J Med Virol . Association between Red Blood Cell Distribution Width and Mortality and Severity among Patients with COVID-19: A Systematic Review and Meta-Analysis

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J Med Virol


. 2021 Jan 15.
doi: 10.1002/jmv.26797. Online ahead of print.
Association between Red Blood Cell Distribution Width and Mortality and Severity among Patients with COVID-19: A Systematic Review and Meta-Analysis


Jane J Lee ¹ , Sahar Memar Montazerin ² , Adeel Jamil ³ , Umer Jamil ³ , Jolanta Marszalek ⁴ , Michael L Chuang ² , Gerald Chi ²



Affiliations

• PMID: 33448439
• DOI: 10.1002/jmv.26797

Abstract

Emerging evidence has underscored the potential usefulness of red blood cell distribution width (RDW) measurement in predicting the mortality and disease severity of COVID-19. This study aimed to assess the association of the plasma RDW levels with adverse prognosis in COVID-19 patients. A comprehensive literature search from inception to September 2020 was performed to harvest original studies reporting RDW on admission and clinical outcomes among patients hospitalized with COVID-19. RDW levels were compared between cases (patients who died or developed more severe symptoms) and controls (patients who survived or developed less severe symptoms). A total of 14,866 subjects from 10 studies were included in the meta-analysis. Higher levels of RDW were associated with adverse outcomes in COVID-19 patients (mean differences=0.72; 95% CI=.47-0.97; I² =89.51%). Deceased patients had higher levels of RDW compared to survived patients (mean differences=0.93; 95% CI=0.63-1.23; I² =85.58%). Severely ill COVID-19 patients showed higher levels of RDW, as opposed to patients classified to have milder symptoms (mean differences=0.61; 95% CI=0.28-0.94; I² =82.18%). Elevated RDW levels were associated with adverse outcomes in COVID-19 patients. This finding warrants further research on whether RDW could be utilized as a simple and reliable biomarker for predicting COVID-19 severity and whether RDW is mechanistically linked with COVID-19 pathophysiology. This article is protected by copyright. All rights reserved.

Keywords: COVID-19; biomarkers; erythrocyte indices; red blood cell distribution width; severe acute respiratory syndrome coronavirus 2.