Zeylabi Fatemeh, Nameh Goshay Fard Najmeh, Parsi Abazar, Pezeshki Seyed Mohammad Sadegh
Cellular and Molecular Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran.
Thalassemia & Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Curr Res Transl Med. 2023 Jul-Sep;71(3):103407. doi: 10.1016/j.retram.2023.103407. Epub 2023 Jul 25.
The 2019 coronavirus disease (COVID-19) is a respiratory infection caused by the SARS-CoV-2 virus with a significant impact on the hematopoietic system and homeostasis. The effect of the virus on blood cells indicates the involvement of the bone marrow (BM) as the place of production and maturation of these cells by the virus and it reminds the necessity of investigating the effect of the virus on the bone marrow.
To investigate the effects of COVID-19 infection in BM, we reviewed literature from the Google Scholar search engine and PubMed database up to 2022 using the terms "COVID-19; SARS-CoV-2; Bone marrow; Thrombocytopenia; Hemophagocytosis; Pancytopenia and Thrombocytopenia.
Infection with the SARS-CoV-2 virus is accompanied by alterations such as single-line cytopenia, pancytopenia, hemophagocytosis, and BM necrosis. The presence of factors such as cytokine release syndrome, the direct effect of the virus on cells through different receptors, and the side effects of current treatments such as corticosteroids are some of the important mechanisms in the occurrence of these alterations.
To our knowledge, this review is the first study to comprehensively investigate BM alterations caused by SAR-CoV-2 virus infection. The available findings show that the significant impact of this viral infection on blood cells and the clinical consequences resulting from them are deeper than previously thought and it may be rooted in the changes that the virus causes in the BM of patients.
2019冠状病毒病（COVID-19）是一种由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的呼吸道感染，对造血系统和内环境稳态有重大影响。病毒对血细胞的影响表明骨髓作为这些细胞的产生和成熟场所受到了病毒的侵袭，这提示有必要研究病毒对骨髓的影响。
为了研究COVID-19感染对骨髓的影响，我们使用“COVID-19；SARS-CoV-2；骨髓；血小板减少症；噬血细胞作用；全血细胞减少症和血小板减少症”等关键词，检索了截至2022年谷歌学术搜索引擎和PubMed数据库中的文献。
感染SARS-CoV-2病毒会伴随如单系血细胞减少、全血细胞减少、噬血细胞作用和骨髓坏死等改变。细胞因子释放综合征等因素的存在、病毒通过不同受体对细胞的直接作用以及当前治疗（如皮质类固醇）的副作用是这些改变发生的一些重要机制。
据我们所知，本综述是第一项全面研究由SARS-CoV-2病毒感染引起的骨髓改变的研究。现有研究结果表明，这种病毒感染对血细胞的重大影响及其导致的临床后果比之前认为的更为严重，这可能源于病毒在患者骨髓中引起的变化。
