key: cord-1031527-fzimugbh
authors: Lucijanic, Marko; Soric, Ena; Sedinic Lacko, Martina; Sabljic, Anica; Krecak, Ivan; Bistrovic, Petra; Jordan, Ana; Manola, Sime; Jaksic, Ozren; Lucijanic, Tomo; Derek, Lovorka; Kusec, Rajko
title: Gradual increase in red cell distribution width is similarly prognostic for in‐hospital mortality in both anemic and non‐anemic COVID‐19 patients
date: 2022-04-21
journal: J Med Virol
DOI: 10.1002/jmv.27785
sha: 11bef71e14f24701f5178ed7e44810db14aab8ad
doc_id: 1031527
cord_uid: fzimugbh

We comment on the recently published paper reporting RDW prognostic properties to be restricted to non-anemic COVID-19 patients only (Rapp JL, Tremblay D, Alpert N, et al. Red cell distribution width is associated with mortality in non-anemic patients with COVID-19. J Med Virol. 2021;93(7):4130-4132.). Based on a large cohort of COVID-19 patients (5872) from our tertiary level institution (University hospital Dubrava) we show that negative prognosis of increasing RDW is present in both patients with and without anemia and is similar for each RDW percentage point. Also, association of increasing RDW with inferior survival is preserved in both patient subgroups with and without anemia after adjustments for clinically important parameters. We comment on possible differences and meaning of these findings. This article is protected by copyright. All rights reserved.

associations in these two groups of patients.

We retrospectively investigated a total of 5872 consecutive Gradual increase in in-hospital mortality was present with each increasing RDW percentage point in both non-anemic and anemic patients (p for trend <0.001 for both subgroups; Figure 1A ). There was a statistically significant interaction between RDW, anemia, and death (p < 0.001), however, no significant differences in in-hospital mortality could be shown between non-anemic and anemic patients in any of the particular RDW subgroups (p > 0.05 for all comparisons). There are several important points that we would like to emphasize. Negative prognostic properties of higher RDW values seem to be present both in patients with and without anemia and increase with each rising RDW percentage point regardless of anemia status. These phenomena persist in both non-anemic and anemic subgroups of patients after adjusting analyses for clinically important parameters. Since anemia is associated with increase in anisocytosis, same degree of elevation in RDW in nonanemic patients is probably achieved due to more pronounced inflammation and comorbidities burden (among other possible causes of increased RDW). This is probably the reason why prognostic impact of increasing RDW was more pronounced in

High red cell distribution width at the time of ST segment elevation myocardial infarction is better at predicting diastolic than systolic left ventricular dysfunction: a single-center prospective cohort study

Clinical and prognostic significance of anisocytosis measured as a red cell distribution width in patients with colorectal cancer

Higher red blood cell distribution width predicts thrombosis risk in primary and secondary myelofibrosis

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

Red cell distribution width is associated with mortality in non-anemic patients with COVID-19

Red cell distribution width is a potent prognostic parameter for in-hospital and post-discharge mortality in hospitalized coronavirus disease 2019 patients: a registry-based cohort study on 3941 patients