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Efficacy of monocyte distribution width in predicting critical illness in patients with COVID-19 pneumonia: a retrospective cohort study

Chia-Hung Lai, Chun-Hung Chen, Yen-Wei Chiu, Fen-Wei Huang, Shih-Yun Wu, Hong-Mo Shih, Po-Ren Hsueh

BMC Infectious Diseases, 2025

878 participants

Abstract

Identifying patients at a risk of severe COVID-19 is crucial for prompt intervention and mortality risk mitigation. The monocyte distribution width (MDW) is an effective accurate predictor of sepsis in emergency settings, facilitating timely patient management. However, few reliable laboratory parameters are available for predicting the severity and prognosis of COVID-19. Thus, this study was conducted to investigate whether MDW can accurately predict the severity and progression of COVID-19 pneumonia. This retrospective cohort study included patients with COVID-19 pneumonia who had been admitted to our hospital between January 1, 2022, and September 31, 2022. The primary outcome was the development of critical illness, which was assessed in terms of intensive care unit (ICU) admission, need for mechanical ventilation (MV), or mortality. The secondary outcomes were durations of ICU stay, MV, and hospital stay. Multivariate logistic regression was performed to estimate the risks of critical illness and mortality. Data from 878 patients with COVID-19 were analyzed. Of these, 258 (29.4%) developed critical illness. The high-MDW group (MDW > 22) showed a higher rate of critical illness (155/452, 34.29%) compared to the low-MDW group (103/426, 24.18%). Mortality was also higher in the high-MDW group (95/452, 21.02%) than in the low-MDW group (37/426, 8.69%). Patients with MDW > 22 exhibited a significantly higher risk of developing critical illness (adjusted odds ratio [aOR]:…

How strong is the evidence?

Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 878 participants or records.

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