Kaufmann Christoph C, Ahmed Amro, Brunner Ulrich, Jäger Bernhard, Aicher Gabriele, Equiluz-Bruck Susanne, Spiel Alexander O, Funk Georg-Christian, Gschwantler Michael, Fasching Peter, Huber Kurt
Third Medical Department With Cardiology and Intensive Care Medicine, Wilhelminenhospital, Vienna, Austria.
Department of Laboratory Medicine, Wilhelminenhospital, Vienna, Austria.
Front Med (Lausanne). 2021 Mar 18;8:652707. doi: 10.3389/fmed.2021.652707. eCollection 2021.
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. 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. A total of 423 eligible patients with COVID-19 were included in the final analyses and 15.4% died within 28 days ( = 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), < 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; = < 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; = 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]; = 0.187]. In this population, RDWwas a significant, independent prognostic marker of short-term mortality in patients with COVID-19.
冠状病毒病（COVID-19）于2019年底在中国首次被发现，此后已蔓延至全球。红细胞分布宽度（RDW）在多种疾病中是一种有效的预后标志物，最近有人提出它在COVID-19中具有预后价值。这项对COVID-19连续患者进行的回顾性观察研究于2020年3月12日至2020年12月4日在奥地利维也纳的威廉明娜医院开展。收集了入院时的RDW水平，并测试其对28天死亡率的预测价值。最终分析纳入了423例符合条件的COVID-19患者，其中15.4%在28天内死亡（n = 65）。与幸存者相比，非幸存者的RDW中位数水平显著更高[14.6%（四分位间距，13.7 - 16.3）对13.4%（四分位间距，12.7 - 14.4），P < 0.001]。RDW升高是28天死亡率的显著预测因素[粗比值比（OR）1.717，95%置信区间（CI）1.462 - 2.017；P = < 0.001]，独立于临床混杂因素、合并症以及已确立的COVID-19预后标志物（最终模型的调整后OR为1.368，95% CI 1.126 - 1.662；P = 0.002）。亚组分析时这种关联依然一致。我们的研究数据还表明，COVID-19入院时的RDW水平与先前记录的非COVID-19相关的RDW水平相似[14.2%（四分位间距，13.3 - 15.7）对14.0%[四分位间距，13.2 - 15.1]；P = 0.187]。在该人群中，RDW是COVID-19患者短期死亡率的一个显著、独立的预后标志物。
