Red Blood Cell Distribution Width in Hospitalized COVID-19 Patients

Introduction: Coronavirus disease-2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is causing dramatic morbidity and mortality worldwide. The Red Blood Cell Distribution Width (RDW) has been strongly associated with increased morbidity and mortality in multiple diseases.Objective: To assess if elevated RDW is associated with unfavorable outcomes in hospitalized COVID-19.Methods: We retrospectively studied clinical outcomes of hospitalized COVID-19 patients for their RDW values. In-hospital mortality was defined as primary outcome, while septic shock, need for mechanical ventilation, and length of stay (LOS) were secondary outcomes.Results: A total of 294 COVID-19 patients were finally studied. Overall prevalence of increased RDW was 49.7% (146/294). RDW was associated with increased risk of in-hospital mortality (aOR, 4.6; 95%CI, 1.5-14.6) and septic shock (aOR, 4.6; 95%CI, 1.4-15.1) after adjusting for anemia, ferritin, lactate, and absolute lymphocyte count. The association remained unchanged even after adjusting for other clinical confounders such as age, sex, body mass index, coronary artery disease, hypertension, diabetes mellitus, and chronic obstructive pulmonary disease. No association was found instead with mechanical ventilation and median LOS.Conclusion: Elevated RDW in hospitalized COVID-19 patients is associated with a significantly increased risk of mortality and septic shock.

Correlation between Red Blood Cell Distribution width, Neutrophil to Lymphocyte Ratio and Neutrophil to Platelet Ratio with 3-month Prognosis of Patients with Intracerebral Hemorrhage: A Retrospective Study

Background: Red cell distribution width (RDW) is a parameter that indicates the heterogeneity of red blood cell size and could be as a prognostic factor in some diseases. Also, intracerebral hemorrhage (ICH) is considered a vascular event with a high mortality rate. Here, we aimed to examine the role of RDW, neutrophil to lymphocyte (NLR) and neutrophil to platelet ratios (NPR) in predicting the prognosis of patients with ICH.Methods: This is a retrospective cohort study which conducted on 140 patients with ICH admitted to the neurology ward and intensive care unit (ICU) in Imam Reza Hospital, Tabriz, Iran. Demographic data, National Institutes of Health Stroke Scale (NIHSS), and complete blood count (CBC) test parameters evaluated within 24 hours after hospitalization. These variables collected and re-evaluated three months later. Results: The mean age of the study population was 61.14 (±16) years and 51% were male. RDW had a significant positive correlation with hemoglobin concentration (r=0.3; p<0.001) and significant negative correlation with MCHC (r=-0.57; p<0.001) and neutrophil count (r=-0.235; p=0.006). Also, the mean NLR (p=0.05), neutrophil and platelet count (p=0.05), NIHSS (p=0.05), and RDW (p=0.01) had a significant difference between the deceased patients and those who partially recovered after 3 months. Moreover, the results of logistic regression showed variables including RDW (p=0.006) and NIHSS (p<0.001) levels were correlated significantly with mortality. Conclusion: RDW could be an appropriate prognostic factor and predictor in determining 3-months survival in ICH. Nevertheless, further large-scale prospective cohorts might be needed to evaluate the associations.