Abstract
Since previous evidence has demonstrated that red blood cell distribution width (RDW) may be a useful prognostic parameter in many critical illnesses and infectious diseases, we investigated the utility of RDW for monitoring patients with coronavirus disease 2019 (COVID-19). The study population consisted of 49 COVID-19 patients, including 16 (32.6%) with severe illness, 12 (24.5%) with severe acute kidney injury (AKI), and 8 (16.3%) requiring renal replacement therapy (RRT). The predictive value of blood tests, performed during emergency department evaluation, was then addressed. A progressive increase of RDW was observed with advancing COVID-19 severity. The area under the curve (AUC) of RDW was 0.73 for predicting severe illness, 0.80 for severe AKI, and 0.83 for RRT, respectively. In multivariate analysis, elevated RDW was associated with 9-fold and 16-fold increased odds of severe COVID-19 and AKI, respectively. The results of this study suggest that RDW should be part of routine laboratory assessment and monitoring of COVID-19.
Highlights
The identification of clinical, demographic, and laboratory factors predictive of clinical deterioration and prognosis is a top research priority in the ongoing coronavirus disease 2019(COVID-19) pandemic [1]
Red blood cell distribution width (RDW) is a readily available laboratory parameter reported on the complete blood count (CBC) with differential by many modern hematology analyzers
This measure reflects the extent of anisocytosis, a condition characterized by pronounced heterogeneity in the volume of circulating erythrocytes [5]
Summary
The identification of clinical, demographic, and laboratory factors predictive of clinical deterioration and prognosis is a top research priority in the ongoing coronavirus disease 2019(COVID-19) pandemic [1]. The concept of using laboratory investigations for early risk stratification is based on a rationale that predictive biomarkers of severe disease would enable the timely identification of patients at higher risk of progression towards unfavorable outcomes (respiratory distress, multiple organ failure, and even death). This may enable an earlier and more appropriate therapeutic intervention, focusing the allocation of limited healthcare resources on patients whom would receive the greatest benefits [3]. Only a few studies have explored the role of this potentially important laboratory parameter in COVID-19, or examined its utility for predicting the clinical outcome in patients with
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