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

• Published in: BMC infectious diseases Vol. 21; no. 1; p. 170
• Main Authors: Faghih Dinevari, Masood, Somi, Mohammad Hossein, Sadeghi Majd, Elham, Abbasalizad Farhangi, Mahdieh, Nikniaz, Zeinab
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 10-02-2021; BioMed Central; BMC
• Subjects: Adult; Age; Aged; Aged, 80 and over; Anemia; Anemia - complications; Anemia - epidemiology; Biomarkers; Blood pressure; C-reactive protein; Cardiovascular diseases; Complications and side effects; Coronaviruses; COVID-19; COVID-19 - complications; COVID-19 - mortality; Diabetes; Diabetes mellitus; Disease transmission; Evaluation; Female; Glasgow Coma Scale; Hemoglobin; Hemoglobins - analysis; Hospitalization; Hospitals; Humans; Hypertension; Hypoxia; ICU admission; Infectious diseases; Intensive Care Units; Iran; Iron; Kidney diseases; Laboratories; Male; Middle Aged; Mortality; Pneumonia; Prevalence; Prognosis; Prospective Studies; Regression analysis; Respiration, Artificial; Respiratory diseases; Risk factors; Severe acute respiratory syndrome coronavirus 2; Severity of Illness Index; Statistical analysis; Survival Rate; Variables; Ventilator requirement; Ventilators; Viral diseases; Iran; China; COVID-19; Ventilator requirement; Anemia; Mortality; ICU admission
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-021-05868-4

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