Anemia is associated with severe illness in COVID‐19: A retrospective cohort study

Abstract

Background and objective Anaemia commonly aggravates the severity of respiratory diseases, whereas thus far, few study has elucidated the impact of anaemia on Corona Virus Disease 2019 (COVID‐19). The aim of this study was to evaluate the clinical characteristics of patients with anaemia, and to further explore the relationship between anaemia and the severity of COVID‐19. METHODS In this single‐center, retrospective, observational study, a total of 222 confirmed patients admitted to Wuhan Ninth Hospital from December 1, 2019 to March 20, 2020 were recruited, including 79 patients with anaemia and 143 patients without anaemia. Clinical characteristics, laboratory findings, disease progression and prognosis were collected and analyzed. Risk factors associated with the severe illness in COVID‐19 were established by univariable and multivariable logistic regression models. Result In our cohort, compared to patients without anaemia, patients with anaemia were more likely to have one or more comorbidities and severe COVID‐19 illness. More patients demonstrated elevated levels of C‐reactive protein (CRP), procalcitonin (PCT) and creatinine in anaemia group. Levels of erythrocyte sedimentation rate (ESR), D‐dimer, myoglobin, T‐pro brain natriuretic peptide (T‐pro‐BNP) and urea nitrogen (BUN) in patients with anaemia were significantly higher than those without. In addition, the proportion of patients with dyspnoea, elevated CRP and PCT was positively associated with the severity of anaemia. The Odd Ratio (OR) of anaemia related to the severe condition of COVID‐19 was 3.47(95% CI: 1.02‐11.75, P=0.046) and 3.77 (95% CI:1.33‐10.71, P=0.013) after adjustment for baseline date and laboratory indices, respectively. Conclusion Anaemia is an independent risk factor associated with the severe illness of COVID‐19, and healthcare professionals should be more sensitive to the haemoglobin levels of COVID‐19 patients on admission. Awareness of anemia as a risk factor for COVID‐19 was of great significance. Trial registration Ethics committee of Wuhan University People's Hospital (wdry2020‐k064) This article is protected by copyright. All rights reserved.

Approaches to Nutritional Screening in Patients with Coronavirus Disease 2019 (COVID-19)

“…Nutritional deficiencies are common among severe and fatal COVID-19, especially elderly adults and patients with age-related comorbidities such as diabetes and cardiovascular disorders [ 2 , 5 , 6 , 24 ]. Hypovitaminosis D [ 5 , 23 ], anemia [ 2 , 6 , 25 , 26 , 27 ], iron metabolism dysfunction [ 2 , 6 ], selenium deficiency [ 22 , 23 ], and hypoproteinemia [ 24 , 28 ] are associated with increased levels of proinflammatory cytokines, disease severity, increased admission to the hospital/intensive care unit (ICU), need for mechanical ventilation, and death among COVID-19 patients.…”

“…Traditional nutritional screening measures, involving a complete nutritional examination, are only performed by qualified health professionals such as nutritionists or physicians [ 42 ]. Given the urgent and rapidly progressing nature of COVID-19 [ 24 , 26 , 41 , 45 ], there is less chance to have such sophisticated examinations frequently conducted. Thus, some vulnerable patients may be missed out ending with the development of serious disease adverse effects.…”

Anemia and COVID‐19: A prospective perspective

“…To the Editor, In a recent report, Tao et al 1 described that anemia, diagnosed based on hemoglobin measured within the first 24 h after hospital admission, was independently associated with progression to severe coronavirus disease 2019 . In a recent meta-analysis, we reported a weighted mean difference (WMD) of −6.52 (95% CI, −9.2, −3.85) g/L in the hemoglobin of patients progressing to severe COVID-19 compared to those who did not.…”

CKD patients: A high‐risk category for severe COVID‐19

“…11 Another study declared anemia as an independent risk factor for severe COVID-19, calling healthcare professionals to be more sensitive to the hemoglobin levels of patients with COVID-19 upon admission. 12 On the other hand, severe COVID-19 is associated with inflammation that can itself affect iron homeostasis, producing anemia. Anemia resulting from COVID-19 is characterized by reduced levels of serum iron and transferrin with normal or increased ferritin levels.…”