Prognosis of COVID-19: Red Cell Distribution Width, Platelet Distribution Width, and C-Reactive Protein

Gowda, Shivakumar Bommenahalli; Gosavi, Siddharth; Rao, Amogh Ananda; Shastry, Shashank; Raj, Sunil Saksena; Menon, Sanjana; Suresh, Ashutosh; Sharma, Anirudha

doi:10.7759/cureus.13078

Cited by 27 publications

(28 citation statements)

References 11 publications

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“…In contrast to what observed in adults [1][2][3], our results do not suggest the existence of clinically significant differences in RDW values in children (0-16 years) according to illness categories, hospitalization, and presence of MIS-C, days of hospitalization or viral load (CT values).…”

Section: Discussioncontrasting

confidence: 99%

“…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).…”

Section: Introductionmentioning

confidence: 98%

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SARS-COV-2 Infection in Children and Red Blood Cell Distribution Width

Kuekou

Palandri²,

Pouplin

et al. 2021

Cureus

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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.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 98%

SARS-COV-2 Infection in Children and Red Blood Cell Distribution Width

Kuekou

Palandri²,

Pouplin

et al. 2021

Cureus

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“…RDW conveys the degree of anisocytosis, which is a hugely inflammation-dependent process. Cytokine release and inflammation lead to higher platelet production, and increased PDW and RDW are associated with increased mortality in adults [ 28 ]. In our study, inpatients had statistically higher RDW while there was no significant difference of PDW levels between inpatients and outpatients.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of hematological parameters and inflammatory markers in children with COVID-19

et al. 2021

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Background The aim of this study was to evaluate hematological parameters in children with COVID-19 and determine the effects of inflammatory biomarkers on the assessment of hospitalization. Methods This retrospective single-center study was performed on 633 children with COVID-19 between March 2020 and January 2021. The study population was separated into two groups: inpatients ( n = 83) and outpatients ( n = 550). Univariate and multivariate logistic regression was applied to identify risk factors for hospitalization. Results Lymphopenia ( n = 228, 36%) was found mainly to be a hematological abnormality in all cases. Compared with outpatients, inpatients had significantly higher white blood cell (WBC) ( p = 0.005), lymphocyte ( p < 0.001), and platelet counts ( p = 0.036), and significantly higher red cell distribution width ( p = 0.001), C-reactive protein (CRP) ( p = 0.003), procalcitonin ( p = 0.001), d -dimer ( p < 0.001), and lymphocyte to monocyte ratio values ( p = 0.004). On the other hand, they had significantly lower values of hemoglobin ( p < 0.001), neutrophil to lymphocyte ratio ( p = 0.024), platelet lymphocyte ratio ( p = 0.001), derivated neutrophil to lymphocyte ratio ( p = 0.037), and mean platelet volume to lymphocyte ratio ( p < 0.001). ROC analysis showed that WBC, CRP, and procalcitonin cutoff values were the best discriminated between inpatients and outpatients. The results for the areas under the curve of WBC, CRP, and procalcitonin used to assess patients’ hospitalization were 0.595 (95% CI 0.519–0.670, p = 0.005), 0.599 (95% CI 0.527–0.672, p = 0.003), and 0.599 (95% CI 0.525–0.673, p = 0.004), respectively. Conclusion We suggest that high WBC and procalcitonin levels can be used as independent predictors of hospitalization in children with COVID-19.

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“…Eight studies reported using MPV in COVID-19 patients who survived and died [19, 24, 25, 37, 38, 40-42]. All studies measured survival and death, except Barrett et al [25] who measured hospitalised patients who had a thrombotic event and death.…”

Section: Resultsmentioning

confidence: 99%

“…Five studies reported using PDW in COVID-19 patients who survived and died [19, 24, 38, 40, 41]. The pooled mean difference of the PDW values was significantly higher in the non-survivors (SMD = 0.45 [95% CI: 0.19, 0.71], p = 0.0007, n = 948); however, there was substantial heterogeneity by the random effect model ( I 2 = 68%) (Supplementary material 5: Figure 2).…”

Section: Resultsmentioning

confidence: 99%

Platelet size as a predictor for severity and mortality in COVID-19 patients: a systematic review and meta-analysis

Daniels

Hua

Denning

2021

Preprint

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Background: Parameters reflecting platelet size can be sensitive indicators that circulating platelets are activated and COVID-19 patients are at increased risk of thrombosis. This systematic review aims to assess the association of mean platelet volume (MPV), platelet distribution width (PDW) and platelet-large cell ratio (P-LCR) with disease severity and mortality in COVID-19 patients. Methods: English and Chinese databases were searched electronically to identify studies reporting data on MPV, PDW or P-LCR in COVID-19 patients. Included articles underwent a quality rating. A meta-analysis was performed using the standard mean difference and interpreted as the common language effect size (CLES). Results: Twenty-two studies (11,906 patients) were included in the meta-analysis. Of these, 14 were rated poor and eight were fair. The MPV and P-LCR was significantly higher at hospital admission in severe patients compared to non-severe patients. The MPV, PDW and P-LCR were significantly higher at hospital admission in non-survivors compared to survivors. There was a marked increase in the probability of a severe COVID-19 patient presenting with higher P-LCR at hospital admission than a non-severe patient (CLES: 68.7% [95% CI: 59.8%, 76.5%]), when compared with MPV and PDW ((CLES: 59.2% [95% CI: 53.1%, 65.1%]) and (CLES: 55.9% [95% CI: 50.6%, 62.2%]), respectively). Conclusion: Severe COVID-19 disease is associated with the increased production of larger, younger platelets. When comparing MPV, PDW and P-LCR, P-LCR is the most important biomarker for evaluating platelet activity. P-LCR testing at hospital admission could identify COVID-19 patients with increased risk for thrombotic events, allowing preventative treatment.

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Prognosis of COVID-19: Red Cell Distribution Width, Platelet Distribution Width, and C-Reactive Protein

Abstract: Bommenahalli Gowda et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Cited by 27 publications

References 11 publications

SARS-COV-2 Infection in Children and Red Blood Cell Distribution Width

SARS-COV-2 Infection in Children and Red Blood Cell Distribution Width

Evaluation of hematological parameters and inflammatory markers in children with COVID-19

Platelet size as a predictor for severity and mortality in COVID-19 patients: a systematic review and meta-analysis

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