key: cord-0685599-7hrll6u0
authors: Gama, Sergio
title: RDW shows prognostic potential in hospitalized patients with COVID‐19
date: 2022-04-29
journal: J Med Virol
DOI: 10.1002/jmv.27764
sha: 81fb3fd4c37433bbeda9cc72c5cc4001f13d7de8
doc_id: 685599
cord_uid: 7hrll6u0

A recent meta-analysis published in the Journal of Medical Virology identified a potential association between red cell distribution width (RDW) and mortality risk in patients with coronavirus disease 2019 (COVID-19). This article is protected by copyright. All rights reserved.

To the Editor, A recent meta-analysis published in the Journal of Medical Virology identified a potential association between red cell distribution width (RDW) and mortality risk in patients with coronavirus disease 2019 (COVID-19). 1 This follows similar reports elsewhere. 2,3 COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), 4 which has been associated with over 5 million deaths worldwide since December 2019. 5 RDW is a routine full blood count (FBC) parameter that reflects the level of change in size between red cells (anisocytosis) 6 and has been widely researched as an independent predictor of mortality in different hospital settings, including critically ill patients with sepsis. 7 Identifying patients with a higher risk of in-hospital mortality may enable prioritization of resources and targeted treatments directed at those at increased risk of death which could ultimately improve outcomes. Table 2 . The multivariate logistic analysis demonstrated that RDW > 14% on admission was associated with a 3.7-fold increased mortality risk in hospitalized patients with COVID-19 (p = 0.015), and this association was independent of the effects of age, WBC, neutrophils, lymphocytes, creatinine, or CRP. Age >70 years, neutrophils ≥10.2 × 10 9 /L, and lymphocytes <0.88 × 10 9 /L were also shown to be important risk factors associated with death in this patient group (Table 2) .

This study showed nonsurvivors presented with higher RDW (p = 0.004), which is comparable with other studies, 2,3 although the author reports more modest differences between sub-groups.

Regression analysis identified a significantly higher mortality risk in hospitalized patients with COVID-19 presenting with RDW greater than 14% on admission, confirming its prognostic potential. RDW has been widely researched as an independent predictor of mortality in other settings, 7 suggesting RDW may act as a generic predictor of mortality, not directly linked to specific pathological changes arising from SARS-CoV-2 infection. Despite this, RDW may play a role in the risk-stratification of hospitalized patients with COVID-19. 

Association between red blood cell distribution width and mortality and severity among patients with COVID-19: a systematic review and meta-analysis

Association of red blood cell distribution width with mortality risk in hospitalized adults with SARS-CoV-2 infection

Red blood cell distribution width (RDW) predicts COVID-19 severity: a prospective, observational study from the cincinnati SARS-CoV-2 emergency department cohort

A novel coronavirus from patients with pneumonia in China

COVID-19 Weekly Epidemiological Update

Learning more and spending less with neglected laboratory parameters: the paradigmatic case of red blood cell distribution width

Prognostic role of red blood cell distribution width in patients with sepsis: a systematic review and meta-analysis

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