The Association between Anemia and Mortality of Severe Pneumonia COVID-19 Patients in the High Care Unit of a Tertiary Hospital in Jakarta

Abstract

Background: Numerous studies explored the association between anemia and mortality in patients with severe pneumonia due to COVID-19. However, the findings were inconsistent. Therefore, this study was conducted to investigate the association between anemia at HCU admission and in-hospital mortality in severe pneumonia COVID-19 patients. Methods: This retrospective cohort study obtained data on 110 COVID-19 patients with severe pneumonia who were admitted to the HCU between January, 1st 2021, and May 31st, 2021. Patients were categorized as anemic and non-anemic based on the World Health Organization (WHO) guidelines. The demographic and clinical characteristics of the subjects were described. The Chi-squared test was carried out followed by a logistic regression test to determine the association of anemia and mortality. Results: Anemia was observed in 31% of 110 patients with severe pneumonia COVID-19. The source population consisted of 60.9% men and 39.1% women with a median age of 58 years. The most prevalent comorbidity was hypertension (38.2%), followed by diabetes mellitus (27.2%), renal diseases (19.1%) and heart diseases (10%). TAnemia on HCU admission was associated with in-hospital mortality in patients with severe pneumonia COVID-19 (RR: 2.794, 95% CI 1.470-5.312). After adjusting comorbidities as confounding factors, anemia was independently associated with mortality (RR: 2.204, 95% CI: 1.124-4.323, P < 0.021). The result also showed anemic patients had longer lengths of stay and higher levels of D-dimer than non-anemic patients. The median duration length of stay among the anemic and non-anemic was 16 (11-22) and 13 (9-17) days, respectively. The median D-dimer among the anemic and non-anemic was 2220 μg/ml and 1010 μg/ml, respectively. Conclusion: There is a significant association between anemia at HCU admission and mortality in patients with severe pneumonia COVID-19 during hospitalization.