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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| Veröffentlicht in: | The American journal of emergency medicine 2021-10, Vol.48, p.140-147 |
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| container_title | The American journal of emergency medicine |
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| creator | Oh, Seung Mi Skendelas, John P. Macdonald, Eric Bergamini, Michael Goel, Swati Choi, Jaeun Segal, Kathryn R. Vivek, Kumar Nair, Singh Leff, Jonathan |
| description | 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 |
| doi_str_mv | 10.1016/j.ajem.2021.03.083 |
| format | Article |
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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 <11 g/dL) was an independent risk factor for severe COVID-19 outcomes. Moving forward, COVID-19 patient management and risk stratification may benefit from addressing anemia on admission.</description><identifier>ISSN: 0735-6757</identifier><identifier>EISSN: 1532-8171</identifier><identifier>DOI: 10.1016/j.ajem.2021.03.083</identifier><identifier>PMID: 33895645</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>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 ; Medical prognosis ; 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</subject><ispartof>The American journal of emergency medicine, 2021-10, Vol.48, p.140-147</ispartof><rights>2021 Elsevier Inc.</rights><rights>Copyright © 2021 Elsevier Inc. All rights reserved.</rights><rights>2021. Elsevier Inc.</rights><rights>2021 Elsevier Inc. All rights reserved. 2021 Elsevier Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c483t-78a9618d47fd54e795ebb4012b7bf12cb5427dfb79f32482dfc5f395ccaf3df23</citedby><cites>FETCH-LOGICAL-c483t-78a9618d47fd54e795ebb4012b7bf12cb5427dfb79f32482dfc5f395ccaf3df23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0735675721002709$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33895645$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Oh, Seung Mi</creatorcontrib><creatorcontrib>Skendelas, John P.</creatorcontrib><creatorcontrib>Macdonald, Eric</creatorcontrib><creatorcontrib>Bergamini, Michael</creatorcontrib><creatorcontrib>Goel, Swati</creatorcontrib><creatorcontrib>Choi, Jaeun</creatorcontrib><creatorcontrib>Segal, Kathryn R.</creatorcontrib><creatorcontrib>Vivek, Kumar</creatorcontrib><creatorcontrib>Nair, Singh</creatorcontrib><creatorcontrib>Leff, Jonathan</creatorcontrib><title>On-admission anemia predicts mortality in COVID-19 patients: A single center, retrospective cohort study</title><title>The American journal of emergency medicine</title><addtitle>Am J Emerg Med</addtitle><description>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 <11 g/dL) was an independent risk factor for severe COVID-19 outcomes. Moving forward, COVID-19 patient management and risk stratification may benefit from addressing anemia on admission.</description><subject>Acute Kidney Injury - epidemiology</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anemia</subject><subject>Anemia - blood</subject><subject>Anemia - therapy</subject><subject>Blood Transfusion - statistics & numerical data</subject><subject>Cause of Death</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Comorbidity</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 - blood</subject><subject>COVID-19 - mortality</subject><subject>Emergency department</subject><subject>Emergency medical care</subject><subject>Emergency medical services</subject><subject>Female</subject><subject>Hemoglobin</subject><subject>Hemoglobins - metabolism</subject><subject>Hospital Mortality</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Hypotension - epidemiology</subject><subject>Hypoxic respiratory failure</subject><subject>Intensive Care Units</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Patients</subject><subject>Respiration, Artificial - statistics & numerical data</subject><subject>Respiratory Insufficiency - epidemiology</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>SARS-CoV-2</subject><subject>Sepsis</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Severity of Illness Index</subject><subject>Shock, Septic - epidemiology</subject><issn>0735-6757</issn><issn>1532-8171</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kU2L1DAch4Mo7rj6BTxIwIsHW_PapLIIy_i2sDAX9RrSJN1JaZuapAPz7c0w66IePIUkT37883sAeIlRjRFu3g21HtxUE0RwjWiNJH0ENphTUkks8GOwQYLyqhFcXIBnKQ0IYcw4ewouKJUtbxjfgP1urrSdfEo-zFDPbvIaLtFZb3KCU4hZjz4foZ_hdvfj5mOFW7jo7N2c03t4DZOf70YHTdm7-BZGl2NIizPZH8pp2JcAmPJqj8_Bk16Pyb24Xy_B98-fvm2_Vre7Lzfb69vKMElzJaRuGywtE73lzImWu65jCJNOdD0mpuOMCNt3ou0pYZLY3vCettwY3VPbE3oJPpxzl7WbnD0NFvWolugnHY8qaK_-vpn9Xt2Fg5IICYJYCXhzHxDDz9WlrEo7xo1jKSesSRGOpWAYEVnQ1_-gQ1jjXL5XKIkoaQlqCkXOlCnVpOj6h2EwUieRalAnkeokUiGqisjy6NWf33h48ttcAa7OgCtlHryLKplixRRzsdSvbPD_y_8FVEywdg</recordid><startdate>20211001</startdate><enddate>20211001</enddate><creator>Oh, Seung Mi</creator><creator>Skendelas, John P.</creator><creator>Macdonald, Eric</creator><creator>Bergamini, Michael</creator><creator>Goel, Swati</creator><creator>Choi, Jaeun</creator><creator>Segal, Kathryn R.</creator><creator>Vivek, Kumar</creator><creator>Nair, Singh</creator><creator>Leff, Jonathan</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20211001</creationdate><title>On-admission anemia predicts mortality in COVID-19 patients: A single center, retrospective cohort study</title><author>Oh, Seung Mi ; Skendelas, John P. ; Macdonald, Eric ; Bergamini, Michael ; Goel, Swati ; Choi, Jaeun ; Segal, Kathryn R. ; Vivek, Kumar ; Nair, Singh ; Leff, Jonathan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c483t-78a9618d47fd54e795ebb4012b7bf12cb5427dfb79f32482dfc5f395ccaf3df23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Acute Kidney Injury - epidemiology</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anemia</topic><topic>Anemia - blood</topic><topic>Anemia - therapy</topic><topic>Blood Transfusion - statistics & numerical data</topic><topic>Cause of Death</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Comorbidity</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>COVID-19 - blood</topic><topic>COVID-19 - mortality</topic><topic>Emergency department</topic><topic>Emergency medical care</topic><topic>Emergency medical services</topic><topic>Female</topic><topic>Hemoglobin</topic><topic>Hemoglobins - metabolism</topic><topic>Hospital Mortality</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Hypotension - epidemiology</topic><topic>Hypoxic respiratory failure</topic><topic>Intensive Care Units</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Patients</topic><topic>Respiration, Artificial - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The American journal of emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Oh, Seung Mi</au><au>Skendelas, John P.</au><au>Macdonald, Eric</au><au>Bergamini, Michael</au><au>Goel, Swati</au><au>Choi, Jaeun</au><au>Segal, Kathryn R.</au><au>Vivek, Kumar</au><au>Nair, Singh</au><au>Leff, Jonathan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>On-admission anemia predicts mortality in COVID-19 patients: A single center, retrospective cohort study</atitle><jtitle>The American journal of emergency medicine</jtitle><addtitle>Am J Emerg Med</addtitle><date>2021-10-01</date><risdate>2021</risdate><volume>48</volume><spage>140</spage><epage>147</epage><pages>140-147</pages><issn>0735-6757</issn><eissn>1532-8171</eissn><abstract>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 <11 g/dL) was an independent risk factor for severe COVID-19 outcomes. Moving forward, COVID-19 patient management and risk stratification may benefit from addressing anemia on admission.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>33895645</pmid><doi>10.1016/j.ajem.2021.03.083</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| 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 Medical prognosis 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 |
| title | On-admission anemia predicts mortality in COVID-19 patients: A single center, retrospective cohort study |
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