On-admission anemia predicts mortality in COVID-19 patients: A single center, retrospective cohort study

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). A single-center, retrospective cohort study was conducted from a random sample of 733 adult patients (age ≥...

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Bibliographic Details
Published in:The American journal of emergency medicine 2021-10, Vol.48, p.140-147
Main Authors: Oh, Seung Mi, Skendelas, John P., Macdonald, Eric, Bergamini, Michael, Goel, Swati, Choi, Jaeun, Segal, Kathryn R., Vivek, Kumar, Nair, Singh, Leff, Jonathan
Format: Article
Language:English
Subjects:
Acute Kidney Injury - epidemiology
Aged
Aged, 80 and over
Anemia
Anemia - blood
Anemia - therapy
Blood Transfusion - statistics & numerical data
Cause of Death
Cohort analysis
Cohort Studies
Comorbidity
Coronaviruses
COVID-19
COVID-19 - blood
COVID-19 - mortality
Emergency department
Emergency medical care
Emergency medical services
Female
Hemoglobin
Hemoglobins - metabolism
Hospital Mortality
Hospitalization
Humans
Hypotension - epidemiology
Hypoxic respiratory failure
Intensive Care Units
Male
Middle Aged
Mortality
Patients
Respiration, Artificial - statistics & numerical data
Respiratory Insufficiency - epidemiology
Retrospective Studies
Risk factors
SARS-CoV-2
Sepsis
Severe acute respiratory syndrome coronavirus 2
Severity of Illness Index
Shock, Septic - epidemiology
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Summary: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). 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. 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. Anemia on admission was independently associated with increased odds of all-cause mortality in patients hospitalized with COVID-19. Furthermore, moderate-severe anemia (Hb
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2021.03.083