Clinical significance of changes in red cell distribution width during
hospitalization for COVID-19
Abstract
Background: The possible differences in characteristics and prognosis,
among patients with coronavirus disease 2019 (COVID-19), with vs.
without changes in red cell distribution width (RDW) during
hospitalization, have not been investigated. Methods: For 477 adults
hospitalized with COVID-19, demographic, laboratory and clinical
characteristics, in-hospital outcomes and all-cause mortality were
compared according: to high (>14.7%, n=146) vs. normal
(≤14.7%, n=331) RDW values at admission, and according to RDW changes
(n=150) vs. stable RDW (n=262) during hospitalization. Results: Both
high RDW at admission and change in RDW during hospitalization were
significantly associated with older age, more severe clinical and
laboratory characteristics, and poor in-hospital outcomes. On median
follow-up lasting 83 days, the mortality rates were higher among
patients with high vs. normal RDW on admission (26.7% vs. 10.0%, P
< .001) and RDW changes vs. stable RDW (34.7% vs. 5.7%, P
< .001). On multivariate analysis, change in RDW was strongly
associated with decreased survival (relative risk 1.50 and 95%
confidence interval 1.29–1.75), while high RDW on admission was not
found to be most significantly associated with mortality. Conclusions:
Among patients with COVID-19, RDW changes during hospitalization were
associated with a severe clinical profile, poor in-hospital outcomes and
increased short-term mortality. Repeated assessment of RDW may provide
useful information for improving the care of hospitalized patients with
COVID-19.