Fever, Tachypnea, and Monocyte Distribution Width Predicts Length of Stay for Patients with COVID-19: A Pioneer Study

• Published in: Journal of personalized medicine 2022-03, Vol.12 (3), p.449
• Main Authors: Lin, Sheng-Feng, Lin, Hui-An, Chuang, Han-Chuan, Tsai, Hung-Wei, Kuo, Ning, Chen, Shao-Chun, Hou, Sen-Kuang
• Format: Article
• Language: English
• Subjects: Biomarkers; Blood; Coronaviruses; COVID-19; Emergency medical care; Fever; Generalized linear models; Hospitals; Infections; Length of stay; Lymphocytes; Monocytes; Mortality; Neutrophils; Normal distribution; Patients; Precision medicine; Regression analysis; Severe acute respiratory syndrome coronavirus 2; Validation studies; Variables
• ISSN: 2075-4426; 2075-4426
• DOI: 10.3390/jpm12030449

(1) Background: Our study investigated whether monocyte distribution width (MDW) could be used in emergency department (ED) settings as a predictor of prolonged length of stay (LOS) for patients with COVID-19. (2) Methods: A retrospective cohort study was conducted; patients presenting to the ED of an academic hospital with confirmed COVID-19 were enrolled. Multivariable logistic regression models were used to obtain the odds ratios (ORs) for predictors of an LOS of >14 days. A validation study for the association between MDW and cycle of threshold (Ct) value was performed. (3) Results: Fever > 38 °C (OR: 2.82, 95% CI, 1.13−7.02, p = 0.0259), tachypnea (OR: 4.76, 95% CI, 1.67−13.55, p = 0.0034), and MDW ≥ 21 (OR: 5.67, 95% CI, 1.19−27.10, p = 0.0269) were robust significant predictors of an LOS of >14 days. We developed a new scoring system in which patients were assigned 1 point for fever > 38 °C, 2 points for tachypnea > 20 breath/min, and 3 points for MDW ≥ 21. The optimal cutoff was a score of ≥2. MDW was negatively associated with Ct value (β: −0.32 per day, standard error = 0.12, p = 0.0099). (4) Conclusions: Elevated MDW was associated with a prolonged LOS.