Blood Test May Show Who Is at Risk of Severe COVID

By EJ Mundell
HealthDay reporter

WEDNESDAY, September 23, 2020 (HealthDay News) – If you’re unlucky enough to be admitted to hospital with COVID-19, a common blood marker can predict the severity of your illness, new research shows.

The blood marker is called a “red blood cell distribution width” (RDW) – basically, the greater the variance in red blood cell size, the poorer a patient’s prognosis, the study authors explain.

A COVID-19 patient’s RDW test result “was strongly correlated with patient mortality, and the correlation persisted when monitoring for other identified risk factors such as patient age, other laboratory tests and some pre-existing conditions, ”said study co-author Dr. Jonathan Carlson, of Massachusetts General Hospital (MGH) in Boston.

The new study was published online September 23 at JAMA network open and was led by Dr. John Higgins, a hospital pathology researcher and associate professor of systems biology at Harvard Medical School.

“We wanted to help find ways to identify high-risk COVID patients as early and as easily as possible – who are likely to become seriously ill and may benefit from aggressive interventions, and which inpatients are likely to have worsen faster, “Higgins said in a hospital press release.

To do this, they looked at blood tests for more than 1,600 adults diagnosed with SARS-CoV-2 infection who had been admitted to one of four Boston-area hospitals in March and April 2020.

Higgins and his team expected to have to unearth an obscure blood marker that could predict poor COVID-19 results. But they quickly found that RDW – already used in standard blood tests – easily did the trick.

In fact, patients with RDW values ​​above the normal range when they were first admitted to the hospital had a 2.7 times higher risk of death than patients with test results within the normal range. , the researchers found. Overall, 31% of patients with above-normal RDW test results died, compared to 11% of those with normal RDW test results.

And if a patient’s RDW level was normal on admission, but slowly began to increase to above normal levels, this also correlated with an increased chance of the patient’s death, the study found. .


The next step for the Boston team is to find out why a high RDW score is linked to worse outcomes. “Such findings could point to new treatment strategies or identify better markers of disease severity,” said study co-author Dr. Aaron Aguirre, MGH cardiologist and intensive care physician .

Dr. Teresa Murray Amato is president of emergency medicine at Long Island Jewish Forest Hills, New York. Reading the new study, she said that “although we know that advanced age and some [health factors] such as diabetes and hypertension are associated with worse outcomes, there is still great variability in symptoms and severity within these groups. “

A blood marker like RDW that could identify at-risk patients would be very helpful, Amato said.

Already, “a high RDW can be an indication of poor overall health” in any hospital patient, she noted. Knowing shortly after hospitalization whether or not a patient is at high risk of death, “we will be in a better position to adapt the treatment scientifically, in order to give our patients the best possible results,” said Amato .

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SOURCES: Teresa Murray Amato, MD, president, emergency medicine, Long Island Jewish Forest Hills, NY; Massachusetts General Hospital, press release, September 23, 2020

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