Emerging evidence has underscored the potential usefulness of red blood cell distribution width (RDW) measurement in predicting the mortality and disease severity of COVID‐19. This study aimed to assess the association of the plasma RDW levels with adverse prognosis in COVID‐19 patients. A comprehensive literature search from inception to September 2020 was performed to harvest original studies reporting RDW on admission and clinical outcomes among patients hospitalized with COVID‐19. RDW levels were compared between cases (patients who died or developed more severe symptoms) and controls (patients who survived or developed less severe symptoms). A total of 14,866 subjects from 10 studies were included in the meta‐analysis. Higher levels of RDW were associated with adverse outcomes in COVID‐19 patients (mean differences = 0.72; 95% CI = 0.47–0.97; I² = 89.51%). Deceased patients had higher levels of RDW compared to patients who survived (mean differences = 0.93; 95% CI = 0.63–1.23; I² = 85.58%). Severely ill COVID‐19 patients showed higher levels of RDW, as opposed to patients classified to have milder symptoms (mean differences = 0.61; 95% CI = 0.28–0.94; I² = 82.18%). Elevated RDW levels were associated with adverse outcomes in COVID‐19 patients. This finding warrants further research on whether RDW could be utilized as a simple and reliable biomarker for predicting COVID‐19 severity and whether RDW is mechanistically linked with COVID‐19 pathophysiology.

中文翻译：

---

COVID-19患者中红细胞分布宽度与死亡率和严重性之间的关联：系统评价和荟萃分析

新兴证据强调了红细胞分布宽度（RDW）测量在预测COVID-19的死亡率和疾病严重性方面的潜在用途。这项研究旨在评估血浆RDW水平与COVID-19患者不良预后的关系。从开始到2020年9月进行了全面的文献检索，以收集报道RCW 19住院患者入院和临床结局的RDW的原始研究。在病例（死亡或出现较重症状的患者）和对照组（幸存或出现较轻症状的患者）之间比较RDW水平。荟萃分析包括来自10项研究的14866名受试者。RDW水平升高与COVID-19患者的不良预后相关（平均差异= 0.72； 95％CI = 0.47-0.97；I ²  = 89.51％）。与存活的患者相比，死者的RDW水平更高（平均差异= 0.93； 95％CI = 0.63–1.23；I ²  = 85.58％）。与分类为轻度症状的患者相比，重症COVID-19患者表现出更高的RDW水平（平均差异= 0.61； 95％CI = 0.28–0.94；I ²  = 82.18％）。RDW水平升高与COVID-19患者的不良预后相关。这一发现值得进一步研究，以探讨RDW是否可以用作预测COVID-19严重程度的简单可靠的生物标记，以及RDW是否与COVID-19病理生理机制相关。