A study on significance and correlation of red cell distribution width with severity of clinical illness in COVID‑19 patients


BACKGROUND: Global pandemic COVID‑19 is an acute respiratory illness with a high rate ofhospitalization and death rate. Red cell distribution width coefficient of variation (RDW‑CV), a routinecomponent of complete blood count (CBC) automatically generated by most hematology analyzersis a useful predictor of clinical outcomes in critically ill patients and in those with infection and sepsis.RDW will provide information for early risk stratification of COVID‑19 patients, thereby enabling timelyintervention for reducing morbidity and mortality. In such a massive pandemic, early stratification ofcases based on routinely available biomarkers can be of great help inefficient utilization of criticalcare and laboratory assets.MATERIALS AND METHODS: We retrospectively studied the significance and correlation ofRDW (CV) (admission) with the severity of clinical illness in 800 confirmed cases of COVID‑19between August 2020 and October 2020 at our hospital. Demographic and clinical details wereobtained from medical records; data pertaining to CBC were retrieved through electronic records ofour fully automated hematology analyzer (NihonKoden 5 part auto analyzer Model‑MEK– 7300K).Statistical workup was done and results were analyzed.RESULTS: Of 800 patients, 60% were male. RDW (CV) >14.5 (elevated) seen in 52% males and47% females. Elevated RDW was noted in 43.6% (300/688) nonsevere illnesses (mild and moderate),82% (92/112) in the severe illness group. The mean RDW (CV) for mild, moderate, and severecases was found to be 14.21 ± 0.61, 15.32 ± 0.67, and 16.34 ± 1.64, respectively. The number ofsurvivors was 704 (88%). The number of people who died was 96 (12%). Elevated RDW was seenin 74% (71/96) who died and 45% (321/704) of people who survived. To determine the efficacy ofRDW (CV) in identifying the severity of disease, a ROC curve was used in which a cutoff value of13.65 is obtained with a sensitivity of 97.3% and specificity of 85%.CONCLUSION: Higher RDW (CV) was found to have a significant association with clinical severity andmortality prediction. Hence, it can be considered as one of the important hematological parametersin the workup to efficiently stratify the patients at the earliest in COVID‑19.