Diagnostic Accuracy of the RDW for Predicting Death in COVID-19

Abstract

Background and Objectives: An association between high red blood cell distribution width (RDW) and mortality has been found in several diseases, including infection and sepsis. Some studies have aimed at determining the association of elevated RDW with adverse prognosis in COVID-19, but its usefulness has not been well established. The objective of this study was to determine the accuracy of the RDW, measured at hospital admission and discharge, for predicting death in patients with COVID-19. Materials andMethods: An observational, retrospective, longitudinal, and analytical study was conducted in two different COVID-19 reference centers in the state of Guanajuato, Mexico. A total of 323 patients hospitalized by COVID-19 were included. Results: We found higher RDW levels at the time of hospital admission in the non-survivors group compared to levels in survivors (median = 13.6 vs. 13.0, p < 0.001). Final RDW levels were even higher in the deceased group when compared with those of survivors (median = 14.6 [IQR, 12.67–15.6] vs. 12.9 [IQR, 12.2–13.5], p < 0.001). For patients who died, an RDW > 14.5% was more common at the time of death than for patients who survived at the time of discharge (81 vs. 13 patients, p < 0.001; RR = 2.3, 95% CI 1.89–2.81). Conclusions: The RDW is an accessible and economical parameter that, together with other characteristics of the presentation and evolution of patients with COVID-19, can be helpful in determining the prognosis. An RDW that increases during hospitalization could be a more important mortality predictor than the RDW at hospital admission.

Comparison of clinical characteristics and complication predictors of IgA vasculitis between pediatric and adult patients in China

“…In some studies, [43,44] RDW also show the diagnostic function of some diseases like organophosphorus poisoning and severe coronary artery disease. Increased RDW during hospitalization was also found to be an important predictor of mortality in most recent studies of Covid-19 [45].…”

Analysis of Risk Factors for Death in the Coronavirus Disease 2019 (COVID-19) Population: Data Analysis from a Large General Hospital in Anhui, China

“…The elevated neutrophil count may contribute to the development of cytokine storms, which can be fatal for critically ill patients [ 17 ]. Additionally, increased RDW levels have been identified as independent predictors of COVID-19 progression [ 18 , 19 ]. There are various reasons for increased RDW levels.…”

Promising applications of red cell distribution width in diagnosis and prognosis of diseases with or without disordered iron metabolism

“…Independent of the types of IBS, RDW, and MPV were increased in patients with IBS. RDW is also -Guerra et al, 2022;Moreno-Torres et al, 2022b;Yi et al, 2022).…”

“…RDW together with the clinical symptoms, could predict the prognosis of acute respiratory distress syndrome mortality in patients infected with COVID‐19. Combination of RDW and MPV could be promising diagnostic biomarkers of psoriasis (Guani‐Guerra et al, 2022; Moreno‐Torres et al, 2022b; Yi et al, 2022).…”