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Red Cell Distribution Width Upon Hospital Admission Predicts Short-Term Mortality in Hospitalized Patients With
Christoph C Kaufmann1, Amro Ahmed1, Ulrich Brunner1
1Third Medical Department With Cardiology and Intensive Care Medicine, Wilhelminenhospital, Vienna, Austria.
Insights
Red cell distribution width (RDW) is a significant predictor of short-term mortality in COVID-19 patients. Higher RDW levels on admission indicate increased risk, independent of other factors, aiding in prognosis.
Area of Science:
- Medical Science
- Clinical Medicine
- Hematology
Background:
- Coronavirus disease (COVID-19) emerged in late 2019 and rapidly became a global pandemic.
- Red cell distribution width (RDW) is recognized as a prognostic indicator in various medical conditions.
- Emerging evidence suggests RDW may also hold prognostic value in COVID-19 patients.
Purpose of the Study:
- To investigate the prognostic value of Red cell distribution width (RDW) in predicting 28-day mortality in patients diagnosed with COVID-19.
- To assess whether RDW levels on admission can serve as an independent predictor of short-term mortality in COVID-19.
Main Methods:
- A retrospective, observational study was conducted with 423 consecutive COVID-19 patients admitted between March 12, 2020, and December 4, 2020.
- Red cell distribution width (RDW) levels were collected upon patient admission.
- Statistical analyses were performed to evaluate the predictive value of RDW for 28-day mortality, including adjustment for confounders.
Main Results:
- A total of 423 patients were analyzed, with a 28-day mortality rate of 15.4% (65 deaths).
- Median RDW levels were significantly higher in non-survivors compared to survivors (14.6% vs. 13.4%, P < 0.001).
- Elevated RDW independently predicted 28-day mortality (adjusted OR 1.368, P = 0.002), even after accounting for clinical factors and comorbidities.
Conclusions:
- Red cell distribution width (RDW) is a significant and independent prognostic marker for short-term mortality in COVID-19 patients.
- RDW levels measured on admission can aid in assessing the risk of mortality in COVID-19.
- The prognostic utility of RDW in COVID-19 is consistent and independent of established risk factors.
Abstract:
Background: Coronavirus disease (COVID-19) was first described at the end of 2019 in China and has since spread across the globe. Red cell distribution width (RDW) is a potent prognostic marker in several medical conditions and has recently been suggested to be of prognostic value in COVID-19. Methods: This retrospective, observational study of consecutive patients with COVID-19 was conducted from March 12, 2020 to December 4, 2020 in the Wilhelminenhospital, Vienna, Austria. RDWlevels on admission were collected and tested for their predictive value of 28-day mortality. Results: A total of 423 eligible patients with COVID-19 were included in the final analyses and 15.4% died within 28 days (n = 65). Median levels of RDWwere significantly higher in non-survivors compared to survivors [14.6% (IQR, 13.7-16.3) vs. 13.4% (IQR, 12.7- 14.4), P < 0.001]. Increased RDW was a significant predictor of 28-day mortality [crude odds ratio (OR) 1.717, 95% confidence interval (CI) 1.462-2.017; P = < 0.001], independent of clinical confounders, comorbidities and established prognostic markers of COVID-19 (adjusted OR of the final model 1.368, 95% CI 1.126-1.662; P = 0.002). This association remained consistent upon sub-group analysis. Our study data also demonstrate that RDW levels upon admission for COVID-19 were similar to previously recorded, non-COVID-19 associated RDW levels [14.2% (IQR, 13.3-15.7) vs. 14.0% [IQR, 13.2-15.1]; P = 0.187]. Conclusions: In this population, RDWwas a significant, independent prognostic marker of short-term mortality in patients with COVID-19.
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