Monocyte distribution width may be useful diagnostic marker for infection

Researchers Alexandra Malinovska and team conducted a study published in Chest Journal and have identified a potential game-changer in the diagnosis of infectious diseases: the Monocyte Distribution Width (MDW). This emerging biomarker, easily and quickly measured as part of the complete blood count (CBC) performed routinely on hospital admission, has shown promising results in detecting infections, particularly in cases of sepsis and COVID-19.

To explore the diagnostic performance of MDW across various infectious disease outcomes and care settings, a systematic review was conducted. The researchers scoured medical databases, including PubMed, Embase, Scopus, and Web of Science, through February 4, 2022, identifying 29 studies that met the inclusion criteria.

● The majority of the studies focused on sepsis (19 studies) and COVID-19 (six studies).

● Pooled estimates of diagnostic performance for sepsis varied based on the reference standard used (Second vs. Third International Consensus Definitions for Sepsis and Septic Shock criteria) and the tube anticoagulant employed.

● The area under the receiver operating characteristic curve (AUC) ranged from 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.

The findings demonstrate that MDW exhibits good diagnostic performance for sepsis and COVID-19. However, the study highlights the importance of choosing appropriate diagnostic thresholds for sepsis, considering the reference standard and tube type used.

The potential of MDW as a quick and accessible tool for identifying infectious diseases holds immense promise for patient care. Early and accurate diagnosis of infections is crucial for initiating timely treatment and preventing complications. MDW's integration into routine CBC counts could significantly enhance clinicians' ability to detect infections promptly, leading to improved patient outcomes.

Further research and validation are necessary to explore the full range of infectious diseases in which MDW may prove valuable. Nevertheless, this exciting advancement in diagnostic technology opens new possibilities for enhancing infectious disease management in various clinical settings. As researchers continue to unlock the potential of MDW, healthcare providers can look forward to improved diagnostic precision and better patient care.

Reference:

Malinovska, A., Hernried, B., Lin, A., Badaki-Makun, O., Fenstermacher, K., Ervin, A. M., Ehrhardt, S., Levin, S., & Hinson, J. S. (2023). Monocyte distribution width as a diagnostic marker for infection. Chest, 164(1), 101–113. https://doi.org/10.1016/j.chest.2022.12.049