Effects of Anemia on Clinical Outcomes in Hospitalized Patients with COVID-19 Pneumonia

Abstract

BSTRACT Objective: We aimed to examine the role of anemia on clinical outcomes including intensive care unit (ICU) admission and mechanical ventilation (MV) in coronavirus disease 2019 (COVID-19) patients. Materials and methods: Totally 175 hospitalized COVID-19 patients were retrospectively included. Patients with a hemoglobin level of <12 g/dL in women and <13 g/dL in men constituted the anemic group, while COVID-19 patients with normal hemoglobin levels constituted the non-anemic group. A logistic regression analysis was performed to investigate the role of anemia and serum ferritin value for prediction of ICU and MV requirement. Results: Of patients, 46 (45.7%, 21 men) had anemia and 129 (68.2%, 88 men) had normal hemoglobin levels. The ICU requirement and MV rates were significantly higher in anemic group compared to non-anemic group (30.4% vs. 15.5%, respectively; p=0.028 and 23.9% vs. 10.9%, respectively; p=0.030). Median length of hospital and ICU stay was longer in patients with anemia (10.5 days vs. 8 days, respectively; p=0.047 and 0 days vs. 0 days, respectively; p=0.027). Anemia and ferritin were significant risk factors for ICU admission in univariate model and multivariate model [OR: 2.384 (95% CI: 1.084-5.246), p=0.031] vs. [OR: 2.738 (95% CI: 1.130-6.635), p=0.026] and [OR: 5.058 (95% CI: 1.968-12.998), p=0.001] vs. [OR: 4.218 (95% CI: 1.521-11.697), p=0.006]. Anemia was also a risk factor for MV [OR: 2.582 (95% CI: 1.075-6.197), p=0.034]. Conclusion: Requirement for therapy in ICU and MV were high among anemic COVID-19 patients. Anemia is also associated with prolonged length of stay in hospital and ICU.