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Association between red blood cell distribution width and mortality of COVID-19 patients - 24/03/21

Doi : 10.1016/j.accpm.2020.10.013 
Leonardo Lorente a, ⁎ , María M. Martín b, Mónica Argueso c, Jordi Solé-Violán d, Alina Perez e, José Alberto Marcos Y Ramos f, Luis Ramos-Gómez g, Sergio López h, Andrés Franco i, Agustín F. González-Rivero j, María Martín a, Verónica Gonzalez a, Julia Alcoba-Flórez k, Miguel Ángel Rodriguez b, Marta Riaño-Ruiz l, Juan Guillermo O Campo c, Lourdes González e, Tamara Cantera f, Raquel Ortiz-López g, Nazario Ojeda h, Aurelio Rodríguez-Pérez h, Casimira Domínguez m, Alejandro Jiménez n
a Intensive Care Unit, Hospital Universitario de Canarias, Ofra, s/n. La Laguna, 38320 Santa Cruz de Tenerife, Spain 
b Intensive Care Unit, Hospital Universitario Nuestra Señora de Candelaria, Crta del Rosario s/n, Santa Cruz de Tenerife 38010, Spain 
c Intensive Care Unit, Complejo Hospitalario Universitario Insular, Plaza Dr. Pasteur s/n, Las Palmas de Gran Canaria 35016, Spain 
d Intensive Care Unit, Hospital Universitario Dr. Negrín, Barranco de la Ballena s/n, Las Palmas de Gran Canaria 35010, Spain 
e Internal Intensive Care Unit, Hospital Universitario de Canarias, Ofra, s/n, La Laguna, 38320 Santa Cruz de Tenerife, Spain 
f Intensive Care Unit, Hospital Doctor José Molina Orosa, Ctra. Arrecife-Tinajo, km 1.300, Arrecife, Lanzarote 35550, Spain 
g Intensive Care Unit, Hospital General La Palma, Buenavista de Arriba s/n, Breña Alta, La Palma 38713, Spain 
h Department of Anaesthesiology, Hospital Universitario Dr. Negrín, Barranco de la Ballena s/n, Las Palmas de Gran Canaria 35010, Spain 
i Immunology Unit of Laboratory Department, Hospital Universitario de Canarias, Ofra, s/n. La Laguna, 38320 Santa Cruz de Tenerife, Spain 
j Laboratory Department, Hospital Universitario de Canarias, Ofra, s/n. La Laguna, 38320 Santa Cruz de Tenerife, Spain 
k Microbiology Unit of Laboratory Department, Hospital Universitario Nuestra Señora de Candelaria, Crta del Rosario s/n, Santa Cruz de Tenerife 38010, Spain 
l Department of Biochemistry, Complejo Hospitalario Universitario Insular, Plaza Dr. Pasteur s/n, Las Palmas de Gran Canaria 35016, Spain 
m Laboratory Department, Hospital Universitario Dr. Negrín, Barranco de la Ballena s/n, Las Palmas de Gran Canaria 35010, Spain 
n Research Unit, Hospital Universitario de Canarias, Ofra, s/n, La Laguna, 38320 Santa Cruz de Tenerife, Spain 

⁎Corresponding author at: Intensive Care Unit, Hospital Universitario de Canarias, Ofra, s/n. La Laguna, 38320 Santa Cruz de Tenerife, Spain.Intensive Care Unit, Hospital Universitario de CanariasOfra, s/n. La LagunaSanta Cruz de Tenerife38320Spain
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Highlights

•
Non-surviving showed higher RDW than surviving patients.
•
There is an association between RDW and mortality.
•
RDW could be used as mortality biomarker.

Il testo completo di questo articolo è disponibile in PDF.

Abstract

Purpose

We have previously reported an association between high red blood cell distribution width (RDW) and mortality in septic and brain infarction patients. However, no association between RDW and mortality in coronavirus disease 2019 (COVID-19) patients has been reported so far; thus, the objective of this study was to determine if that association exists.

Methods

Prospective and observational study carried out in 8 Intensive Care Units from 6 hospitals of Canary Islands (Spain) including COVID-19 patients. We recorded RDW at ICU admission and 30-day survival.

Results

We found that patients who did not survive (n=25) compared to surviving patients (n=118) were older (p=0.004), showed higher RDW (p=0.001), urea (p<0.001), APACHE-II (p<0.001) and SOFA (p<0.001), and lower platelet count (p=0.007) and pH (p=0.008). Multiple binomial logistic regression analysis showed that RDW was associated with 30-day mortality after controlling for: SOFA and age (OR=1.659; 95% CI=1.130–2.434; p=0.01); APACHE-II and platelet count (OR=2.062; 95% CI=1.359–3.129; p=0.001); and pH and urea (OR=1.797; 95% CI=1.250–2.582; p=0.002). The area under the curve (AUC) of RDW for mortality prediction was of 71% (95% CI=63–78%; p<0.001). We did not find significant differences in the predictive capacity between RDW and SOFA (p=0.66) or between RDW and APACHE-II (p=0.12).

Conclusions

Our study provides new information regarding the ability to predict mortality in patients with COVID-19. There is an association between high RDW and mortality. RDW has a good performance to predict 30-day mortality, similar to other severity scores (such as APACHE II and SOFA) but easier and faster to obtain.

Il testo completo di questo articolo è disponibile in PDF.

Abbreviations : APACHE II, aPTT, ARDS, COPD, FIO2, GCS, INR, NTproBNP, PaO2, RDW, SOFA

Keywords : Red blood cell distribution width, COVID-19, Patients, Mortality, Outcome


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© 2020  Société française d'anesthésie et de réanimation (Sfar). Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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Vol 40 - N° 1

Articolo 100777- Febbraio 2021 Ritorno al numero
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