Red blood cell distribution width: A severity indicator in patients with COVID‐19

Abstract

Red blood cell distribution width (RDW) was frequently assessed in infection and reported to be associated with adverse outcomes. However, there was no consensus regarding the optimal cutoff value for RDW. Records of 98 patients with COVID-19 from the First People's Hospital of Jingzhou were reviewed. They were divided into two groups according to the cutoff value for RDW on admission by receiver operator characteristic curve analysis: ≤11.5%(n = 50) and >11.5% (n = 48). The association of RDW with the severity and outcomes of COVID-19 was analyzed. The receiver operating characteristic curve indicated that the RDW was a good discrimination factor for identifying COVID-19 severity (area under the curve = 0.728, 95% CI: 0.626-0.830, p < 0.001). Patients with RDW > 11.5% more frequently suffered from critical COVID-19 than those with RDW ≤ 11.5% (62.5% vs. 26.0%, p < 0.001). Multivariate logistic regression analysis showed RDW to be an independent predictor for critical illness due to COVID-19 (OR = 2.40, 95% CI: 1.27−4.55, p = 0.007).A similar result was obtained when we included RDW > 11.5% into another model instead of RDW as a continuous variable (OR = 5.41, 95% CI: 1.53−19.10, p = 0.009). RDW, as an inexpensive and routinely measured parameter, showed promise as a predictor for critical illness in patients with COVID-19

The Relationship Between Prognosis and Red Cell Distribution Width (RDW) and RDW-Albumin Ratio (RAR) in Patients with Severe COVID-19 Disease

“… 3 , 22 , 27 Wang et al, reported that RDW could predict critical COVID-19 cases early when the cut-off value was >11.5%. 23 Kilercik et al, demonstrated that when the cut-off value of RDW was 13.7, it showed 75.7% sensitivity and 81.6% specificity with an AUC of 0.787, and that it was the most valuable blood parameter for estimation of disease severity. 24 Wang et al, determined that sensitivity, specificity and the AUC values were 73.1%, 80.2%, and 0.870, respectively when the cut-off value of RDW-SD was 42.15.…”

“…22 Conditions such as oxidative stress, tissue hypoxia, neuro-humoral over-activity, endothelial dysfunction and inflammation that play important roles in COVID-19 infection affect the RDW levels. 23 RDW demonstrates anisocytosis among red blood cells (RBC). Anisocytosis is mostly due to inflammation.…”

A Composite Ranking of Risk Factors for COVID-19 Time-To-Event Data from a Turkish Cohort

“…The association of red blood cell distribution width with COVID-19 severity and mortality is reported in (Foy et al 2020; C Wang et al, 2020; Wang et al, 2022).…”

A composite ranking of risk factors for COVID-19 time-to-event data from a Turkish cohort

“…D-dimer has been recommended as a quantity to monitor in COVID-19 patients ( Thachil et al, 2020) due to ample evidence of its association with disease severity ( Tang et al, 2020 , Berger et al, 2020 , Terra et al, 2022 . The association of red blood cell distribution width with COVID-19 severity and mortality is reported in ( Foy et al, 2020 , Wang et al, 2020 , 2022) . Age is perhaps the best established risk factor for severity and mortality, see, e.g.…”

“…The association of red blood cell distribution width with COVID-19 severity and mortality is reported in ( Foy et al, 2020 , Wang et al, 2020 , 2022) .…”