Retrospective study on the efficacy of monocyte distribution width (MDW) as a screening test for COVID-19

Abstract Background Pathogenic genetic testing for Coronavirus disease 2019 (COVID-19) can detect viruses with high sensitivity, however there are several challenges. In the prevention, testing, and treatment of COVID-19, more effective, safer, and convenient methods are desired. We evaluated the possibility of monocyte distribution width (MDW) as an infection biomarker in COVID-19 testing. Methods The efficacy of MDW as a screening test for COVID-19 was retrospectively assessed in 80 patients in the COVID-19 group and 232 patients in the Non-COVID-19 group (141 patients with acute respiratory infection, 19 patients with non-respiratory infection, 1 patient with viral infection, 11 patients who had received treatment for COVID-19, 1 patient in contact with COVID-19 patients, and 59 patients with non-infectious disease). Results The median MDW in 80 patients in the COVID-19 group was 23.3 (17.2–33.6), and the median MDW in 232 patients in the Non-COVID-19 group was 19.0 (13.6–30.2) ( P  < 0.001). When the COVID-19 group was identified using the MDW cut-off value of 21.3 from the Non-COVID-19 group, the area under the curve (AUC) was 0.844, and the sensitivity and specificity were 81.3% and 78.2%, respectively. Comparison of MDW by severity between the COVID-19 group and patients with acute respiratory infection in the Non-COVID-19 group showed that MDW was significantly higher in the COVID-19 group for all of mild, moderate I, and moderate II disease. Conclusions MDW (cut-off value: 21.3) may be used as a screening test for COVID-19 in fever outpatients, etc.