Monocyte distribution width as a novel sepsis indicator in COVID-19 patients

Laila Alsuwaidi,Firas Al Najjar,Mahmood Hachim,Rania Seliem,Aaron Han,Nahid Shaikh,Saba Al Heialy

doi:10.1186/s12879-021-07016-4

Abstract

BackgroundThe severe acute respiratory syndrome coronavirus (SARS-CoV-2) is a highly transmittable virus which causes the novel coronavirus disease (COVID-19). Monocyte distribution width (MDW) is an in-vitro hematological parameter which describes the changes in monocyte size distribution and can indicate progression from localized infection to systemic infection. In this study we evaluated the correlation between the laboratory parameters and available clinical data in different quartiles of MDW to predict the progression and severity of COVID-19 infection.MethodsA retrospective analysis of clinical data collected in the Emergency Department of Rashid Hospital Trauma Center-DHA from adult individuals tested for SARS-CoV-2 between January and June 2020. The patients (n = 2454) were assigned into quartiles based on their MDW value on admission. The four groups were analyzed to determine if MDW was an indicator to identify patients who are at increased risk for progression to sepsis.ResultsOur data showed a significant positive correlation between MDW and various laboratory parameters associated with SARS-CoV-2 infection. The study also revealed that MDW ≥ 24.685 has a strong correlation with poor prognosis of COVID-19.ConclusionsMonitoring of monocytes provides a window into the systemic inflammation caused by infection and can aid in evaluating the progression and severity of COVID-19 infection.

Highlights

The severe acute respiratory syndrome coronavirus (SARS-CoV-2) is a highly transmittable virus which causes the novel coronavirus disease (COVID-19) that has affected over 131 million people worldwide and has caused 2.85 million deaths globally as of April 5th, 2021
We investigated the correlation between routine laboratory parameters in different quartiles of Monocyte distribution width (MDW) values to evaluate the usefulness of this value in predicting disease outcomes
We included only the laboratory-confirmed cases, as the diagnosis was performed by real-time reverse transcriptase-polymerase chain reaction (RT-PCR) conducted on a nasopharyngeal swab of the patient according to the World Health Organization (WHO) guidance

Summary

Introduction

The severe acute respiratory syndrome coronavirus (SARS-CoV-2) is a highly transmittable virus which causes the novel coronavirus disease (COVID-19) that has affected over 131 million people worldwide and has caused 2.85 million deaths globally as of April 5th, 2021. MDW is an in-vitro hematological parameter which describes the changes in monocyte size distribution and can indicate progression from localized infection to systemic infection [4]. This parameter can be performed along with other routine parameters on several Beckman Coulter DxH analyzers. The severe acute respiratory syndrome coronavirus (SARS-CoV-2) is a highly transmittable virus which causes the novel coronavirus disease (COVID-19). Monocyte distribution width (MDW) is an in-vitro hematological parameter which describes the changes in monocyte size distribution and can indicate progression from localized infection to systemic infection. In this study we evaluated the correlation between the laboratory parameters and available clinical data in different quartiles of MDW to predict the progression and severity of COVID-19 infection

Methods

Results

Discussion

Conclusion