On-admission anemia predicts mortality in COVID-19 patients: A single center, retrospective cohort study.
On-admission anemia predicts mortality in COVID-19 patients: A single center, retrospective cohort study.
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DOI：
10.1016/j.ajem.2021.03.083
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发表时间：
2021-10
期刊：
影响因子：
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通讯作者：
Leff J
中科院分区：
文献类型：
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作者：
Oh SM;Skendelas JP;Macdonald E;Bergamini M;Goel S;Choi J;Segal KR;Vivek K;Nair S;Leff J
我们研究了基于入院血红蛋白（Hb）水平的贫血对2019冠状病毒病（COVID-19）住院患者严重结局的影响，作为预后风险因素。一项单中心、回顾性队列研究从2020年3月至6月间在Montefiore医学中心急诊科就诊的4356例实验室确诊的SARS-CoV-2病例中随机抽取733例成人患者（年龄≥ 18岁）进行。主要结局是COVID-19住院严重结局的复合终点。次要结局是院内全因死亡率。在我们最终分析的733例患者中，438例（59.8%）出现贫血。轻度贫血105例（14.3%），中重度贫血333例（45.5%）。总体而言，437例患者（59.6%）的复合终点为重度结局。入院时贫血是全因死亡的独立危险因素（比值比1.52，95% CI [1.01-2.30]，p = 0.046），但不是复合严重结局的独立危险因素。然而，入院时中重度贫血（Hb < 11 g/dL）与住院期间的严重结局（OR 1.53，95% CI [1.05-2.23]，p = 0.028）和死亡率（OR 1.67，95% CI [1.09-2.56]，p = 0.019）独立相关。入院时贫血与COVID-19住院患者的全因死亡率增加独立相关。此外，中重度贫血（Hb <11 g/dL）是严重COVID-19结局的独立风险因素。展望未来，COVID-19患者管理和风险分层可能会从解决入院时的贫血中受益。
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.