scholarly journals Association between red blood cell distribution width and mortality and severity among patients with COVID‐19: A systematic review and meta‐analysis

2021 ◽  
Vol 93 (4) ◽  
pp. 2513-2522
Author(s):  
Jane J. Lee ◽  
Sahar M. Montazerin ◽  
Adeel Jamil ◽  
Umer Jamil ◽  
Jolanta Marszalek ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Meta Analysis ◽  
Cell Distribution ◽  
Distribution Width ◽  
Red Blood Cell Distribution

scholarly journals Red Blood Cell Distribution Width, Disease Severity, and Mortality in Hospitalized Patients with SARS-CoV-2 Infection: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (2) ◽  
pp. 286
Author(s):  
Angelo Zinellu ◽  
Arduino A. Mangoni
Keyword(s):  
Systematic Review ◽  
Blood Cell ◽  
Disease Severity ◽  
Red Blood Cell ◽  
Effect Size ◽  
Meta Analysis ◽  
Severe Illness ◽  
Cell Distribution ◽  
Distribution Width ◽  
Red Blood Cell Distribution

The identification of biomarkers predicting disease severity and outcomes is the focus of intense research in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 infection). Ideally, such biomarkers should be easily derivable from routine tests. We conducted a systematic review and meta-analysis of the predictive role of the red blood cell distribution width (RDW), a routine hematological test, in patients with SARS-CoV-2 infection. We searched the electronic databases PubMed, Web of Science and Scopus, from January 2020 to November 2020, for studies reporting data on the RDW and coronavirus disease 2019 (COVID-19) severity, defined as severe illness or admission to the intensive care unit (ICU), and mortality. Eleven studies in 4901 COVID-19 patients were selected for the meta-analysis. Pooled results showed that the RDW values were significantly higher in patients with severe disease and non-survivors (standard mean difference, SMD = 0.56, 95% CI 0.31 to 0.81, p < 0.001). Heterogeneity between studies was extreme (I2 = 80.6%; p < 0.001). In sensitivity analysis, the effect size was not modified when each study was in turn removed (effect size range, between 0.47 and 0.63). The Begg’s (p = 0.53) and Egger’s tests (p = 0.52) showed no evidence of publication bias. No significant correlations were observed between SMD and age, gender, whole blood count, end point, study geographic area, or design. Our meta-analysis showed that higher RDW values are significantly associated with COVID-19 severity and mortality. This routine parameter might assist with early risk stratification in patients with SARS-CoV-2 infection.

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