Assessing the Role of Red Blood Cell Distribution Width in Hospital Mortality Among Elderly and Non-Elderly COVID-19 Patients: A Prospective Study in a Brazilian University Hospital

This study investigated the role of red blood cell distribution width (RDW) as a risk factor for hospital mortality in COVID-19 patients at a public hospital in Minas Gerais, Brazil. The study included 161 patients over 16 years old hospitalized between May and October 2020, with 39 (24.2%) deaths. Key mortality risk factors identified were age over 70 years (RR=2.78; p<0.001), male sex (RR=2.28; p=0.005), cardiovascular disease (RR=1.8; p=0.044), and abnormal chest X-ray upon admission (RR=3.07; p=0.022). Although high RDW at admission did not significantly predict mortality (31.1% vs 21.7%; RR=1.43; p=0.413), it was linked to higher mortality in patients aged 70 and over (66.7% vs 33.3%; RR=2; p=0.029). High RDW during hospitalization was a strong mortality factor for the entire cohort (41.1% vs 10.2%; RR=4.03; p<0.001) and at any time during the stay (39.7% vs 9.6%; RR=4.14; p<0.001). The Cox model analysis showed that age >70 years (HR=4.8; p<0.001), white race (HR=3.2; p=0.018), need for invasive ventilation (HR=3.8; p=0.001), and abnormal chest X-ray (HR=3.5; p=0.044) were significant risk factors, but RDW was not associated with mortality.