ABSTRACT
Introduction: COVID-19 is a global pandemic disease first identified in Wuhan, China in late 2019. As of March 2022, over 450 million cases and 6 million deaths have been reported across the world, with the confirmed numbers probably being a fraction of the real numbers. Red Cell Distribution width (RDW) is a measure of anisocytosis, that is, variation in the circulating red blood cell volume. It is a nonspecific marker of acute illness. Increased RDW is suggestive of dysfunctional erythropoiesis and/or shortened RBC lifespan. Hence, it is a good predictor of clinical outcome in many disorders. Aims & Objectives: AIMS: To prove association of RDW with COVID-19 infection requiring ICU stay in a tertiary care hospital. OBJECTIVE(S): Primary Objective: To assess the predictive value of RDW on admission with requirement of ICU as a marker of severity in COVID-19 patients. Secondary Objectives: To compare RDW to other markers commonly used in COVID-19 infection, such as D-Dimer and CRP. Material(s) and Method(s): Patients over 18 years of age getting admitted at COVID ward or ICU at P.D. Hinduja Hospital, Mumbai were included in the study. RDW, CRP and D-dimer values of Ward group and ICU group patients were noted and compared. Result(s): 234 patients were screened and 190 patients were included in the final study. RDW was found to have significant association with ICU requirement (p = 0.0066). Further, an RDW value of 13 or more is found to be 85% sensitive for predicting ICU requirement. RDW of 16 or more is found to be 80% specific for predicting requirement of ICU stay. Regarding secondary objectives, RDW was found to have significant correlation with D-Dimer (p = 0.0005) but not with CRP (p = 0.12). Conclusion(s): RDW can be a potentially useful marker for risk stratification in COVID-19. A value of RDW more than 16 is associated with a significant risk of ICU requirement in COVID-19 disease. Further studies may be indicated to find a statistically significant correlation between RDW values and mortality in COVID- 19.