Diagnostic Accuracy of Red Blood Cell Distribution Width to Platelet Ratio for Predicting Liver Fibrosis in Patients with Chronic Hepatitis B: A Meta-analysis

Chronic hepatitis-B is a liver disease caused by hepatitis B virus infection lasting for more than 6 months since the first appearance of signs and symptoms. Red Blood Cell Distribution Width (RDW) is more related to an inflammation process compared to the fibrotic stage. Increase in RDW value results from an increase in erythrocyte destruction or ineffective erythrocyte production caused by the inflammation process. The inflammation can suppress erythrocyte maturation and enable new reticulocytes to be released into blood circulation. Liver inflammation is the characteristic of chronic hepatitis B virus infection. This study aimed to know the RDW value towards the fibrotic stage in chronic hepatitis B patients. This study was a retrospective study conducted in the Dr. Wahidin Sudirohusodo Hospital Makassar. The data were taken from medical records of chronic hepatitis B patients in January 2015-July 2016. The research subjects were chronic hepatitis B patients who underwent routine blood examination for the first time when the patients had just hospitalized. The investigated was continued with fibroscan examination in Gastroenterohepathology Department of the Dr. Wahidin Sudirohusodo General Hospital. Statistical analysis was analyzed with Kruskal-Wallis test using SPSS ver.22. One hundred data of chronic hepatitis B patient consisted of 27 patients without fibrosis, 16 with moderate fibrosis and 11 with severe fibrosis were obtained in this study. Kruskal-Wallis test results showed no significant difference between RDW value with a fibrotic stage in chronic hepatitis B patient (p = 0.255). This study results showed no significant difference between RDW value and fibrotic stage in chronic hepatitis B patients. Red blood cell distribution width value cannot be used as a predictor of liver fibrosis. It is suggested to conduct further studies using larger sample size and more equally distributed sample based on fibrotic stage.

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Red Blood Cell Distribution Width, Disease Severity, and Mortality in Hospitalized Patients with SARS-CoV-2 Infection: A Systematic Review and Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm10020286 ◽

2021 ◽

Vol 10 (2) ◽

pp. 286

Author(s):

Angelo Zinellu ◽

Arduino A. Mangoni

Keyword(s):

Systematic Review ◽

Blood Cell ◽

Disease Severity ◽

Red Blood Cell ◽

Effect Size ◽

Meta Analysis ◽

Severe Illness ◽

Cell Distribution ◽

Distribution Width ◽

Red Blood Cell Distribution

The identification of biomarkers predicting disease severity and outcomes is the focus of intense research in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 infection). Ideally, such biomarkers should be easily derivable from routine tests. We conducted a systematic review and meta-analysis of the predictive role of the red blood cell distribution width (RDW), a routine hematological test, in patients with SARS-CoV-2 infection. We searched the electronic databases PubMed, Web of Science and Scopus, from January 2020 to November 2020, for studies reporting data on the RDW and coronavirus disease 2019 (COVID-19) severity, defined as severe illness or admission to the intensive care unit (ICU), and mortality. Eleven studies in 4901 COVID-19 patients were selected for the meta-analysis. Pooled results showed that the RDW values were significantly higher in patients with severe disease and non-survivors (standard mean difference, SMD = 0.56, 95% CI 0.31 to 0.81, p < 0.001). Heterogeneity between studies was extreme (I2 = 80.6%; p < 0.001). In sensitivity analysis, the effect size was not modified when each study was in turn removed (effect size range, between 0.47 and 0.63). The Begg’s (p = 0.53) and Egger’s tests (p = 0.52) showed no evidence of publication bias. No significant correlations were observed between SMD and age, gender, whole blood count, end point, study geographic area, or design. Our meta-analysis showed that higher RDW values are significantly associated with COVID-19 severity and mortality. This routine parameter might assist with early risk stratification in patients with SARS-CoV-2 infection.

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