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Laboratory medicine in sport and exercise has significantly developed during the last decades with the awareness that physical activity contributes to improved health status, and is present in monitoring both professional and recreational athletes. Training and competitions can modify concentrations of a variety of laboratory parameters, so the accurate laboratory data interpretation includes controlled and known preanalytical and analytical variables to prevent misleading interpretations. The paper represents a comprehensive summary of the lectures presented during the 35 th Annual Symposium of the Croatian Society of Medical Biochemistry and Laboratory Medicine. It describes management of frequent sport injuries and sums up current knowledge of selected areas in laboratory medicine and sports including biological variation, changes in biochemical parameters and glycemic status. Additionally, the paper polemicizes sex hormone disorders in sports, encourages and comments research in recreational sports and laboratory medicine. In order to give the wider view, the connection of legal training protocols as well as monitoring prohibited substances in training is also considered through the eyes of laboratory medicine., Competing Interests: Potential conflict of interest None declared., (Croatian Society of Medical Biochemistry and Laboratory Medicine.)

Higher red blood cell distribution width (RDW) levels have gained attention in the prognostication of many chronic metabolic and malignant diseases, as well as coronavirus disease 2019 (COVID-19). We aimed to evaluate whether accounting for RDW might contribute to risk stratification when added to commonly used risk scoring systems in adult COVID-19 patients. We retrospectively analyzed a cohort of 3212 non-critical COVID-19 patients hospitalized in a tertiary-level institution from March 2020 to June 2021. Admission RDW values were considered normal if they were ≤14.5% in males or ≤16.1% in females. The Modified Early Warning Score (MEWS), International Severe Acute Respiratory and Emerging Infections Consortium Coronavirus Clinical Characterisation Consortium score (ISARIC 4C), and Veterans Health Administration COVID-19 (VACO) index were evaluated as prognostic scores. RDW exceeded the upper limit in 628 (19.6%) of the patients. When RDW was accounted for, risks of the predicted outcomes were considerably different within the same MEWS, 4C score, and VACO index levels. The same patterns applied equally to patients who started, and those who did not start, remdesivir before deterioration. RDW may be a useful tool for stratifying risk when considered on top of commonly used prognostic scores in non-critical COVID-19 patients.