Mild anemia as a single independent predictor of mortality in patients with COVID‐19
Abstract The coronavirus disease 2019 (COVID‐19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2) has led to an unprecedented international health crisis. COVID‐19 clinical presentations cover a wide range from asymptomatic to severe illness and death. Given the limited therape...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-08-01
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| Series: | eJHaem |
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| Online Access: | https://doi.org/10.1002/jha2.167 |
| _version_ | 1797740022829416448 |
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| author | Douglas Tremblay Joseph L. Rapp Naomi Alpert Wil Lieberman‐Cribbin John Mascarenhas Emanuela Taioli Saghi Ghaffari |
| author_facet | Douglas Tremblay Joseph L. Rapp Naomi Alpert Wil Lieberman‐Cribbin John Mascarenhas Emanuela Taioli Saghi Ghaffari |
| author_sort | Douglas Tremblay |
| collection | DOAJ |
| description | Abstract The coronavirus disease 2019 (COVID‐19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2) has led to an unprecedented international health crisis. COVID‐19 clinical presentations cover a wide range from asymptomatic to severe illness and death. Given the limited therapeutic resources and unexpected clinical features of the disease, readily accessible predictive biomarkers are urgently needed to improve patient care and management. We asked the degree to which anemia may influence the outcome of patients with COVID‐19. To this end, we identified 3777 patients who were positively diagnosed with COVID‐19 between March 1 and April 1 2020 in New York City. We evaluated 2,562 patients with available red blood cell, hemoglobin, and related laboratory values. Multivariable cox proportional hazards regression showed that anemia was a significant independent predictor of mortality (hazard ratio (HR): 1.26, 95% Confidence Interval [CI]: 1.06‐1.51), independent of age, sex, and comorbidities. There was a direct correlation between the degree of anemia and the risk of mortality when hemoglobin was treated as a continuous variable (HRadj 1.05; [CI]: 1.01‐1.09). The hemoglobin level that was maximally predictive of mortality, was 11.5 g/dL in males and 11.8 g/dL in females. These findings identify a routinely measured biomarker that is predictive of disease outcomes and will aid in refining clinical care algorithms and optimize resource allocation. Mechanisms of impacts of anemia on COVID‐19 outcome are likely to be multiple in nature and require further investigation. |
| first_indexed | 2024-03-12T14:05:43Z |
| format | Article |
| id | doaj.art-5e4a807f18234792a73db0dec9249ed0 |
| institution | Directory Open Access Journal |
| issn | 2688-6146 |
| language | English |
| last_indexed | 2024-03-12T14:05:43Z |
| publishDate | 2021-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | eJHaem |
| spelling | doaj.art-5e4a807f18234792a73db0dec9249ed02023-08-21T14:10:34ZengWileyeJHaem2688-61462021-08-012331932610.1002/jha2.167Mild anemia as a single independent predictor of mortality in patients with COVID‐19Douglas Tremblay0Joseph L. Rapp1Naomi Alpert2Wil Lieberman‐Cribbin3John Mascarenhas4Emanuela Taioli5Saghi Ghaffari6Department of Medicine Division of Hematology Oncology Icahn School of Medicine at Mount Sinai New York New York USAInstitute for Translational Epidemiology Icahn School of Medicine at Mount Sinai New York New York USAInstitute for Translational Epidemiology Icahn School of Medicine at Mount Sinai New York New York USAInstitute for Translational Epidemiology Icahn School of Medicine at Mount Sinai New York New York USADepartment of Medicine Division of Hematology Oncology Icahn School of Medicine at Mount Sinai New York New York USAInstitute for Translational Epidemiology Icahn School of Medicine at Mount Sinai New York New York USATisch Cancer Institute Icahn School of Medicine at Mount Sinai New York New York USAAbstract The coronavirus disease 2019 (COVID‐19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2) has led to an unprecedented international health crisis. COVID‐19 clinical presentations cover a wide range from asymptomatic to severe illness and death. Given the limited therapeutic resources and unexpected clinical features of the disease, readily accessible predictive biomarkers are urgently needed to improve patient care and management. We asked the degree to which anemia may influence the outcome of patients with COVID‐19. To this end, we identified 3777 patients who were positively diagnosed with COVID‐19 between March 1 and April 1 2020 in New York City. We evaluated 2,562 patients with available red blood cell, hemoglobin, and related laboratory values. Multivariable cox proportional hazards regression showed that anemia was a significant independent predictor of mortality (hazard ratio (HR): 1.26, 95% Confidence Interval [CI]: 1.06‐1.51), independent of age, sex, and comorbidities. There was a direct correlation between the degree of anemia and the risk of mortality when hemoglobin was treated as a continuous variable (HRadj 1.05; [CI]: 1.01‐1.09). The hemoglobin level that was maximally predictive of mortality, was 11.5 g/dL in males and 11.8 g/dL in females. These findings identify a routinely measured biomarker that is predictive of disease outcomes and will aid in refining clinical care algorithms and optimize resource allocation. Mechanisms of impacts of anemia on COVID‐19 outcome are likely to be multiple in nature and require further investigation.https://doi.org/10.1002/jha2.167anemiaCOVID‐19haemoglobinmortalityprognosisRBC |
| spellingShingle | Douglas Tremblay Joseph L. Rapp Naomi Alpert Wil Lieberman‐Cribbin John Mascarenhas Emanuela Taioli Saghi Ghaffari Mild anemia as a single independent predictor of mortality in patients with COVID‐19 eJHaem anemia COVID‐19 haemoglobin mortality prognosis RBC |
| title | Mild anemia as a single independent predictor of mortality in patients with COVID‐19 |
| title_full | Mild anemia as a single independent predictor of mortality in patients with COVID‐19 |
| title_fullStr | Mild anemia as a single independent predictor of mortality in patients with COVID‐19 |
| title_full_unstemmed | Mild anemia as a single independent predictor of mortality in patients with COVID‐19 |
| title_short | Mild anemia as a single independent predictor of mortality in patients with COVID‐19 |
| title_sort | mild anemia as a single independent predictor of mortality in patients with covid 19 |
| topic | anemia COVID‐19 haemoglobin mortality prognosis RBC |
| url | https://doi.org/10.1002/jha2.167 |
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