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

Foy, Brody H.; Carlson, Jonathan C.; Reinertsen, Erik; Valls, Raimon Padros I.; López, Roger Pallarès; Palanques-Tost, Eric; Mow, Christopher; Westover, M. Brandon; Aguirre, Aaron D.; Higgins, John M.

doi:10.1001/jamanetworkopen.2020.22058

Cited by 225 publications

(289 citation statements)

References 33 publications

(119 reference statements)

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“…To our knowledge, this is the first study in the literature that reproduces prognostic accuracy of a previously published threshold of RDW in a completely independent cohort of patients with COVID-19. The reproducibility and concordance of our data support the notion that RDW may serve as a reliable prognosticator and a clinician's friendly biomarker accessible to almost every physician in the world, for patients with COVID-19 (11).…”

Section: Discussionsupporting

confidence: 77%

“…Interestingly, our cohort exhibited lower median RDW levels (12.8%) compared to Foy et al (survivors: 13.8%, nonsurvivors:15%) (11). In addition, our cohort exhibited higher percentage of patients (n = 156, 80.8%) below the suggested cutoff threshold for RDW (14.5%) compared to Foy et al (n = 1173, 71.5%) (11).…”

Section: Discussioncontrasting

confidence: 64%

“…RDW has been suggested, in combination with hemoglobin and neutrophil to lymphocyte ratio, as a diagnostic and prognostic biomarker of COVID-19 (7-10). Recently, a large prospective study by Foy et al demonstrated that elevated baseline RDW (>14.5%) levels were independently associated with worse clinical outcomes in hospitalized patients with COVID-19 (11). Despite relative enthusiasm, peripheral blood biomarkers, including RDW, need to be validated and reproduced in multiple cohorts from different institutions to support their widespread clinical applicability.…”

Section: Introductionmentioning

confidence: 99%

“…Despite relative enthusiasm, peripheral blood biomarkers, including RDW, need to be validated and reproduced in multiple cohorts from different institutions to support their widespread clinical applicability. To this end, we aimed to further validate in a completely different cohort of patients with COVID-19 (validation cohort), derived from a low incidence and mortality country (Greece), the association of RDW threshold of 14.5%, previously published by Foy et al (derivation cohort) with markers of disease progression and mortality (11).…”

Section: Introductionmentioning

confidence: 99%

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Increased Red Cell Distribution Width Is Associated With Disease Severity in Hospitalized Adults With SARS-CoV-2 Infection: An Observational Multicentric Study

et al. 2020

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Background: There is an amenable need for clinically applicable biomarkers in patients with SARS-CoV-2 infection. Red Cell Distribution Width (RDW) has been recently suggested as a prognostic biomarker for COVID-19.Methods: This was an observational study enrolling patients between February 26 and May 15 2020. We aimed to validate the association of the previously published RDW threshold of 14.5% with markers of disease progression and mortality.Results: A total number of 193 hospitalized patients with COVID-19 were enrolled and analyzed. Median age was 61 years (95% CI: 58–64). Patients with baseline RDW ≥14.5% (n = 41, 19.2%) presented with more progressive disease compared to patients with baseline RDW <14.5% (n = 156, 80.8%) as indicated by significant differences in maximum FiO2% during hospitalization (median: 100, 95% CI: 45.2–100, vs. 35, 95% CI: 31–40, p = 0.0001, respectively). Values of RDW ≥14.5% were also strongly associated with increased risk of mortality (HR: 4.1, 95% CI: 0.88–19.23), (p = 0.02).Conclusion: Our study provides evidence to support reproducibility and validity of a specified cut-off threshold of RDW as biomarker of disease severity and mortality in patients with COVID-19.

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Section: Discussionsupporting

confidence: 77%

Section: Discussioncontrasting

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Increased Red Cell Distribution Width Is Associated With Disease Severity in Hospitalized Adults With SARS-CoV-2 Infection: An Observational Multicentric Study

et al. 2020

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“…Additionally, in our analysis, the strongest affected interaction in cardiomyocytes was observed between HSP90AA1 and MAST2. MAST2 regulates IL12 production in macrophages and shows association with red blood cell distribution width which was identified recently as a biomarker of COVID19 mortality [75]. Interestingly, MAST2 also showed an affected connection with the top bottleneck gene APP.…”

Section: Discussionmentioning

confidence: 95%

ACE2 interaction networks in COVID-19: a physiological framework for prediction of outcome in patients with cardiovascular risk factors

Wicik

Eyileten

Jakubik

et al. 2020

Preprint

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Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (coronavirus disease 2019; is associated with adverse outcome in patients with cardiovascular disease (CVD).Aim: To characterize the interaction between SARS-CoV-2 and Angiotensin Converting Enzyme 2 (ACE2) functional networks with focus on CVD.Methods: Using bioinformatic tools, network medicine approaches and publicly available datasets, we investigated ACE2 tissue expression and described ACE2 interaction network which could be affected by SARS-CoV-2 infection. We identified top ACE2 interactors, including miRNAs which are shared regulators between the ACE2, virus-infection related proteins and heart interaction networks, using lung and nervous system networks as a reference. We also identified main SARS-CoV-2 risk groups and performed drug predictions for them.Results: We found the same range of ACE2 expression confidence in respiratory and cardiovascular systems (averaging 4.48 and 4.64, respectively). Analysing the complete ACE2 interaction network, we identified 11 genes (ACE2, DPP4, ANPEP, CCL2, TFRC, MEP1A, ADAM17, FABP2, NPC1, CLEC4M, TMPRSS2) associated with virus-infection related processes. Previously described genes associated with cardiovascular risk factors DPP4, CCL2 and ANPEP were extensively connected with top regulators of ACE2 network, including ACE, INS and KNG1. Enrichment analysis revealed several disease phenotypes associated with interaction networks of ACE2, heart tissue, and virus-infection related protein, with the strongest associations with the following diseases (in decreasing rank order): obesity, hypertensive disease, noninsulin dependent diabetes mellitus, congestive heart failure, and coronary artery disease. We described for the first time microRNAs-miR (miR-302c-5p, miR-1305, miR-587, miR-26b-5p, and mir-27a-3p), which were common regulators of the three networks: ACE2, heart tissue and virus-infection related proteins.Conclusion: Our study provides novel information regarding the complexity of signaling pathways affected by SARS-CoV-2 and proposes predictive tools as miR towards personalized diagnosis and therapy in COVID-19. Additionally, our study provides a list of miRNAs with biomarker potential in prediction of adverse outcome in patients with COVID-19 and CVD.

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Disorders of red cells and platelets

2021

Blood Cells

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

Abstract: This cohort study assesses the potential use of red blood cell distribution width for risk stratification of patients with coronavirus disease 2019.

Cited by 225 publications

References 33 publications

Increased Red Cell Distribution Width Is Associated With Disease Severity in Hospitalized Adults With SARS-CoV-2 Infection: An Observational Multicentric Study

Increased Red Cell Distribution Width Is Associated With Disease Severity in Hospitalized Adults With SARS-CoV-2 Infection: An Observational Multicentric Study

ACE2 interaction networks in COVID-19: a physiological framework for prediction of outcome in patients with cardiovascular risk factors

Disorders of red cells and platelets

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