Jandaghian Setareh, Vaezi Atefeh, Manteghinejad Amirreza, Nasirian Maryam, Vaseghi Golnaz, Haghjooy Javanmard Shaghayegh
Applied Physiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Setareh Jandaghian and Atefeh Vaezi are co-first authors.
Arch Acad Emerg Med. 2021 Oct 13;9(1):e67. doi: 10.22037/aaem.v9i1.1325. eCollection 2021.
Red blood cell distribution width (RDW) has been introduced as a predictive factor for mortality in several critical illnesses and infectious diseases. This study aimed to assess the possible relationship between RDW on admission and COVID-19 in-hospital mortality.
This cross-sectional study was performed using the Isfahan COVID-19 registry. Adult confirmed cases of COVID-19 admitted to four hospitals affiliated with Isfahan University of Medical Sciences in Iran were included. Age, sex, O2 saturation, RDW on admission, Intensive Care Unit admission, laboratory data, history of comorbidities, and hospital outcome were extracted from the registry. Cox proportional hazard regression was used to study the independent association of RDW with mortality.
4152 patients with the mean age of 61.1 ± 16.97 years were included (56.2% male). 597 (14.4%) cases were admitted to intensive care unit (ICU) and 477 (11.5%) cases died. The mortality rate of patients with normal and elevated RDW was 7.8% and 21.2%, respectively (OR= 3.1, 95%CI: 2.6-3.8), which remained statistically significant after adjusting for age, O2 saturation, comorbidities, and ICU admission (2.03, 95% CI: 1.68-2.44). Moreover, elevated RDW mortality Hazard Ratio in patients who were not admitted to ICU was higher than ICU-admitted patients (3.10, 95% CI: 2.35-4.09 vs. 1.47, 95% CI: 1.15-1.88, respectively).
The results support the presence of an association between elevated RDW and mortality in patients with COVID-19, especially those who were not admitted to ICU. It seems that elevated RDW can be used as a predictor of mortality in COVID-19 cases.
红细胞分布宽度（RDW）已被视为多种危重病和传染病死亡率的预测因素。本研究旨在评估入院时的RDW与新冠肺炎住院死亡率之间的可能关系。
本横断面研究使用了伊斯法罕新冠肺炎登记册。纳入了伊朗伊斯法罕医科大学附属四家医院收治的成年新冠肺炎确诊病例。从登记册中提取年龄、性别、血氧饱和度、入院时的RDW、重症监护病房入院情况、实验室数据、合并症病史和医院结局。采用Cox比例风险回归研究RDW与死亡率的独立关联。
纳入4152例患者，平均年龄61.1±16.97岁（男性占56.2%）。597例（14.4%）患者入住重症监护病房（ICU），477例（11.5%）患者死亡。RDW正常和升高的患者死亡率分别为7.8%和21.2%（OR=3.1，95%CI：2.6 - 3.8），在调整年龄、血氧饱和度、合并症和ICU入院情况后仍具有统计学意义（2.03，95%CI：1.68 - 2.44）。此外，未入住ICU患者的RDW升高导致的死亡风险比高于入住ICU的患者（分别为3.10，95%CI：2.35 - 4.09和1.47，95%CI：1.15 - 1.88）。
结果支持RDW升高与新冠肺炎患者死亡率之间存在关联，尤其是未入住ICU的患者。似乎RDW升高可作为新冠肺炎病例死亡率的预测指标。
