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Biomedicine

Volume: 44 Issue: 1

  • Open Access
  • Original Article

Cytopathological study of pleural effusion in SARS-CoV2 RTPCR positive subjects during pandemic at tertiary care hospital

 

Sonali T. Advani1, Anita P. Javalgi, Vishwanath G. Shettar 

 

1Department of Pathology, SDM College of Medical Sciences and Hospital, Shri Dharmasthala Manjunatheswara University, Sattur, Dhawrad, 580 009, Karnataka, India 

Department of Orthopaedics, Karnataka Institute of Medical Sciences, Hubli, 580023, Karnataka, India 

 

 Corresponding author: Anita P. Javalgi. Email: [email protected] 

Year: 2024, Page: 140-145, Doi: https://doi.org/10.51248/.v44i1.3511

Received: Oct. 1, 2023 Accepted: Jan. 9, 2024 Published: May 1, 2024

Abstract

 

 Introduction and Aim: Respiratory system is the most common system affected by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Review of literature reveals that pleural effusion were seen in one third of cases with Middle East Respiratory Syndrome(MERS) but were rarely reported in SARS –CoV2.This study aims to study the cytomorphological changes in Pleural effusion seen in SARS CoV-2 positive cases, to correlate the cytological findings with radiological CT COVID-19 Reporting and Data System(CORADS)scorings and to categorize pleural effusion as isolated cause of SARS CoV-2 or aggravation of underlying other etiologies. 

Materials and Methods: Pleural fluid samples of SARS CoV-2 RT PCR positive cases, obtained from patients of all age groups were included in the study. The samples were predominantly from Covid19 wave 1 (March 2020- February 2021) and few from Covid wave 2(March 2021-April 2021). Biochemical analysis, hematological parameters, cytomorphology and associated comorbidity was recorded, and analysis done. 

Results: Male predominance was observed. Most common cytological and biochemical finding in pleural fluid analysis was Exudative pleural effusion. Predominant cytological features showed lymphocytic effusion. Radiology showed maximum left sided pleural effusion (42%). CORADS score was 6 in majority of cases and effusion as an isolated cause was seen in few cases. 

Conclusion: Pleural effusion is a rare finding in SARS COV-2 induced bronchopneumonia. Effusion is seen with a high CORADS score, and they carry a high risk of mortality. This study suggests having SARS CoV-2 infection as a differential diagnostic entity when we find the mentioned morphological and biochemical findings as discussed in the present study 

Keywords: Covid19; exudative effusion; lymphocytic effusion.

References

 

1. Cantley, R.L., Hrycaj, S., Konopka, K., Chan, M.P., Huang, T., Pantanowitz, L. Cytologic findings in effusions from patients with SARS-CoV-2 infection. Journal of the American Society of Cytopathology.2021; 10(3):261-269. 2. Hussein, M., Haq, I.U., Hameed, M., Thomas, M., Elarabi, A., Allingawi, M., et al., Pleural effusion as an isolated finding in COVID-19 infection. Respir Med Case Rep. 2020;31:101269. 

3. Zhang, J., Chai, C., Li, L., Qu, M., Duan, H., Ren, L., et al., COVID-19 with pleural effusion as the initial symptom: a case study analysis. Ann Palliat Med. 2020;9(5):3710-3715. 

4. Zhan, N., Guo, Y., Tian, S., Huang, B., Tian, X., Zou, J., et al., Clinical characteristics of COVID-19 complicated with pleural effusion. BMC Infect Dis. 2021;21(1):176-177. 

5. Ye, Q., Wang, B., Mao, J. The pathogenesis and treatment of the `Cytokine Storm' in COVID-19.Journal of Infection.2020; 80(6):607-613. 6. Chong, W.H., Saha, B.K., Conuel, E., Chopra, A. The incidence of pleural effusion in COVID-19 pneumonia: State-of-the-art review. Heart Lung. 2021;50(4):481-490. 

7. Sahn, S.A. The pathophysiology of pleural effusions. Annu Rev Med. 1990;41:7-13. 

8. Krishna, R., Antoine, M.H., Rudrappa, M. Pleural effusion. In: StatPearls Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan., PMID: 28846252. 

9. Jin, Y., Yang, H., Ji, W., Wu, W., Chen, S., Zhang, W., et al., Virology, epidemiology, pathogenesis, and control of COVID-19. Viruses. 2020;12(4):372-376. 

10. Parasher, A. COVID-19: Current understanding of its pathophysiology, clinical presentation and treatment. Postgrad Med J. 2021; 97(1147):312-320. 

11. Yuki, K., Fujiogi, M., Koutsogiannaki, S. COVID-19 pathophysiology: A review. Clin Immunol. 2020;215:108427. 

12. Hui, D.S., Azhar E. I., Madani, T.A., Ntoumi, F., Kock, R., Dar, O., et al., The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health - The latest 2019 novel coronavirus outbreak in Wuhan, China. Int J Infect Dis. 2020; 91:264-266. 

13. Pachauri, A., Singh, S.N., Verma, S.K., Awasthi, S. Thrombocytosis, haemorrhagic pleural effusion and fibro-infiltrative patches with cavitary lung lesions in a child with COVID-19 pneumonia. BMJ Case Rep. 2022;15(6):e249466. 

14. Rathore, S.S., Hussain, N., Manju, A.H., Wen, Q., Tousif, S., Avendaño-Capriles, C.A., et al., Prevalence and clinical outcomes of pleural effusion in COVID-19 patients: A systematic review and meta-analysis. J Med Virol. 2022; 94(1):229-239. 

15. Saha, B.K., Chong, W.H., Austin, A., Kathuria, R., Datar, P., Shkolnik, B., et al., Pleural abnormalities in COVID-19: A narrative review. J Thorac Dis. 2021;13(7):4484-4499. 

Cite this article

 

Sonali T. Advani, Anita P. Javalgi, Vishwanath G. Shettar . Cytopathological study of pleural effusion in SARS-CoV2 RTPCR positive subjects during pandemic at tertiary care hospital. Biomedicine: 2024; 44(1): 140-145 

 

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