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Could Anemia Impact the Severity of Infections? COVID-19 as an Example
Sham ZainAlAbdin1, Salahdein Aburuz1,2, Amal Akour1,2
1Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates.
Insights
Anemia significantly increases the risk of severe COVID-19, intensive care unit (ICU) admission, and mortality in hospitalized patients. Monitoring anemia in COVID-19 patients is crucial for reducing complications and improving outcomes.
Area of Science:
- Infectious Diseases
- Hematology
- Critical Care Medicine
Background:
- The link between anemia and COVID-19 severity/mortality is under-researched.
- This study is the first from the UAE to investigate anemia's impact on COVID-19 outcomes.
Purpose of the Study:
- To assess the influence of anemia on COVID-19 severity.
- To evaluate the association between anemia and intensive care unit (ICU) admission.
- To determine the effect of anemia on mortality rates in COVID-19 patients.
Main Methods:
- Retrospective chart review of hospitalized COVID-19 patients in the UAE.
- Analysis of clinical and laboratory data, disease severity, ICU admissions, and mortality.
- Correlation of outcomes with the presence of anemia.
Main Results:
- Anemia (11.7% of patients) was linked to a 1.59-fold higher risk of severe COVID-19.
- Anemic patients had a 2.83-fold higher risk of ICU admission.
- Mortality was 2.56-fold higher in anemic patients; older age and male gender also predicted severe illness and ICU admission.
Conclusions:
- Anemia is a significant risk factor for severe COVID-19, ICU admission, and mortality.
- Healthcare providers should monitor hematological parameters in COVID-19 patients with anemia.
- The association between anemia and severe outcomes warrants consideration in other infectious diseases.
Background:
The association between anemia and severity of infection as well as mortality rates among patients infected with COVID-19 has scarcely been studied. This is the first study from the UAE aimed to assess the influence of anemia on COVID-19 severity, ICU admission, and mortality rate.
Methods:
A retrospective chart review of hospitalized COVID-19 patients was conducted in a large COVID-19 referral hospital in UAE. The study included adult patients with confirmed COVID-19. Clinical and laboratory data, severity of the disease, ICU admissions, and mortality rates were analyzed and correlated to the presence of anemia among the patients.
Results:
A total of 3092 patients were included. 362 patients (11.7%) were anemic and most of the cases were between asymptomatic and mild COVID-19 (77.4%, n=2393). Among patients with anemia, 30.1% (n=109) had moderate to severe COVID-19. Statistically, anemia was associated significantly with a higher risk for severe COVID-19 outcome compared to nonanemic patients (AOR:1.59, 95% CI:1.24-2.04, p<0.001). Intensive care unit (ICU) admission was almost 3 times higher among anemic patients compared to nonanemic (AOR:2.83,95% CI:1.89-4.25, p<0.001). In addition, the overall mortality rate of 2.8% (n=87) was 2.5-fold higher in anemic than nonanemic patients (OR:2.56, CI: 1.49-4.06, p<0.001). Moreover, older age (≥48-year-old) and male gender were independent predictors for severe illness (Age: OR=1.26, CI:1.07-1.51, p=0.006; Gender: OR:1.43,CI:1.15-1.78, p<0.001)) and ICU admission (Age: OR:2.08, CI:1.47-2.94, p<0.001; Gender: OR: 1.83, CI:1.12-3.00, p=0.008) whereas only age ≥48 years old contributed to higher mortality rate (OR:1.60, CI:1.04-2.46, p=0.034).
Conclusion:
Anemia was a major risk factor for severe COVID-19, ICU admission and mortality among hospitalized COVID-19 patients. Thus, healthcare providers should be aware of monitoring the hematological parameters among hospitalized patients with COVID-19 and anemia to reduce the risk of disease complications and mortality. This association should also be considered in other infectious diseases.
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