jérome Lambert
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
- INSERM UMR1153 ECSTRRA Team, Paris, France
| | - Céline Behier
- Laboratory of Biology, Centre Hospitalier d'Angoulême, Angoulême, France
| | - Nicolas Chapuis
- Department of Hematobiology, Cochin Hospital, Paris, HP, France
| | - Simon Chevalier
- Department of Hematobiology, Biology and pathology Institute, CHU Grenoble Alpes, Grenoble, France
| | - Jérôme Debus
- Department of Hematobiology and Transfusion, Hôpital Louis-Mourier, Colombes, France
| | - Anne Delaval
- Department of Hematobiology, CH Robert Ballanger, Aulnay-sous-Bois, France
| | - Maxime Depoorter
- Department of Hematobiology, Centre Hospitalier Régional de la Haute Senne, Soignies, Belgium
| | - Cécile Dumas
- Department of Hematobiology, Hospices Civils de Lyon, Lyon, France
| | - Amély Dumesges
- Laboratory of Hematology, Saint-Antoine Hospital, Paris, France
| | - Pascale Dussert
- Laboratory of Nord Franche-Comté Hospital, Trévenans, France
| | | | | | - Delphine Gerard
- Laboratory of Hematology, Nancy University Hospital, Nancy, France
| | - Pauline Gravière Bollotte
- Laboratory of Hematology, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, Bron, France
| | | | | | | | - Emily Ronez
- Laboratory of Hematology, Ambroise Paré University Hospital, Boulogne-Billancourt, France
| | | | - Margaux Wiber
- Laboratory of Hematology, Angers University Hospital, Angers, France
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