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?:abstract
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Objective: Coronavirus disease 2019 (COVID-19) is a novel highly infectious disease with variable laboratory parameters changes The disease is highly contagious and any delay in the diagnosis leads to an increased possibility of its spread This study explores the use of blood film as a cheap, rapid and feasible laboratory test in the disease diagnosis In low medical resources countries, this can be a crucial diagnostic method Case report: A 51-year-old Iraqi male had investigations done by Istishari Medical – private – Laboratory He was diagnosed with COVID-19, of a moderate severity The CBC showed normal hemoglobin of 15 71 g/dL (packed cell volume, PCV of 49 4%), WCC of 7 4 × 109/L, neutrophils of 5 3 × 109/L (71 7%), lymphocytes of 1 0 × 109 (14 1%), monocytes and platelets count 125 × 109/L Serum ferritin of 664 0 μg/L (NR: 30 0–400 0), CRP of 59 0 mg/L (NR: <5 0) and D-Dimer of 0 27 mg/ml (NR: up to 0 5) The biochemical changes for the liver and renal functions expressed mild changes Stained peripheral blood smear showed presence of many characteristic large atypical lymphocytes, constituting about 43% of the all lymphocytes (14 5% of the WCC) The most common subtype seen in the patient\'s blood film displayed a distinctive abundant pale blue cytoplasm, sometimes confined to its irregular margins which indented by ‘hug’ the surrounding RBC The nucleus exhibits loosely condensed chromatin with inconspicuous nucleoli Less frequently, lymphoplasmacytoid lymphocyte was noticed in the stained blood smear These cells showed ample pale blue unevenly stained cytoplasm with paranuclear of which contains eccentric nucleus with condensed chromatin Methodology: In this study, a peripheral blood smear of a COVID-19 patient was examined for the presence of abnormal leukocytes morphological changes Results: The blood film showed presence of atypical lymphocytes constituting about 43% of all lymphocytes (14 5% of the white cell count) This case report of COVID-19 patient represents an unusual feature of coronavirus family infections other than severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Conclusion: This study shows that the presence of reactive lymphocytes in the patient\'s blood film can be a pivotal finding in the diagnosis of COVID-19 Additionally, it emphasized the importance of blood film examination as an essential hematological test for COVID-19
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