Monocyte Distribution Width (MDW) as novel inflammatory marker with prognostic significance in COVID-19 patients

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...

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Autores principales:	Giovanni Riva, Sara Castellano, Vincenzo Nasillo, Anna Maria Ottomano, Giuliano Bergonzini, Ambra Paolini, Beatrice Lusenti, Jovana Milić, Sara De Biasi, Lara Gibellini, Andrea Cossarizza, Stefano Busani, Massimo Girardis, Giovanni Guaraldi, Cristina Mussini, Rossella Manfredini, Mario Luppi, Enrico Tagliafico, Tommaso Trenti
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/60ddce3f295d4e9f880f9293b2a78470
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spelling	oai:doaj.org-article:60ddce3f295d4e9f880f9293b2a784702021-12-02T17:41:09ZMonocyte Distribution Width (MDW) as novel inflammatory marker with prognostic significance in COVID-19 patients10.1038/s41598-021-92236-62045-2322https://doaj.org/article/60ddce3f295d4e9f880f9293b2a784702021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-92236-6https://doaj.org/toc/2045-2322Abstract 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.Giovanni RivaSara CastellanoVincenzo NasilloAnna Maria OttomanoGiuliano BergonziniAmbra PaoliniBeatrice LusentiJovana MilićSara De BiasiLara GibelliniAndrea CossarizzaStefano BusaniMassimo GirardisGiovanni GuaraldiCristina MussiniRossella ManfrediniMario LuppiEnrico TagliaficoTommaso TrentiNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Giovanni Riva Sara Castellano Vincenzo Nasillo Anna Maria Ottomano Giuliano Bergonzini Ambra Paolini Beatrice Lusenti Jovana Milić Sara De Biasi Lara Gibellini Andrea Cossarizza Stefano Busani Massimo Girardis Giovanni Guaraldi Cristina Mussini Rossella Manfredini Mario Luppi Enrico Tagliafico Tommaso Trenti Monocyte Distribution Width (MDW) as novel inflammatory marker with prognostic significance in COVID-19 patients
description	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.
format	article
author	Giovanni Riva Sara Castellano Vincenzo Nasillo Anna Maria Ottomano Giuliano Bergonzini Ambra Paolini Beatrice Lusenti Jovana Milić Sara De Biasi Lara Gibellini Andrea Cossarizza Stefano Busani Massimo Girardis Giovanni Guaraldi Cristina Mussini Rossella Manfredini Mario Luppi Enrico Tagliafico Tommaso Trenti
author_facet	Giovanni Riva Sara Castellano Vincenzo Nasillo Anna Maria Ottomano Giuliano Bergonzini Ambra Paolini Beatrice Lusenti Jovana Milić Sara De Biasi Lara Gibellini Andrea Cossarizza Stefano Busani Massimo Girardis Giovanni Guaraldi Cristina Mussini Rossella Manfredini Mario Luppi Enrico Tagliafico Tommaso Trenti
author_sort	Giovanni Riva
title	Monocyte Distribution Width (MDW) as novel inflammatory marker with prognostic significance in COVID-19 patients
title_short	Monocyte Distribution Width (MDW) as novel inflammatory marker with prognostic significance in COVID-19 patients
title_full	Monocyte Distribution Width (MDW) as novel inflammatory marker with prognostic significance in COVID-19 patients
title_fullStr	Monocyte Distribution Width (MDW) as novel inflammatory marker with prognostic significance in COVID-19 patients
title_full_unstemmed	Monocyte Distribution Width (MDW) as novel inflammatory marker with prognostic significance in COVID-19 patients
title_sort	monocyte distribution width (mdw) as novel inflammatory marker with prognostic significance in covid-19 patients
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/60ddce3f295d4e9f880f9293b2a78470
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Monocyte Distribution Width (MDW) as novel inflammatory marker with prognostic significance in COVID-19 patients

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