Hantavirus Disease and COVID-19

Authors

Allison K. Joyce, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA, USA
Tarrah T. Oliver, Tséhootsooí Medical Center, Fort Defiance, AZ, USA
Aaron D. Kofman, Emory University, Atlanta, GA, USA
Donna L. Talker, Tséhootsooí Medical Center, Fort Defiance, AZ, USA
Shahrokh Safaeian, Tséhootsooí Medical Center, Fort Defiance, AZ, USA
Deniz Peker Barclift, Emory University, Atlanta, GA, USA
Adam J. Perricone, Emory University, Atlanta, GA, USA
Shawn M. D'Andrea, Tséhootsooí Medical Center, Fort Defiance, AZ, USA
Amy N. Whitesell, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA, USA
Del Yazzie, Navajo Epidemiology Center, Window Rock, AZ, USA
Jeannette Guarner, Emory University, Atlanta, GA, USA
Mozafar Saleki, Tséhootsooí Medical Center, Fort Defiance, AZ, USA
Glynnis B. Ingall, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
Mary J. Choi, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA, USA
Ramona Antone-Nez, Navajo Epidemiology Center, Window Rock, AZ, USA

Document Type

Article

Publication Date

3-3-2022

Abstract

OBJECTIVES: Navajo Nation is disproportionately affected by hantavirus cardiopulmonary syndrome (HCPS), a severe respiratory disease that can quickly progress to respiratory failure and cardiogenic shock. The initial signs and symptoms of HCPS are indistinguishable from coronavirus disease 2019 (COVID-19). However, this distinction is critical, as the disease course differs greatly, with most patients with COVID-19 experiencing mild to moderate illness. We set out to determine if the evaluation of peripheral blood smears for five hematopathologic criteria previously identified as hallmarks of hantavirus infection, or "the hantavirus 5-point screen," could distinguish between COVID-19 and HCPS.

METHODS: The hantavirus 5-point screen was performed on peripheral blood smears from 139 patients positive for COVID-19 seeking treatment from Tséhootsooí Medical Center and two Emory University hospitals.

RESULTS: Of these 139 individuals, 136 (98%) received a score of 3/5 or below, indicating low suspicion for HCPS. While thrombocytopenia, one of the key signs of HCPS, was seen in the patients with COVID-19, it was generally mild and remained stable on repeat specimens collected 12 to 24 hours later.

CONCLUSIONS: Given these findings, the 5-point screen remains a useful rapid screening tool for potential HCPS cases and may be useful to distinguish early HCPS from COVID-19 in HCPS endemic regions.

Recommended Citation

Joyce AK, Oliver TT, Kofman AD, Talker DL, Safaeian S, Peker Barclift D, Perricone AJ, D'Andrea SM, Whitesell AN, Yazzie D, Guarner J, Saleki M, Ingall GB, Choi MJ, Antone-Nez R. Hantavirus Disease and COVID-19. Am J Clin Pathol. 2022 Mar 3;157(3):470-475. doi: 10.1093/ajcp/aqab155. PMID: 34643226.