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Author Spotlight: Developing a Point-of-Care Hemoglobin Estimation Method for Anemia Management
Published on: January 19, 2024
On-admission anemia predicts mortality in COVID-19 patients: A single center, retrospective cohort study
Seung Mi Oh1, John P Skendelas2, Eric Macdonald1
1Department of Anesthesiology, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
Insights
Anemia on admission increases mortality risk in hospitalized COVID-19 patients. Moderate-severe anemia is linked to severe outcomes and death, suggesting anemia management is crucial for patient care.
Area of Science:
- Internal Medicine
- Infectious Diseases
- Hematology
Background:
- Anemia, a common condition, may impact COVID-19 severity.
- Hemoglobin levels on admission could serve as a prognostic indicator for coronavirus disease 2019 (COVID-19).
Purpose of the Study:
- To investigate the prognostic value of admission anemia in predicting severe outcomes and mortality in hospitalized COVID-19 patients.
Main Methods:
- Retrospective cohort study of 733 adult patients with laboratory-confirmed SARS-CoV-2 infection.
- Data collected from Montefiore Medical Center between March-June 2020.
- Primary outcome: composite endpoint of in-hospital severe COVID-19 outcomes; Secondary outcome: in-hospital all-cause mortality.
Main Results:
- Anemia was present in 59.8% of patients on admission.
- Anemia on admission independently predicted all-cause mortality (OR 1.52).
- Moderate-severe anemia (Hb < 11 g/dL) independently predicted both severe outcomes (OR 1.53) and mortality (OR 1.67).
Conclusions:
- Admission anemia is an independent risk factor for mortality in COVID-19 patients.
- Moderate-severe anemia is a significant predictor of severe COVID-19 outcomes.
- Incorporating anemia assessment into COVID-19 patient management may improve risk stratification and care.
Objectives:
We investigated the impact of anemia based on admission hemoglobin (Hb) level as a prognostic risk factor for severe outcomes in hospitalized patients with coronavirus disease 2019 (COVID-19).
Methods:
A single-center, retrospective cohort study was conducted from a random sample of 733 adult patients (age ≥ 18 years) obtained from a total of 4356 laboratory confirmed SARS-CoV-2 cases who presented to the Emergency Department of Montefiore Medical Center between March-June 2020. The primary outcome was a composite endpoint of in-hospital severe outcomes of COVID-19. A secondary outcome was in-hospital all-cause mortality.
Results:
Among the 733 patients included in our final analysis, 438 patients (59.8%) presented with anemia. 105 patients (14.3%) had mild, and 333 patients (45.5%) had moderate-severe anemia. Overall, 437 patients (59.6%) had a composite endpoint of severe outcomes. On-admission anemia was an independent risk factor for all-cause mortality, (Odds Ratio 1.52, 95% CI [1.01-2.30], p = 0.046) but not for composite severe outcomes. However, moderate-severe anemia (Hb < 11 g/dL) on admission was independently associated with both severe outcomes (OR1.53, 95% CI [1.05-2.23], p = 0.028) and mortality (OR 1.67, 95% CI [1.09-2.56], p = 0.019) during hospitalization.
Conclusion:
Anemia on admission was independently associated with increased odds of all-cause mortality in patients hospitalized with COVID-19. Furthermore, moderate-severe anemia (Hb <11 g/dL) was an independent risk factor for severe COVID-19 outcomes. Moving forward, COVID-19 patient management and risk stratification may benefit from addressing anemia on admission.
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