The association between red cell distribution width and poor outcomes in hospitalized patients with influenza

Topaz, Guy; Kitay-Cohen, Yona; Peled, Lee; Gharra, Wesal; Kaminer, Keren; Eitan, Mayan; Mahamid, Lamis; Shilo, Lotan

doi:10.1016/j.jcrc.2017.05.014

Cited by 17 publications

(17 citation statements)

References 18 publications

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“…Higher RDW was found in influenza patients compared to healthy controls, although there was no difference between the COVID-19 group and the other groups. Topaz et al showed that higher RDW was a predictor of severe hospital complications in patients with influenza [20]. Foy et al showed a relation between elevated RDW (>14.5%) and mortality in COVID-19 patients [21].…”

Section: Discussionmentioning

confidence: 99%

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The role of haematological parameters in patients with COVID-19 and influenza virus infection

Kazancıoğlu

Baştuğ²,

Özbay

et al. 2020

Epidemiol. Infect.

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SARS-CoV-2, the causative agent of coronavirus disease 19 (COVID-19), was identified in Wuhan, China. Since then, the novel coronavirus started to be compared to influenza. The haematological parameters and inflammatory indexes are associated with severe illness in COVID-19 patients. In this study, the laboratory data of 120 COVID-19 patients, 100 influenza patients and 61 healthy controls were evaluated. Lower lymphocytes, eosinophils, basophils, platelets and higher delta neutrophil index (DNI), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were found in COVID-19 and influenza groups compared to healthy controls. The eosinophils, lymphocytes and PLR made the highest contribution to differentiate COVID-19 patients from healthy controls (area under the curves (AUCs): 0.819, 0.817 and 0.716, respectively; P-value is <0.0001 for all). The NLR, the optimal cutoff value was 3.58, which resulted in a sensitivity of 30.8 and a specificity of 100 (AUC: 0.677, P < 0.0001). Higher leucocytes, neutrophils, DNI, NLR, PLR and lower lymphocytes, red blood cells, haemoglobin, haematocrit levels were found in severe patients at the end of treatment. Nonsevere patients showed an upward trend for lymphocytes, eosinophils and platelets, and a downward trend for neutrophils, DNI, NLR and PLR. However, there was an increasing trend for eosinophils, platelets and PLR in severe patients. In conclusion, NLR and PLR can be used as biomarkers to distinguish COVID-19 patients from healthy people and to predict the severity of COVID-19. The increasing value of PLR during follow-up may be more useful compared to NLR to predict the disease severity.

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Section: Discussionmentioning

confidence: 99%

“…Topaz et al . showed that higher RDW was a predictor of severe hospital complications in patients with influenza [20]. Foy et al .…”

Section: Discussionmentioning

confidence: 99%

The role of haematological parameters in patients with COVID-19 and influenza virus infection

Kazancıoğlu

Baştuğ²,

Özbay

et al. 2020

Epidemiol. Infect.

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“…It is therefore likely that the major contributor to RDW elevation in this cohort is an increase in RBC volume variance. RDW is a non-specific marker of general illness [8][9][10][11][12][13][14][15][16][17] and is therefore unlikely to be causally related to COVID-19 disease progression. COVID-19 is associated with altered turnover in all WBC lineages as noted above as well as with altered platelet dynamics in COVIDassociated coagulopathy.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7] Elevated RDW is associated with increased risk for a remarkably wide range of morbidity and mortality: all-cause mortality, mortality from heart disease, pulmonary disease, sepsis, influenza, and cancer; complications in heart failure, severity of coronary artery disease and viral hepatitis; advanced stage and grade for many cancers; development of diabetes, chronic obstructive pulmonary disease, stroke, anemia, and many more. [8][9][10][11][12][13][14][15][16][17] RDW thus appears to represent a non-specific marker of illness with the potential to provide general quantitative prognostic value that may be particularly powerful for a new and unknown disease. RDW is the coefficient of variation in RBC volume, or the standard deviation divided by the mean.…”

Section: Introductionmentioning

confidence: 99%

Elevated RDW is Associated with Increased Mortality Risk in COVID-19

Foy

Carlson

Reinertsen

et al. 2020

Preprint

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BackgroundCoronavirus disease 2019 is an acute respiratory illness with a high rate of hospitalization and mortality. Prognostic biomarkers are urgently needed. Red blood cell distribution width (RDW), a component of complete blood counts that reflects cellular volume variation, has been shown to be associated with elevated risk for morbidity and mortality in a wide range of diseases. MethodsWe retrospectively studied the relationship between RDW and COVID-19 mortality risk for 1198 adult patients diagnosed with SARS-CoV-2 at 4 Partners ResultsElevated RDW (> 14.5%) was associated with increased mortality in patients of all ages with a risk ratio of 2.5 (95% CI, 2.3 -2.8). Stratified by age, the risk ratio was 6.2 (4.4 -7.9, N = 312) < 50 years, 3.2 (2.5 -4.1, N = 230) 50-60, 2.3 (1.6 -3.1, N = 236) 60-70, 1.2 (0.7 -1.8, N = 203) 70-80, and 1.9 (1.5 -2.3, N = 216) > 80 years. RDW was significantly associated with mortality in Cox proportional hazards models adjusted for age, D-Dimer, absolute lymphocyte count, and common comorbidities (p < 1e-4 for RDW in all cases). Patients whose RDW increased during admission had a ~3-fold elevation in mortality risk compared to those whose RDW did not change. ConclusionsElevated RDW at diagnosis and an increase in RDW during admission are both associated with increased mortality risk for adult COVID-19 patients at a large academic medical center network.

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“… 5 , 6 , 7 Elevated RDW is associated with an increased risk for all-cause mortality; mortality from heart disease, pulmonary disease, sepsis, influenza, and cancer; complications associated with heart failure, severity of coronary artery disease and viral hepatitis, advanced stage and grade for many cancers; and the development of diabetes, chronic obstructive pulmonary disease, stroke, anemia, and many other conditions. 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 RDW appears to be a nonspecific marker of illness that has the potential to provide general quantitative risk stratification that may be particularly useful for a new and unknown disease.…”

Section: Introductionmentioning

confidence: 99%

Association of Red Blood Cell Distribution Width With Mortality Risk in Hospitalized Adults With SARS-CoV-2 Infection

et al. 2020

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The association between red cell distribution width and poor outcomes in hospitalized patients with influenza

Cited by 17 publications

References 18 publications

The role of haematological parameters in patients with COVID-19 and influenza virus infection

The role of haematological parameters in patients with COVID-19 and influenza virus infection

Elevated RDW is Associated with Increased Mortality Risk in COVID-19

Association of Red Blood Cell Distribution Width With Mortality Risk in Hospitalized Adults With SARS-CoV-2 Infection

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