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Article

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

1
Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
2
Discipline of Clinical Pharmacology, College of Medicine and Public Health, Flinders University and Flinders Medical Centre, Adelaide, SA 5042, Australia
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2021, 10(2), 286; https://doi.org/10.3390/jcm10020286
Received: 4 December 2020 / Revised: 2 January 2021 / Accepted: 12 January 2021 / Published: 14 January 2021
(This article belongs to the Special Issue COVID-19: From Pathophysiology to Clinical Practice)
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. View Full-Text
Keywords: red blood cell distribution width; COVID-19; disease severity; mortality red blood cell distribution width; COVID-19; disease severity; mortality
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MDPI and ACS Style

Zinellu, A.; Mangoni, A.A. Red Blood Cell Distribution Width, Disease Severity, and Mortality in Hospitalized Patients with SARS-CoV-2 Infection: A Systematic Review and Meta-Analysis. J. Clin. Med. 2021, 10, 286. https://doi.org/10.3390/jcm10020286

AMA Style

Zinellu A, Mangoni AA. Red Blood Cell Distribution Width, Disease Severity, and Mortality in Hospitalized Patients with SARS-CoV-2 Infection: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine. 2021; 10(2):286. https://doi.org/10.3390/jcm10020286

Chicago/Turabian Style

Zinellu, Angelo, and Arduino A. Mangoni. 2021. "Red Blood Cell Distribution Width, Disease Severity, and Mortality in Hospitalized Patients with SARS-CoV-2 Infection: A Systematic Review and Meta-Analysis" Journal of Clinical Medicine 10, no. 2: 286. https://doi.org/10.3390/jcm10020286

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