Red Cell Distribution Width Upon Hospital Admission Predicts Short-Term Mortality in Hospitalized Patients With COVID-19: A Single-Center Experience

Christoph C Kaufmann; Amro Ahmed; Ulrich Brunner; Bernhard Jäger; Gabriele Aicher; Susanne Equiluz-Bruck; Alexander O Spiel; Georg-Christian Funk; Michael Gschwantler; Peter Fasching; Kurt Huber

doi:10.3389/fmed.2021.652707

Red Cell Distribution Width Upon Hospital Admission Predicts Short-Term Mortality in Hospitalized Patients With COVID-19: A Single-Center Experience

Front Med (Lausanne). 2021 Mar 18:8:652707. doi: 10.3389/fmed.2021.652707. eCollection 2021.

Authors

Affiliations

¹ Third Medical Department With Cardiology and Intensive Care Medicine, Wilhelminenhospital, Vienna, Austria.
² Department of Laboratory Medicine, Wilhelminenhospital, Vienna, Austria.
³ Department of Hospital Hygiene, Wilhelminenhospital, Vienna, Austria.
⁴ Department of Emergency Medicine, Wilhelminenhospital, Vienna, Austria.
⁵ Karl-Landsteiner-Institute for Lung Research and Pulmonary Oncology, Wilhelminenhospital, Vienna, Austria.
⁶ Department of Gastroenterology and Hepatology, Wilhelminenhospital, Vienna, Austria.
⁷ Department of Endocrinology and Rheumatology, Wilhelminenhospital, Vienna, Austria.
⁸ Sigmund Freud University, Medical School, Vienna, Austria.

Abstract

Background: 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. Methods: 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. Results: A total of 423 eligible patients with COVID-19 were included in the final analyses and 15.4% died within 28 days (n = 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), P < 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; P = < 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; P = 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]; P = 0.187]. Conclusions: In this population, RDWwas a significant, independent prognostic marker of short-term mortality in patients with COVID-19.

Keywords: COVID-19; pre-COVID-19; prognosis; red cell distribution width; short-term mortality.