Jordan Ana, Trkulja Vladimir, Jurin Ivana, Marević Sanja, Đerek Lovorka, Lukšić Ivica, Manola Šime, Lucijanić Marko
Cardiology Department, University Hospital Dubrava, 10000 Zagreb, Croatia.
School of Medicine, University of Zagreb, 10000 Zagreb, Croatia.
Life (Basel). 2024 Oct 5;14(10):1267. doi: 10.3390/life14101267.
Higher red blood cell distribution width (RDW) levels have gained attention in the prognostication of many chronic metabolic and malignant diseases, as well as coronavirus disease 2019 (COVID-19). We aimed to evaluate whether accounting for RDW might contribute to risk stratification when added to commonly used risk scoring systems in adult COVID-19 patients. We retrospectively analyzed a cohort of 3212 non-critical COVID-19 patients hospitalized in a tertiary-level institution from March 2020 to June 2021. Admission RDW values were considered normal if they were ≤14.5% in males or ≤16.1% in females. The Modified Early Warning Score (MEWS), International Severe Acute Respiratory and Emerging Infections Consortium Coronavirus Clinical Characterisation Consortium score (ISARIC 4C), and Veterans Health Administration COVID-19 (VACO) index were evaluated as prognostic scores. RDW exceeded the upper limit in 628 (19.6%) of the patients. When RDW was accounted for, risks of the predicted outcomes were considerably different within the same MEWS, 4C score, and VACO index levels. The same patterns applied equally to patients who started, and those who did not start, remdesivir before deterioration. RDW may be a useful tool for stratifying risk when considered on top of commonly used prognostic scores in non-critical COVID-19 patients.
较高的红细胞分布宽度（RDW）水平在许多慢性代谢疾病、恶性疾病以及2019冠状病毒病（COVID-19）的预后评估中受到关注。我们旨在评估在成人COVID-19患者常用的风险评分系统中加入RDW是否有助于风险分层。我们回顾性分析了2020年3月至2021年6月在一家三级医疗机构住院的3212例非重症COVID-19患者队列。男性入院时RDW值≤14.5%或女性≤16.1%被认为是正常的。改良早期预警评分（MEWS）、国际严重急性呼吸和新兴感染联盟冠状病毒临床特征联盟评分（ISARIC 4C）以及退伍军人健康管理局COVID-19（VACO）指数被作为预后评分进行评估。628例（19.6%）患者的RDW超过上限。当考虑RDW时，在相同的MEWS、4C评分和VACO指数水平内，预测结果的风险有很大差异。同样的模式同样适用于病情恶化前开始和未开始使用瑞德西韦的患者。在非重症COVID-19患者常用的预后评分基础上考虑RDW时，它可能是一种有用的风险分层工具。
