Department of Anaesthesia, Pain Medicine & Critical Care, AIIMS, New Delhi, India.
Rev Med Virol. 2022 Mar;32(2):e2264. doi: 10.1002/rmv.2264. Epub 2021 Jun 6.
The red blood cell distribution width (RDW), an indicator of anisocytosis has emerged as a potential tool for risk stratification of critically ill patients with sepsis. Prognostic predictors are of paramount interest for prompt intervention and optimal utilization of the healthcare system in this ongoing context of the Coronavirus Disease 2019 (COVID-19) pandemic. The current systematic review and meta-analysis aims to explore the utility of RDW in the prognosis of COVID-19 patients. A comprehensive screening of electronic databases was performed up to 30th April 2021 after enrolling in PROSPERO (CRD42020206685). Observational studies or interventional studies, evaluating the impact of RDW in COVID-19 outcomes (mortality and severity) are included in this meta-analysis.Our search retrieved 25 studies, with a total of 18,392 and 3,446 COVID-19 patients for mortality and disease severity outcomes. Deceased and critically ill patients had higher RDW levels on admission in comparison to survivors and non-severe patients (SMD = 0.46; 95%CI 0.31-0.71; I = 88% and SMD = 0.46; 95%CI 0.26-0.67; I = 60%, respectively). In a sub-group analysis of 2,980 patients, RDW > 14.5 has been associated with increased risk of mortality (OR = 2.73; 95%CI 1.96-3.82; I = 56%). However, the evidences is of low quality. A higher level of RDW on admission in COVID-19 patients is associated with increased morbidity and mortality. However, further studies regarding the cut-off value of RDW are the need of the hour.
红细胞分布宽度（RDW）是不均一性的指标，已成为脓毒症危重症患者风险分层的潜在工具。在当前 2019 年冠状病毒病（COVID-19）大流行的背景下，预后预测指标对于及时干预和优化医疗保健系统的利用至关重要。本系统评价和荟萃分析旨在探讨 RDW 在 COVID-19 患者预后中的应用。在 PROSPERO（CRD42020206685）注册后，我们对电子数据库进行了全面筛选，截止日期为 2021 年 4 月 30 日。本荟萃分析纳入了评估 RDW 对 COVID-19 结局（死亡率和严重程度）影响的观察性研究或干预性研究。我们的检索共获得了 25 项研究，其中有 18392 例和 3446 例 COVID-19 患者的死亡率和疾病严重程度结局。与存活者和非重症患者相比，死亡和重症患者入院时的 RDW 水平更高（SMD=0.46；95%CI 0.31-0.71；I²=88%和 SMD=0.46；95%CI 0.26-0.67；I²=60%）。在 2980 例患者的亚组分析中，RDW＞14.5 与死亡率增加相关（OR=2.73；95%CI 1.96-3.82；I²=56%）。然而，证据质量较低。COVID-19 患者入院时较高的 RDW 水平与发病率和死亡率增加相关。然而，目前需要进一步研究 RDW 的临界值。
