Anemia in Chronic obstructive pulmonary disease: Prevalence, pathogenesis, and potential impact

Sarkar, Malay; Rajta, Puja Negi; Khatana, Jasmin

doi:10.4103/0970-2113.152626

Cited by 51 publications

(51 citation statements)

References 93 publications

(96 reference statements)

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“…Anemia of chronic disease is probably the most common type of anemia associated with COPD. 19 Male patients had mean Hb level slightly lower than the normal in our study. The difference in the Hb level was neither significant among male and female groups nor in other groups like AECOPD with cor pulmonale, systemic diseases and AECOPD patients who were smokers.…”

Section: Discussioncontrasting

confidence: 55%

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Role of CBC Parameters in COPD with Acute Exacerbation in a Tertiary Care Center

et al. 2019

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Chronic obstructive pulmonary disease (COPD) is a major global health problem. It is a complex disease characterised by chronic inflammation in the airways by noxious particles. Episodes of increased symptoms called as acute exacerbations are associated with accelerated decline in the lung function. Blood cultures to find out the causative organism in these cases are time consuming. Complete Blood Count (CBC) parameters like Total leukocyte count (TLC), hemoglobin (Hb), platelet count, Mean Platelet Volume (MPV), Platelet Distribution Width (PDW) are found to be related with COPD and its acute exacerbation. An observational hospital based descriptive study was conducted for a period of six months in the Department of Pathology and Medicine of a tertiary care centre. A total of 144 patients of COPD with acute exacerbation (AECOPD) were included in the study. The mean age of the patients was 70.47 ± 9.49 years with female preponderance (61.1%). Though mean hemoglobin level (13.25 ± 2.70 gm %), (95% CI 12.80-13.69) showed statistical significance, other CBC parameters had no obvious difference among the different groups of AECOPD patients. But we cannot deny on the clinical significance of these parameters. The TLC and platelet count were slightly lower in the AECOPD patients with cor pulmonale when compared with AECOPD patients without cor pulmonale. Similarly, platelet parameters like MPV and PDW were slightly higher in the AECOPD patients who are smokers. Though these parameters were not statistically significant, they are found to be cost effective, time saving and clinically significant which would definitely help in the management of AECOPD patients. Hence, these parameters can be used as an easily measurable AECOPD biomarker.

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Section: Discussioncontrasting

confidence: 55%

“…Anemia has been recognized as a frequent comorbidity in COPD patients. 19,20 The prevalence of anemia in patients with COPD varies from 7.5% to 33%. Anemia of chronic disease is probably the most common type of anemia associated with COPD.…”

Section: Discussionmentioning

confidence: 99%

Role of CBC Parameters in COPD with Acute Exacerbation in a Tertiary Care Center

et al. 2019

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“…2) Plasma cytokines such as interleukin 1 (IL-1) and tumor necrosis factor-α (TNF-α) could not only attenuate the renal erythropoietin (EPO) production, but also blunt the erythroid progenitor response to EPO. In addition, INF-γ contributes to apoptosis of the erythroid progenitors and decrease the EPO receptor expression [17]. 3) RBC are dynamic reservoirs of cytokines [18].…”

Section: Discussionmentioning

confidence: 99%

A Tool to Early Predict Severe Corona Virus Disease 2019 (COVID-19) : A Multicenter Study using the Risk Nomogram in Wuhan and Guangdong, China

Gong

Qiu

et al. 2020

Preprint

128

160

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Older age; higher LDH, CRP, RDW, DBIL, BUN; lower ALB on admission correlated with higher odds of severe COVID-19. An effective prognostic nomogram composed of 7 features could allow early identification of patients at risk of exacerbation to severe COVID-19. Abstract BackgroundDue to no reliable risk stratification tool for severe corona virus disease 2019 patients at admission, we aimed to construct an effective model for early identifying cases at high risk of progression to severe COVID-19. MethodsIn this retrospective three-centers study, 372 non-severe COVID-19 patients during hospitalization were followed for more than 15 days after admission. Patients who deteriorated to severe or critical COVID-19 and patients who kept non-severe state were assigned to the severe and non-severe group, respectively. Based on baseline data of the two groups, we constructed a risk prediction nomogram for severe COVID-19 and evaluate its performance. ResultsThe train cohort consisted of 189 patients, while the two independent validation cohorts consisted of 165 and 18 patients. Among all cases, 72 (19.35%) patients developed severe COVID-19. We found that old age, and higher serum lactate dehydrogenase, C-reactive protein, the coefficient of variation of red blood cell distribution width, blood urea nitrogen, direct bilirubin, lower albumin, are associated with severe COVID-19. We generated the nomogram for early identifying severe COVID-19 in the train cohort (AUC 0.912 [95% CI 0.846-0.978], sensitivity 85.71%, specificity 87.58%); in validation cohort (0.853 [0.790-0.916], 77.5%, 78.4%). The calibration curve for probability of severe COVID-19 showed optimal agreement between prediction by nomogram and actual observation. Decision curve and clinical impact curve analysis indicated that nomogram conferred high clinical net benefit. ConclusionOur nomogram could help clinicians to early identify patients who will exacerbate to severe COVID-19, which will enable better centralized management and early treatment of severe patients.

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“…[20] The mechanisms of anemia in COPD are multifactorial. [21] Postulated mechanisms include anemia of chronic disease (ACD), iron deficiency, vitamin deficiency, associated co-morbidities, hypogonadism, and treatment related. [22] Of these ACD is probably the predominant mechanism.…”

Section: Discussionmentioning

confidence: 99%

Predictors of outcome in patients admitted with acute exacerbation of chronic obstructive pulmonary disease in a rural Tertiary Care Center

Ittyachen

Krishnamoorthy

Bhatt

et al. 2016

J Family Med Prim Care

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Background:Chronic obstructive pulmonary disease (COPD) is associated with a high degree of mortality and morbidity around the world with the burden of the disease being more in the developing countries. In the Indian context data is limited. This study was carried out to determine the predictors of outcome in patients admitted with acute exacerbation of COPD in a rural Tertiary Care Center in the state of Kerala.Materials and Methods:This was a prospective cohort study. Patients admitted with acute exacerbation of COPD in the Intensive Care Unit between August 2013 and July 2014 was included in the study. Sociodemographic data, clinical variables, and investigations were collected. Mortality with respect to relevant risk factors was compared using Kaplan–Meier method and Cox proportional hazard model.Results:Seventy patients were enrolled in the study of whom 58 (82.9%) were above the age of 60 years. Majority of the patients (87.1%) were males. Tobacco smoking was the main risk factor in them. All the females had a history of exposure to biomass fuel in the form of firewood; none of them were smokers. Majority of patients (80.0%) had a history of one or more co-existing illnesses. Anemia was found to be an independent risk factor for mortality (adjusted hazard ratio: 3.167, 95% confidence interval: 1.516–6.616). Risk factors for poor outcome in COPD patients reported from other centers in India were not found to be relevant in this study.Conclusions:Anemia could be an independent risk factor for mortality in COPD patients. India already has a high prevalence of iron deficiency anemia especially in the rural area and in the geriatric population. Henceforth, family practitioners and primary care physicians may remain vigilant regarding the development of anemia in their COPD patients and institute remedial measures without delay. Futhermore, the wide variation reported in the predictors of outcome of COPD along with the finding of this study calls for an urgent need for more studies.

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Anemia in Chronic obstructive pulmonary disease: Prevalence, pathogenesis, and potential impact

Cited by 51 publications

References 93 publications

Role of CBC Parameters in COPD with Acute Exacerbation in a Tertiary Care Center

Role of CBC Parameters in COPD with Acute Exacerbation in a Tertiary Care Center

A Tool to Early Predict Severe Corona Virus Disease 2019 (COVID-19) : A Multicenter Study using the Risk Nomogram in Wuhan and Guangdong, China

Predictors of outcome in patients admitted with acute exacerbation of chronic obstructive pulmonary disease in a rural Tertiary Care Center

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