Red Cell Distribution Width as a Prognostic Indicator for Mortality and ICU Admission in Patients with COVID-19

Abstract

Background: COVID-19 disease caused by the SARS-CoV-2 virus can lead to an acute respiratory illness with a high hospitalization and mortality risk. Therefore, prognostic indicators are essential for early interventions. As a component of complete blood counts, the coefficient of variation (CV) of red blood cell distribution width (RDW) reflects cellular volume variations. It has been shown that RDW is associated with increased mortality risk in a wide range of diseases. This study aimed to determine the relationship between RDW and mortality risk in COVID-19 patients. Methods: This retrospective study was performed on 592 patients admitted to hospital between February 2020 and December 2020. Patients were divided into low and high RDW groups and the relationship between RDW and mortality, intubation, admission to intensive care unit (ICU), and need for oxygen therapy was investigated. Results: The mortality rate in the low RDW group was 9.4%, while that in the high group was 20% (p < 0.001). Also, ICU admission in the low group was 8%, whereas this was 10% in the high RDW group (p = 0.040). The results of the Kaplan–Meyer curve showed that the survival rate was higher in the low group compared to the high RDW group. Cox results in the crude model showed that higher RDW values were directly related to increased mortality, although this was not significant after adjustment for other covariates. Conclusion: The results of our study reveal that high RDW is associated with increased hospitalization and risk of death and that RDW may be a reliable indicator of COVID-19 prognosis.