Monocyte distribution width as a biomarker of sepsis in the intensive care unit: A pilot study

Agnello, Luisa; Sasso, Bruna Lo; Giglio, Rosaria Vincenza; Bivona, Giulia; Gambino, Caterina Maria; Cortegiani, Andrea; Ciaccio, Anna Maria; Vidali, Matteo; Ciaccio, Marcello

doi:10.1177/0004563220970447

Cited by 31 publications

(29 citation statements)

References 7 publications

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“…Our best cut-point for MDW associated with sepsis was 24.63, a higher value than those reported in other studies, probably because they were performed in different clinical settings such as Infectious Diseases Units or Emergency Departments [22][23][24][25]. Our study confirm previously reported data by Agnello et al, even if slightly different values of MDW should be due to the use of K2EDTA tube instead of K3EDTA [26,27]. The MDW cut-off value should be discussed and evaluated on the basis of the clinical setting in which the studies have been performed.…”

Section: Discussionsupporting

confidence: 83%

Monocyte distribution width (MDW) parameter as a sepsis indicator in intensive care units

Piva

Zuin

Pelloso

et al. 2021

Clinical Chemistry and Laboratory Medicine (CCLM)

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Objectives Patients in Intensive Care Units (ICU) are a high-risk population for sepsis, recognized as a major cause of admission and death. The aim of the current study was to evaluate the diagnostic accuracy and prognostication of monocyte distribution width (MDW) in sepsis for patients admitted to ICU. Methods Between January and June 2020, we conducted a prospective observational study during the hospitalization of 506 adult patients admitted to the ICU. MDW was evaluated in 2,367 consecutive samples received for routine complete blood counts (CBC) performed once a day and every day during the study. Sepsis was diagnosed according to Sepsis-3 criteria and patients enrolled were classified in the following groups: no sepsis, sepsis and septic shock. Results MDW values were significantly higher in patients with sepsis or septic shock in comparison to those within the no sepsis group [median 26.23 (IQR: 23.48–29.83); 28.97 (IQR: 21.27–37.21); 21.99 (IQR: 19.86–24.36) respectively]. ROC analysis demonstrated that AUC is 0.785 with a sensitivity of 66.88% and specificity of 77.79% at a cut-off point of 24.63. In patients that developed an ICU-acquired sepsis MDW showed an increase from 21.33 [median (IQR: 19.47–21.72)] to 29.19 [median (IQR: 27.46–31.47)]. MDW increase is not affected by the aetiology of sepsis, even in patients with COVID-19. In sepsis survivors a decrease of MDW values were found from the first time to the end of their stay [median from 29.14 (IQR: 26.22–32.52) to 25.67 (IQR: 22.93–30.28)]. Conclusions In ICU, MDW enhances the sepsis detection and is related to disease severity.

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Section: Discussionsupporting

confidence: 83%

Monocyte distribution width (MDW) parameter as a sepsis indicator in intensive care units

Piva

Zuin

Pelloso

et al. 2021

Clinical Chemistry and Laboratory Medicine (CCLM)

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“…MDW is a novel biomarker of sepsis, whose prognostic value has been recently highlighted [69][70][71]. Ognibene, et al [72] reported that MDW is a good analyte for predicting positivity in a molecular diagnostic testing for SARS-CoV-2.…”

Section: Monocyte Distribution Width (Mdw)mentioning

confidence: 99%

Biomarkers for Prognosis and Treatment Response in COVID-19 Patients

2021

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During a severe infection such as coronavirus disease 2019 , the level of almost all analytes can change, presenting a correlation with disease severity and survival; however, a biomarker cannot be translated into clinical practice for treatment guidance until it is proven to have a significant impact. Several studies have documented the association between COVID-19 severity and circulating levels of C-reactive protein (CRP) and interleukin-6, and the accuracy of the CRP level in predicting treatment responses has been evaluated. Moreover, promising findings on prothrombin and D-dimer have been reported. However, the clinical usefulness of these biomarkers in COVID-19 is far from proven. The burst of data generation during this pandemic has led to the publication of numerous studies with several notable drawbacks, weakening the strength of their findings. We provide an overview of the key findings of studies on biomarkers for the prognosis and treatment response in COVID-19 patients. We also highlight the main drawbacks of these studies that have limited the clinical use of these biomarkers.

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“…In previous studies, we showed the usefulness of MDW as a sepsis biomarker in the ED 5 and ICU settings. 6 Moreover, we defined a reference interval (RI) for MDW using a healthy blood donor population. 3 In this study, we performed secondary analyses in the populations previously considered, 5,6 with the aim to validate a common decisional cutoff for screening sepsis in the acute setting.…”

Section: Validation Of Monocyte Distribution Width Decisional Cutoff For Sepsis Detection In the Acute Settingmentioning

confidence: 99%

Validation of monocyte distribution width decisional cutoff for sepsis detection in the acute setting

Agnello

Sasso

Vidali

et al. 2021

Int J Lab Hematology

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Monocyte distribution width as a biomarker of sepsis in the intensive care unit: A pilot study

Cited by 31 publications

References 7 publications

Monocyte distribution width (MDW) parameter as a sepsis indicator in intensive care units

Monocyte distribution width (MDW) parameter as a sepsis indicator in intensive care units

Biomarkers for Prognosis and Treatment Response in COVID-19 Patients

Validation of monocyte distribution width decisional cutoff for sepsis detection in the acute setting

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