Introduction.

Hematologic alterations have been seen in patients with severe COVID-19 characterized by leukocytosis or leukopenia, thrombocytopenia, neutrophil hypersegmentation, hemophagocytosis, and leukemoid reaction. Likewise, presence of cytopenias and myelodysplastic features has been reported, which implies alterations in the hematopoiesis requiring to be elucidated.

Objective.

To identify cytomorphological changes in bone marrow progenitor cells of patients with severe COVID-19.

Methods.

Descriptive cross-sectional observational study. Cytomorphological analyses were performed on bone marrow aspirate samples from intensive care unit (ICU) patients with severe COVID-19 (n = 6).

Results.

A hypercellular bone marrow with myelodysplastic disorders compatible features that involved all hematopoietic cell lineages was evidenced. Dyserythropoiesis, dysgranulopoiesis, as well as alterations in monocytes, lymphocytes, plasma cells and platelets were observed.

Conclusions.

SARS-CoV-2 can promote hematological changes consistent with myelodysplastic alterations and presence of microthrombs in patients with severe COVID19.

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