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Anemia associated with higher mortality, severe disease in hospitalized COVID-19 patients

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Anemia in hospitalized patients with COVID-19 is associated with a more pronounced pro-inflammatory profile at baseline and an increased incidence of in-hospital mortality and severe disease, according to a new study that suggests anemia is a potential predictor of disease severity in COVID-19 patients.

Retrospective data was collected from all adult patients admitted for COVID-19 between September 1, 2020, and August 31, 2022, in the 2 participating hospitals. Anemia was defined as hemoglobin (Hb) levels below 13 g/dl for males and below 12 g/dl for females. The association between anemia, in-hospital mortality, and severe COVID-19 was analyzed using Cox’s regression analysis.

Out of the 1562 patients included in the analysis, the prevalence of anemia was found to be 45.1% (95% CI 43-48%). Patients with anemia were significantly older and had more co-morbidities compared to those without anemia. They also exhibited higher baseline levels of procalcitonin, C-reactive protein (CRP), ferritin, and interleukin-6 (IL-6).

The study found that the incidence of mortality was approximately 4 times higher in patients with anemia compared to those without. After adjusting for 17 potential confounders, the presence of anemia was found to significantly increase the risk of death (HR = 2.68; 95% CI: 1.59-4.52) and the risk of severe COVID-19 (OR = 2.31; 95% CI: 1.65-3.24). Propensity score analysis further confirmed these findings.

Veronese N, Segala FV, Carruba L, et al. Anemia as a risk factor for disease progression in patients admitted for COVID-19: data from a large, multicenter cohort study. Sci Rep. 2023;13(1):9035. doi: 10.1038/s41598-023-36208-y. PMID: 37270578.