Monocyte Distribution Width (MDW) As Novel Inflammatory Marker with Prognostic Significance in COVID-19 Patients

Overview

Journal Sci Rep

Specialty Science

Date 2021 Jun 17

PMID 34135448

Citations 26

Authors

Giovanni Riva

Sara Castellano

Vincenzo Nasillo

Anna Maria Ottomano

Giuliano Bergonzini

Ambra Paolini

Beatrice Lusenti

Jovana Milic

Sara De Biasi

Lara Gibellini

Andrea Cossarizza

Stefano Busani

Massimo Girardis

Giovanni Guaraldi

Cristina Mussini

Rossella Manfredini

Mario Luppi

Enrico Tagliafico

Tommaso Trenti

Affiliations

Soon will be listed here.

Abstract

Monocyte Distribution Width (MDW), a new cytometric parameter correlating with cytomorphologic changes occurring upon massive monocyte activation, has recently emerged as promising early biomarker of sepsis. Similar to sepsis, monocyte/macrophage subsets are considered key mediators of the life-threatening hyper-inflammatory disorder characterizing severe COVID-19. In this study, we longitudinally analyzed MDW values in a cohort of 87 COVID-19 patients consecutively admitted to our hospital, showing significant correlations between MDW and common inflammatory markers, namely CRP (p < 0.001), fibrinogen (p < 0.001) and ferritin (p < 0.01). Moreover, high MDW values resulted to be prognostically associated with fatal outcome in COVID-19 patients (AUC = 0.76, 95% CI: 0.66-0.87, sensitivity 0.75, specificity 0.70, MDW threshold 26.4; RR = 4.91, 95% CI: 1.73-13.96; OR = 7.14, 95% CI: 2.06-24.71). This pilot study shows that MDW can be useful in the monitoring of COVID-19 patients, as this innovative hematologic biomarker is: (1) easy to obtain, (2) directly related to the activation state of a fundamental inflammatory cell subset (i.e. monocytes, pivotal in both cytokine storm and sepsis immunopathogenesis), (3) well correlated with clinical severity of COVID-19-associated inflammatory disorder, and, in turn, (4) endowed with relevant prognostic significance. Additional studies are needed to define further the clinical impact of MDW testing in the management of COVID-19 patients.

Citing Articles

The Role of Monocyte Distribution Width (MDW) in the Prediction of Death in Adult Patients with Sepsis.

Theodoridis D, Tsifi A, Magiorkinis E, Tsamakidis X, Voulgaridis A, Moustaferi E Microorganisms. 2025; 13(2).

PMID: 40005792 PMC: 11858437. DOI: 10.3390/microorganisms13020427.

The Need for Standardized Guidelines for the Use of Monocyte Distribution Width (MDW) in the Early Diagnosis of Sepsis.

Piccioni A, Spagnuolo F, Baroni S, Savioli G, Valletta F, Bungaro M J Pers Med. 2025; 15(1).

PMID: 39852198 PMC: 11766780. DOI: 10.3390/jpm15010005.

Machine learning interpretability methods to characterize the importance of hematologic biomarkers in prognosticating patients with suspected infection.

Upadhyaya D, Tarabichi Y, Prantzalos K, Ayub S, Kaelber D, Sahoo S Comput Biol Med. 2024; 183:109251.

PMID: 39393128 PMC: 11576231. DOI: 10.1016/j.compbiomed.2024.109251.

Monocyte Anisocytosis Changes in Patients After Major Burn Injuries.

Nazemidashtarjandi S, Muldur S, Supple M, Ryan C, Ryan C, Yonker L J Burn Care Res. 2024; 46(1):138-144.

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Monocyte Distribution Width Predicts Sepsis, Respiratory Failure, and Death in COVID-19.

Frugoli A, Ong J, Meyer B, Khiatah B, Bernstein R, Hernandez A Cureus. 2024; 15(12):e50525.

PMID: 38222192 PMC: 10787605. DOI: 10.7759/cureus.50525.

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