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Meta-Analysis
. 2022 Mar;32(2):e2264.
doi: 10.1002/rmv.2264. Epub 2021 Jun 6.

Role of red blood cell distribution width, as a prognostic indicator in COVID-19: A systematic review and meta-analysis

Soumya Sarkar  1 , Sundara Kannan  1 , Puneet Khanna  1 , Akhil Kant Singh  1
Affiliations
Meta-Analysis

Role of red blood cell distribution width, as a prognostic indicator in COVID-19: A systematic review and meta-analysis

Soumya Sarkar et al. Rev Med Virol. 2022 Mar.

Abstract

The red blood cell distribution width (RDW), an indicator of anisocytosis has emerged as a potential tool for risk stratification of critically ill patients with sepsis. Prognostic predictors are of paramount interest for prompt intervention and optimal utilization of the healthcare system in this ongoing context of the Coronavirus Disease 2019 (COVID-19) pandemic. The current systematic review and meta-analysis aims to explore the utility of RDW in the prognosis of COVID-19 patients. A comprehensive screening of electronic databases was performed up to 30th April 2021 after enrolling in PROSPERO (CRD42020206685). Observational studies or interventional studies, evaluating the impact of RDW in COVID-19 outcomes (mortality and severity) are included in this meta-analysis.Our search retrieved 25 studies, with a total of 18,392 and 3,446 COVID-19 patients for mortality and disease severity outcomes. Deceased and critically ill patients had higher RDW levels on admission in comparison to survivors and non-severe patients (SMD = 0.46; 95%CI 0.31-0.71; I2 = 88% and SMD = 0.46; 95%CI 0.26-0.67; I2 = 60%, respectively). In a sub-group analysis of 2,980 patients, RDW > 14.5 has been associated with increased risk of mortality (OR = 2.73; 95%CI 1.96-3.82; I2 = 56%). However, the evidences is of low quality. A higher level of RDW on admission in COVID-19 patients is associated with increased morbidity and mortality. However, further studies regarding the cut-off value of RDW are the need of the hour.

Keywords: Coronavirus Disease 2019; Severe Acute Respiratory Syndrome Coronavirus-2; red blood cell distribution width.

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Figures

FIGURE 1
FIGURE 1
PRISMA‐2009‐Flow‐Diagram
FIGURE 2
FIGURE 2
ROBINS‐I assesment for the included non‐randomized cohort studies
FIGURE 3
FIGURE 3
(a) The impact of the Red blood cell distribution width (RDW) on mortality in Coronavirus Disease 2019 (COVID‐19) patients. (b) Subgroup analysis of impact of the RDW >14.5 on mortality in COVID‐19 patients
FIGURE 4
FIGURE 4
The impact of Red blood cell distribution width on disease severity in Coronavirus Disease 2019 patients
FIGURE 5
FIGURE 5
Funnel plot of the included studies for assessment of publication bias
See this image and copyright information in PMC

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