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

Theodoros Karampitsakos; Karolina Akinosoglou; Ourania Papaioannou; Vassiliki Panou; Athanasios Koromilias; Petros Bakakos; Stelios Loukides; Demosthenes Bouros; Charalampos Gogos; Argyrios Tzouvelekis

doi:10.3389/fmed.2020.616292

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

Front Med (Lausanne). 2020 Dec 11:7:616292. doi: 10.3389/fmed.2020.616292. eCollection 2020.

Affiliations

¹ Department of Respiratory Medicine, University Hospital of Patras, Patras, Greece.
² Department of Internal Medicine, University General Hospital of Patras, Patras, Greece.
³ First Academic Department of Pneumonology, Hospital for Diseases of the Chest, "Sotiria," Medical School, National and Kapodistrian University of Athens, Athens, Greece.
⁴ Second Academic Department of Respiratory Medicine, ATTIKON General Hospital, National and Kapodistrian University of Athens, Athens, Greece.

Abstract

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.

Keywords: COVID-19; SARS-CoV-2; biomarkers; mortality; red cell distribution width (RDW).