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

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.

Could red cell distribution width be used for predicting cardiac injury in neonates with COVID‐19?

“…Numerous studies have shown that RDW is an independent prognostic factor for adults admitted to emergency departments 3,28,29 . Contrary to what was observed in adults, no significant relationship has been demonstrated between RDW and hospitalization for COVID‐19 or MIS‐C in the pediatric age group 30 . The hemopoietic system is affected by aging, especially in terms of bone marrow cellularity, but these effects become apparent after the age of 65 years.…”

“… 3 , 28 , 29 Contrary to what was observed in adults, no significant relationship has been demonstrated between RDW and hospitalization for COVID‐19 or MIS‐C in the pediatric age group. 30 The hemopoietic system is affected by aging, especially in terms of bone marrow cellularity, but these effects become apparent after the age of 65 years. This suggests that RDW may be a stronger prognostic factor in COVID‐19‐infected adults than in infants, whose bone marrow can rapidly replace defective RBCs.…”

Symptom clusters helping the assessment of SARS-COV-2-infected children: Amiens cohort versus European data

“…Being able to identify symptom clustering and how they are related to disease severity and outcome may help implement a clinical bedside approach which may prove to be more useful than a radiological one in predicting child management and allowing a better resource allocation. [17,23]…”

“…Being able to identify symptom clustering and how they are related to disease severity and outcome may help implement a clinical bedside approach which may prove to be more useful than a radiological one in predicting child management and allowing a better resource allocation. [17,23] Regarding VL values, the literature data show contrasting evidence on the VL association with disease severity [24][25][26][27] or age. [28][29][30] Studies in children are limited to a small population with conflicting results about the comparability of VL in children with COVID-19, despite well-defined cohorts of adult studies.…”