Maccabitech Institute for Research & Innovation, Maccabi Healthcare Services, Tel Aviv, Israel.
Kahn Sagol Maccabi Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv, Israel.
Ann Med. 2021 Dec;53(1):1410-1418. doi: 10.1080/07853890.2021.1968484.
Red blood cell distribution width (RDW) has been assessed during COVID-19 patient hospitalization, however, further research should be done to evaluate RDW from routine community blood tests, before infection, as a risk factor for COVID-19 related hospitalization and mortality.
RDW was measured as a predictor along with age, sex, chronic illnesses, and BMI in logistic regressions to predict hospitalization and mortality. Hospitalization and mortality odds ratios (ORs) were estimated with 95% confidence intervals (CI). RDW was evaluated separately as continuous and discrete (High RDW ≥ 14.5) variables.
Four thousand one hundred and sixty-eight patients were included in this study, where 824 patients (19.8%) had a high RDW value ≥14.5% (High RDW: 64.7% were female, mean age 58 years [±22] Normal RDW: 60.2% female, mean age 46 years [±19]). Eight hundred and twenty-nine patients had a hospitalization, where the median time between positive PCR and hospital entry was 5 [IQR 1-18] days. Models were analyzed with RDW (continuous) and adjusted for age, sex, comorbidities, and BMI suggested an OR of 1.242 [95% CI = 1.187-2.688] for hospitalization and an OR of 2.911 [95% CI = 1.928-4.395] for mortality ( < .001). RDW (discrete) with the same adjustments presented an OR of 2.232 [95% CI = 1.853-1.300] for hospitalization and an OR of 1.263 [95% CI = 1.166-1.368] for mortality ( < .001).
High RDW values obtained from community blood tests are associated with greater odds of hospitalization and mortality for patients with COVID-19.KEY MESSAGESRDW measures before SARS-CoV-2 infection is a predictive factor for hospitalization and mortality.RDW threshold of 14.5% provides high sensitivity and specificity for COVID-19 related mortality, comparatively to other blood tests.Patient records should be accessed by clinicians for prior RDW results, if available, followed by further monitoring.
在 COVID-19 患者住院期间已经评估了红细胞分布宽度（RDW），但是，应该进一步研究在感染之前从常规社区血液检查中获得的 RDW，作为 COVID-19 相关住院和死亡的危险因素。
将 RDW 与年龄、性别、慢性疾病和 BMI 一起作为预测因子进行逻辑回归分析，以预测住院和死亡。使用 95%置信区间（CI）估计住院和死亡的优势比（OR）。RDW 分别作为连续和离散（高 RDW≥14.5）变量进行评估。
本研究共纳入 4168 例患者，其中 824 例（19.8%）高 RDW 值≥14.5%（高 RDW：64.7%为女性，平均年龄 58 岁[±22]；正常 RDW：60.2%为女性，平均年龄 46 岁[±19]）。829 例患者住院，阳性 PCR 与住院之间的中位时间为 5[IQR 1-18]天。用 RDW（连续）进行模型分析，并调整年龄、性别、合并症和 BMI，提示住院的 OR 为 1.242[95%CI=1.187-2.688]，死亡率的 OR 为 2.911[95%CI=1.928-4.395]（ < .001）。具有相同调整的 RDW（离散）显示住院的 OR 为 2.232[95%CI=1.853-1.300]，死亡率的 OR 为 1.263[95%CI=1.166-1.368]（ < .001）。
从社区血液检查中获得的高 RDW 值与 COVID-19 患者的住院和死亡几率更高相关。
在 SARS-CoV-2 感染之前测量的 RDW 是住院和死亡的预测因素。RDW 阈值为 14.5%，与其他血液检查相比，对 COVID-19 相关死亡率具有较高的灵敏度和特异性。如果有患者记录可供临床医生访问，则应先获取之前的 RDW 结果，然后再进行进一步监测。
