Monocyte Distribution Width as a Diagnostic Marker for Infection: A Systematic Review and Meta-analysis.
COVID-19
MDW
acute care
diagnosis making
diagnostic performance
monocyte distribution width
sepsis
Journal
Chest
ISSN: 1931-3543
Titre abrégé: Chest
Pays: United States
ID NLM: 0231335
Informations de publication
Date de publication:
07 2023
07 2023
Historique:
received:
26
07
2022
revised:
16
11
2022
accepted:
22
12
2022
medline:
11
7
2023
pubmed:
22
1
2023
entrez:
21
1
2023
Statut:
ppublish
Résumé
Monocyte distribution width (MDW) is an emerging biomarker for infection. It is available easily and quickly as part of the CBC count, which is performed routinely on hospital admission. The increasing availability and promising results of MDW as a biomarker in sepsis has prompted an expansion of its use to other infectious diseases. What is the diagnostic performance of MDW across multiple infectious disease outcomes and care settings? A systematic review of the diagnostic performance of MDW across multiple infectious disease outcomes was conducted by searching PubMed, Embase, Scopus, and Web of Science through February 4, 2022. Meta-analysis was performed for outcomes with three or more reports identified (sepsis and COVID-19). Diagnostic performance measures were calculated for individual studies with pooled estimates created by linear mixed-effects models. We identified 29 studies meeting inclusion criteria. Most examined sepsis (19 studies) and COVID-19 (six studies). Pooled estimates of diagnostic performance for sepsis differed by reference standard (Second vs Third International Consensus Definitions for Sepsis and Septic Shock criteria) and tube anticoagulant used and ranged from an area under the receiver operating characteristic curve (AUC) of 0.74 to 0.94, with mean sensitivity of 0.69 to 0.79 and mean specificity of 0.57 to 0.86. For COVID-19, the pooled AUC of MDW was 0.76, mean sensitivity was 0.79, and mean specificity was 0.59. MDW exhibited good diagnostic performance for sepsis and COVID-19. Diagnostic thresholds for sepsis should be chosen with consideration of reference standard and tube type used. Prospero; No.: CRD42020210074; URL: https://www.crd.york.ac.uk/prospero/.
Sections du résumé
BACKGROUND
Monocyte distribution width (MDW) is an emerging biomarker for infection. It is available easily and quickly as part of the CBC count, which is performed routinely on hospital admission. The increasing availability and promising results of MDW as a biomarker in sepsis has prompted an expansion of its use to other infectious diseases.
RESEARCH QUESTION
What is the diagnostic performance of MDW across multiple infectious disease outcomes and care settings?
STUDY DESIGN AND METHODS
A systematic review of the diagnostic performance of MDW across multiple infectious disease outcomes was conducted by searching PubMed, Embase, Scopus, and Web of Science through February 4, 2022. Meta-analysis was performed for outcomes with three or more reports identified (sepsis and COVID-19). Diagnostic performance measures were calculated for individual studies with pooled estimates created by linear mixed-effects models.
RESULTS
We identified 29 studies meeting inclusion criteria. Most examined sepsis (19 studies) and COVID-19 (six studies). Pooled estimates of diagnostic performance for sepsis differed by reference standard (Second vs Third International Consensus Definitions for Sepsis and Septic Shock criteria) and tube anticoagulant used and ranged from an area under the receiver operating characteristic curve (AUC) of 0.74 to 0.94, with mean sensitivity of 0.69 to 0.79 and mean specificity of 0.57 to 0.86. For COVID-19, the pooled AUC of MDW was 0.76, mean sensitivity was 0.79, and mean specificity was 0.59.
INTERPRETATION
MDW exhibited good diagnostic performance for sepsis and COVID-19. Diagnostic thresholds for sepsis should be chosen with consideration of reference standard and tube type used.
TRIAL REGISTRY
Prospero; No.: CRD42020210074; URL: https://www.crd.york.ac.uk/prospero/.
Identifiants
pubmed: 36681146
pii: S0012-3692(23)00122-8
doi: 10.1016/j.chest.2022.12.049
pii:
doi:
Substances chimiques
Biomarkers
0
Types de publication
Meta-Analysis
Systematic Review
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
101-113Informations de copyright
Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.