Evidence map›Paper›PMID 41664076›Full record

ArticleVirology journal2026

The prognostic value of red cell distribution width-to-albumin ratio (RAR) in COVID-19 pneumonia: implications for early diagnosis.

Heming Huang, Wei Xu, Yang Wang, Yanjia Shi, Sijing Tang, Jiarui Pei, Yun Zhou, Liya Zhang, Ying Xue

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Article in Virology journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Heming HuangDepartment of Endocrinology and Metabolism, Tongji Hospital, School of Medicine, Tongji University, No. 389, Xincun Road, Shanghai, 200065, China.
Wei XuDepartment of Endocrinology and Metabolism, Tongji Hospital, School of Medicine, Tongji University, No. 389, Xincun Road, Shanghai, 200065, China.
Yang WangDepartment of Endocrinology and Metabolism, Tongji Hospital, School of Medicine, Tongji University, No. 389, Xincun Road, Shanghai, 200065, China.
Yanjia ShiDepartment of Endocrinology and Metabolism, Tongji Hospital, School of Medicine, Tongji University, No. 389, Xincun Road, Shanghai, 200065, China.
Sijing TangDepartment of Endocrinology and Metabolism, Tongji Hospital, School of Medicine, Tongji University, No. 389, Xincun Road, Shanghai, 200065, China.
Jiarui PeiDepartment of Endocrinology and Metabolism, Tongji Hospital, School of Medicine, Tongji University, No. 389, Xincun Road, Shanghai, 200065, China.
Yun ZhouDepartment of Endocrinology and Metabolism, Tongji Hospital, School of Medicine, Tongji University, No. 389, Xincun Road, Shanghai, 200065, China.
Liya ZhangNursing Department, Tongji Hospital, School of Medicine, Tongji University, No. 389, Xincun Road, Shanghai, 200065, China. lialia7@126.com.ORCID http://orcid.org/0009-0009-6516-0834
Ying XueDepartment of Endocrinology and Metabolism, Tongji Hospital, School of Medicine, Tongji University, No. 389, Xincun Road, Shanghai, 200065, China. doxy0622@163.com.ORCID http://orcid.org/0000-0002-6812-5665

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis study aimed to evaluate the diagnostic value of red blood cell distribution width-to-albumin ratio (RAR), a biomarker integrating hematological and metabolic information, for COVID-19 pneumonia.

methodsThis retrospective study analyzed clinical data from 2,205 patients with COVID-19. RAR values were calculated as the ratio of red blood cell distribution width (RDW) to serum albumin concentration. Diagnostic performance of RAR in COVID-19 pneumonia was assessed using receiver operating characteristic (ROC) curve analysis, and the optimal cut-off was determined. Mediation analysis was conducted to examine the role of chronological age in the association between RAR and COVID-19 pneumonia risk.

resultsAmong COVID-19 patients, RAR demonstrated strong diagnostic performance for COVID-19 pneumonia, with area under the curve (AUC) of 0.769 [95% confidence interval (CI): 0.747-0.791], sensitivity of 76.8%, and specificity of 65.3% at the optimal cut-off value of 0.154. Its diagnostic utility likely stems from simultaneously reflecting hematopoietic dysfunction (elevated RDW) and systemic metabolic imbalance (hypoalbuminemia). Mediation analysis indicated that chronological age accounted for 14.16% of the association between elevated RAR and COVID-19 pneumonia risk (β = 0.1139, 95%CI: 0.0802-0.1524).

conclusionRAR represents a promising biomarker for the early detection and risk stratification of COVID-19 pneumonia. By simultaneously capturing hematologic and metabolic disturbances, RAR provides a more comprehensive reflection of disease severity. The observed age-mediation effect suggests that elderly individuals with elevated RAR may face heightened risk, warranting enhanced clinical monitoring or prioritized intervention.

Indexed as

COVID-19Erythrocyte IndicesPneumonia, ViralSerum AlbuminAdultAgedBiomarkersEarly DiagnosisFemaleHumansMaleMiddle AgedPrognosisRetrospective StudiesROC CurveSARS-CoV-2BiomarkersSerum AlbuminChronological ageCOVID-19 pneumoniaDiagnosisRed blood cell distribution width-to-albumin ratio

Identifiers

PMID41664076
PMCPMC12990469

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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 Socratic graph.