Evidence map›Paper›PMID 36513693›Full record

ArticleScientific reports2022

Monocyte distribution width as a pragmatic screen for SARS-CoV-2 or influenza infection.

Oluwakemi Badaki-Makun, Scott Levin, Arnaud Debraine, Benjamin Hernried, Alexandra Malinovska, Aria Smith, Matthew Toerper, Katherine Z J Fenstermacher, Taylor Cottle, Malgorzata Latallo and 2 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Scientific reports, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.7field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 7 citations in OpenAlex.

  1. Trial
  2. Observational
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 3 institutions in 1 country.

Oluwakemi Badaki-MakunDepartment of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA. obadaki2@jhmi.edu.
Scott LevinMalone Center for Engineering in Healthcare, Johns Hopkins Whiting School of Engineering, 1800 Orleans Street, Baltimore, MD, 21287, USA.
Arnaud DebraineStoCastic, Baltimore, MD, USA.
Benjamin HernriedDepartment of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Alexandra MalinovskaDepartment of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Aria SmithMalone Center for Engineering in Healthcare, Johns Hopkins Whiting School of Engineering, 1800 Orleans Street, Baltimore, MD, 21287, USA.
Matthew ToerperMalone Center for Engineering in Healthcare, Johns Hopkins Whiting School of Engineering, 1800 Orleans Street, Baltimore, MD, 21287, USA.
Katherine Z J FenstermacherDepartment of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Taylor CottleDepartment of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Malgorzata LatalloDepartment of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Richard E RothmanDepartment of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Jeremiah S HinsonMalone Center for Engineering in Healthcare, Johns Hopkins Whiting School of Engineering, 1800 Orleans Street, Baltimore, MD, 21287, USA. hinson@jhmi.edu.
Johns Hopkins Medicine · USBeckman Coulter Foundation · USJohns Hopkins University · US

Funding

Connected Emergency Care (CEC) Patient Safety Learning LabR18HS026640 · AHRQ · JOHNS HOPKINS UNIVERSITY · PI HINSON, JEREMIAH STEPHEN · 2018 to 2021
$2.4M
AHRQ HHS R18 HS026640
6 · The paper itself

Abstract

Monocyte distribution width (MDW) is a novel marker of monocyte activation, which is known to occur in the immune response to viral pathogens. Our objective was to determine the performance of MDW and other leukocyte parameters as screening tests for SARS-CoV-2 and influenza infection. This was a prospective cohort analysis of adult patients who underwent complete blood count (CBC) and SARS-CoV-2 or influenza testing in an Emergency Department (ED) between January 2020 and July 2021. The primary outcome was SARS-CoV-2 or influenza infection. Secondary outcomes were measures of severity of illness including inpatient hospitalization, critical care admission, hospital lengths of stay and mortality. Descriptive statistics and test performance measures were evaluated for monocyte percentage, MDW, white blood cell (WBC) count, and neutrophil to lymphocyte ratio (NLR). 3,425 ED patient visits were included. SARS-CoV-2 testing was performed during 1,922 visits with a positivity rate of 5.4%; influenza testing was performed during 2,090 with a positivity rate of 2.3%. MDW was elevated in patients with SARS-Cov-2 (median 23.0U; IQR 20.5-25.1) or influenza (median 24.1U; IQR 22.0-26.9) infection, as compared to those without (18.9U; IQR 17.4-20.7 and 19.1U; 17.4-21, respectively, P < 0.001). Monocyte percentage, WBC and NLR values were within normal range in patients testing positive for either virus. MDW identified SARS-CoV-2 and influenza positive patients with an area under the curve (AUC) of 0.83 (95% CI 0.79-0.86) and 0.83 (95% CI 0.77-0.88), respectively. At the accepted cut-off value of 20U for MDW, sensitivities were 83.7% (95% CI 76.5-90.8%) for SARS-CoV-2 and 89.6% (95% CI 80.9-98.2%) for influenza, compared to sensitivities below 45% for monocyte percentage, WBC and NLR. MDW negative predictive values were 98.6% (95% CI 98.0-99.3%) and 99.6% (95% CI 99.3-100.0%) respectively for SARS-CoV-2 and influenza. Monocyte Distribution Width (MDW), available as part of a routine complete blood count (CBC) with differential, may be a useful indicator of SARS-CoV-2 or influenza infection.

Indexed as

COVID-19Influenza, HumanAdultCOVID-19 TestingHumansMonocytesProspective StudiesSARS-CoV-2

Identifiers

PMID36513693
PMCPMC9745720
OpenAlexW4311317166

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.