Anemia predicts poor outcomes of COVID-19 in hospitalized patients: a prospective study in Iran

BMC Infect Dis. 2021 Feb 10;21(1):170. doi: 10.1186/s12879-021-05868-4.

Abstract

Background: There are limited number of studies with controversial findings regarding the association between anemia at admission and coronavirus disease 2019 (COVID-19) outcomes. Therefore, in this research, we aimed to investigate the prospective association between anemia and COVID-19 outcomes in hospitalized patients in Iran.

Methods: In this prospective study, the data of 1274 consecutive patients hospitalized due to COVID-19 were statistically analyzed. All biomarkers, including hemoglobin and high-sensitivity C-reactive protein (hs-CRP) levels were measured using standard methods. Anemia was defined as a hemoglobin (Hb) concentration of less than 13 g/dL and 12 g/dL in males and females, respectively. Assessing the association between anemia and COVID-19 survival in hospitalized patients was our primary endpoint.

Results: The mean age of the participants was 64.43 ± 17.16 years, out of whom 615 (48.27%) were anemic subjects. Patients with anemia were significantly older (P = 0.02) and had a higher frequency of cardiovascular diseases, hypertension, kidney disease, diabetes, and cancer (P < 0.05). The frequency of death (anemic: 23.9% vs. nonanemic: 13.8%), ICU admission (anemic: 27.8% vs. nonanemic:14.71%), and ventilator requirement (anemic: 35.93% vs. nonanemic: 20.63%) were significantly higher in anemic patients than in nonanemic patients (P < 0.001). According to the results of regression analysis, after adjusting for significant covariate in the univariable model, anemia was independently associated with mortality (OR: 1.68, 95% CI: 1.10, 2.57, P = 0.01), ventilator requirement (OR: 1.74, 95% CI: 1.19, 2.54, P = 0.004), and the risk of ICU admission (OR: 2.06, 95% CI: 1.46, 2.90, P < 0.001).

Conclusion: The prevalence of anemia in hospitalized patients with COVID-19 was high and was associated with poor outcomes of COVID-19.

Keywords: Anemia; COVID-19; ICU admission; Mortality; Ventilator requirement.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anemia / complications*
  • Anemia / epidemiology
  • COVID-19 / complications*
  • COVID-19 / mortality*
  • Female
  • Hemoglobins / analysis
  • Hospitalization
  • Humans
  • Intensive Care Units
  • Iran
  • Male
  • Middle Aged
  • Prevalence
  • Prospective Studies
  • Respiration, Artificial
  • Severity of Illness Index
  • Survival Rate

Substances

  • Hemoglobins