Red Cell Distribution Width (RDW) – A useful parameter to assess prognosis in COVID patients

Background and Objectives: The world is currently grappling with the COVID-19 pandemic.Therefore, it is important to identify reliable and cost-effective biomarkers that can help in triageand early detection of severe patients, thus preventing morbidity and mortality thereby reducing theneed for invasive and critical care management. With this study, we aimed to observe --1) Variations in red cell distribution width (RDW) in survivors and non – survivors of COVID – 19.2) If there is an association between elevated RDW and unfavourable outcome in patients.3) If there was an association between RDW and currently used biomarkers. Method: Aretrospective study was conducted from June – August 2020 on 100 RTPCR confirmed patients, with50 admitted in ICU (non-survivors) and 50 in isolation wards (survivors). Eight laboratoryparameters with their changes were monitored daily on all patients. Results: We found that all eightparameters (RDW, CRP, LDH, Albumin, WBC count, Ferritin, Creatinine, NLR) were markedlyderanged among non-survivors as compared to survivors. A male preponderance was found in thestudy. RDW values progressively increased in non-survivors till the end of the observation period andindicated unfavourable outcome sooner. In survivors, RDW showed minimal variation throughout theobservation period. The RDW values were not affected by complications arising due to COVID-19infection or by therapy as compared to other biomarkers. Conclusions: RDW showed a directrelationship with other commonly used biomarkers and can be successfully used in triage andtreatment of mild, moderate and severe Covid-19 patients.