COVID-19’da hangi anemi mortaliteyle ilişkili? Hafif, orta, ciddi?

Öz

Amaç:COVID-19 hastalarında yoğun bakım (ICU) kabulü sırasında anemi prevalansını, anemi ile mortalite, hastanede ve yoğun bakımda kalış sürelerinin((LOS-H ve LOC-ICU) ilişkisini araştırmayı amaçladık. Gereç ve Yöntemler:Yoğun bakım ihtiyacı olan 288 COVID-19 hastasını retrospektif olarak analiz ettik. Hastalar iki gruba ayrıldı: anemikler ve anemik olmayanlar. Grupların demografik verileri, ICU kabulleri sırasındaki labaratuar bulguları, LOS-H ve LOS-ICU ve mortaliteleri kıyaslandı. Hemoglobin düzeyleri temel alınarak ileri bir sınıflama yapıldı; ciddi, orta ve hafif anemik hastalar analiz edildi. LOS-H, LOS-ICU ve mortalite hemoglobin düzeyi 109 g/L altındaki ve üstündeki hastalar arasında kıyaslandı. Böylece orta ve ciddi anemik hastalarla hafif anemikler ve anemik olmayanlar karşılaştırıldı. Bulgular:Yoğun bakım kabulü sırasında 137 hastada (%47,6) anemi saptandı. Bunların 54’ünün (%39,4) hafif, 76’sının (%55,5) orta, 7’sinin (%5,1) ağır anemisi vardı. Anemik hastalar daha yaşlı, çoklu komorbiditeye sahip, daha düşük hemoglobin ve albümin, daha yüksek kırmızı küre dağılım genişliği(RDW), kreatinin ve prokalsitonin düzeylerine sahipti. LOS-H , LOS-ICU ve mortalite oranları anemik olan ve olmayan hastalar arasında anlamlı olarak fark göstermezken, hemoglobin düzeyleri ≤ 109 g/L hastalarda (orta ve ağır anemikler) mortalite oranları hemoglobin düzeyleri > 109 g/L (hafif anemikler ve anemik olmayanlar) göre anlamlı olarak yüksekti. LOS-H ve LOS-ICU bu hasta gruplarında anlamlı fark göstermedi. Sadece yedi hastanın ağır anemisi vardı ve bunların tamamı öldü Sonuç:Bu çalışmanın sonuçları; yoğun bakımdaki COVID-19 hastalarında anemi prevalansının yüksek ve hafif anemi artmış mortalite ile ilişkili değilken orta ve ağır aneminin artmış mortalite ile ilişkili olduğunu göstermiştir.COVID-19 hastalarında anemik hastaların hemoglobin düzeyleri hastalığın ilerleyişinin erken tespiti için sık monitorize edilmelidir. Anahtar kelimeler: hafif anemi,; mortalite; yoğun bakım; SARS-CoV-2

Anahtar Kelimeler

• hafif anemi
• mortalite
• yoğun bakım
• SARS-CoV-2

Which anemia is associated with mortality in COVID-19? Mild, moderate or severe ?

Öz

Aim:We aimed to investigate the prevalence of anemia at admission to intensive care unit (ICU), association between anemia and mortality, lengths of stay in hospital and ICU (LOS-H and LOS-ICU) in COVID-19 patients. Material and Methods:We retrospectively analyzed the data of 288 COVID-19 patients who needed ICU admission. Patients were divided into two groups: anemic and nonanemic. Demographic data, labaratory findings at ICU admission, LOS-H and LOS-ICU, mortality were compared between groups. A further classification was made based on hemoglobin levels; severe, moderate and mild anemic patients were analyzed. LOS-H, LOS-ICU and mortality were compared between patients with hemoglobin > 109 g/L and ≤ 109 g/L. Thus; moderate and severe anemic patients were compared to mild anemic and nonanemic patients. Results: Anemia was detected in 137 (47.6%) patients upon admission to the ICU. Of those; 54 patients (39.4%) had mild, 76 patients (55.5%) had moderate, 7 patients (5.1%) had severe anemia. Anemic patients were older, had multiple comorbidities, lower hemoglobin and albumin, higher red cell distribution width (RDW), creatinine and procalcitonin levels. While LOS-H, LOS-ICU and mortality rates did not significantly differ between anemic and nonanemic patients; mortality rate was significantly high in patients with hemoglobin levels ≤ 109 g/L (moderate anemic) compared to patients with a hemoglobin level > 109 g/L (mild anemic and nonanemic). LOS-H and LOS-ICU were not significantly different between these patient groups. Only seven patients had severe anemia and all of these died. Conclusion: The results of this retrospective study showed that the anemia prevalence in ICU patients with COVID-19 was high, and mild anemia was not associated with higher mortality rates, while moderate and severe anemia were. Hemoglobin levels of anemic patients with COVID-19 should be closely monitored for timely detecting signs of disease progression.

Anahtar Kelimeler

• mild anemia
• mortality
• intensive care
• SARS-CoV-2

Kaynakça

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