Abstract
SARS-COV-2 infection due to Coronavirus is highly contagious and causes varying degrees of illness throughout the world. Recent literature has shown an association between red blood cell distribution width (RDW) and adverse outcomes among adult patients with COVID‐19. Multiple hypotheses can explain the potential prognostic role of RDW in COVID-19 infection.The aim of this study is to describe RDW values in SARS-COV-2 infected children admitted to the Pediatric Emergency Department to shed light on the potential role of RDW as a prognostic factor in this specific group.Of 1086 tested children observed from March 2020 to April 2021, 36 positive SARS-COV-2 children (0-16 years) did not show clinically significant differences in RDW values according to illness categories, days of hospitalization, presence of multisystem inflammatory syndrome in children (MIS-C), or viral load (cycle threshold (CT) values).This study is the first to investigate this issue in a SARS-COV-2 infected pediatric population.Despite our negative results, given the high incidence of Delta variant in children, the low cost of the examination, its prognostic role described in adults, and its association to other pediatric illnesses, we believe that the role of RDW in SARS-COV-2 infected children should be deeper assessed and that larger collaborative studies on this issue are required.
Highlights
As recently discussed by Bommenahalli Gowda et al [1], there seems to be an association between red blood cell distribution width (RDW) and adverse outcomes among patients with COVID‐19
Of 1086 tested children observed from March 2020 to April 2021, 36 positive SARS-COV-2 children (0-16 years) did not show clinically significant differences in RDW values according to illness categories, days of hospitalization, presence of multisystem inflammatory syndrome in children (MIS-C), or viral load (cycle threshold (CT) values)
Given the high incidence of Delta variant in children, the low cost of the examination, its prognostic role described in adults, and its association to other pediatric illnesses, we believe that the role of RDW in SARS-COV-2 infected children should be deeper assessed and that larger collaborative studies on this issue are required
Summary
As recently discussed by Bommenahalli Gowda et al [1], there seems to be an association between red blood cell distribution width (RDW) and adverse outcomes among patients with COVID‐19. Consistent with this, Henry et al [2] suggested the utility of measuring RDW as a single point prognostic factor for adults admitted in the emergency departments (ED). RDW is a measure of the range of variation of red blood cell (RBC) volume that is reported as part of a standard complete blood count. Multiple hypotheses can explain the potential prognostic role of RDW in COVID-19. Conditions that have an impact on erythrocyte’s biology and anisocytosis may be secondary to indirect RBC damage consequent to hemolytic anemia or intravascular coagulopathy, direct damage due to infection of erythrocytes or their bone marrow precursors, and an iron metabolism perturbation caused by sustained inflammatory response [2]
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