Original scientific paper
https://doi.org/10.3325/cmj.2022.63.4 4
Red cell distribution width is a potent prognostic parameter for in-hospital and post-discharge mortality in hospitalized coronavirus disease 2019 patients: a registry-based cohort study on 3941 patients
Marko Lucijanić
orcid.org/0000-0002-1372-2040
; Hematology Department, University Hospital Dubrava, Zagreb, Croatia
Ana Jordan
; Primary Respiratory and Intensive Care Center, University Hospital Dubrava, Zagreb, Croatia
Ivana Jurin
; Primary Respiratory and Intensive Care Center, University Hospital Dubrava, Zagreb, Croatia
Nevenka Piskač Živković
; Primary Respiratory and Intensive Care Center, University Hospital Dubrava, Zagreb, Croatia
Ena Sorić
; Primary Respiratory and Intensive Care Center, University Hospital Dubrava, Zagreb, Croatia
Irzal Hadžibegović
; Primary Respiratory and Intensive Care Center, University Hospital Dubrava, Zagreb, Croatia
Armin Atić
; Primary Respiratory and Intensive Care Center, University Hospital Dubrava, Zagreb, Croatia
Josip Stojić
; Primary Respiratory and Intensive Care Center, University Hospital Dubrava, Zagreb, Croatia
Diana Rudan
; Primary Respiratory and Intensive Care Center, University Hospital Dubrava, Zagreb, Croatia
Ozren Jakšić
; Hematology Department, University Hospital Dubrava, Zagreb, Croatia
Nikolina Bušić
; Primary Respiratory and Intensive Care Center, University Hospital Dubrava, Zagreb, Croatia
Lovorka Đerek
; Primary Respiratory and Intensive Care Center, University Hospital Dubrava, Zagreb, Croatia
Ivica Lukšić
; Primary Respiratory and Intensive Care Center, University Hospital Dubrava, Zagreb, Croatia
Bruno Baršić
; Primary Respiratory and Intensive Care Center, University Hospital Dubrava, Zagreb, Croatia
Abstract
Aim To investigate clinical and prognostic associations of
red cell distribution width (RDW) in hospitalized coronavi
-
rus disease 2019 (COVID-19) patients.
Methods We retrospectively analyzed the records of 3941
consecutive COVID-19 patients admitted to a tertiary-level
institution from March 2020 to March 2021 who had avail
-
able RDW on admission.
Results The median age was 74 years. The median Charl
-
son comorbidity index (CCI) was 4. The majority of pa
-
tients (84.1%) on admission presented with severe or criti
-
cal COVID-19. Patients with higher RDW were significantly
more likely to be older and female, to present earlier dur
-
ing infection, and to have higher comorbidity burden, worse
functional status, and critical presentation of COVID-19 on
admission. RDW was not significantly associated with C-re
-
active protein, occurrence of pneumonia, or need for oxy
-
gen supplementation on admission. During hospital stay,
patients with higher RDW were significantly more likely to
require high-flow oxygen therapy, mechanical ventilation,
intensive care unit, and to experience prolonged immobi
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lization, venous thromboembolism, bleeding, and bacte
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rial sepsis. Thirty-day and post-hospital discharge mortality
gradually increased with each rising RDW percent-point. In
a series of multivariate Cox-regression models, RDW demon
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strated robust prognostic properties at >14% cut-off level.
This cut-off was associated with inferior 30-day and postdischarge survival independently of COVID-19 severity, age,
and CCI; and with 30-day survival independently of COVID
severity and established prognostic scores (CURB-65, 4Cmortality, COVID-gram and VACO-index).
Conclusion RDW has a complex relationship with COVID19-associated inflammatory state and is affected by prior
comorbidities. RDW can improve the prognostication in
hospitalized COVID-19 patients.
Keywords
Hrčak ID:
278998
URI
Publication date:
17.2.2022.
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