AI Article Synopsis
- Anemia is linked to an increased risk of cardiac arrest and stroke in COVID-19 patients, with a study analyzing the impact of hemoglobin levels at ICU admission on these outcomes.
- The retrospective study reviewed data from over 6,900 ICU patients across 370 international sites, measuring the incidence of stroke or cardiac arrest within 30 days of admission, with anemia classified into normal, mild, moderate, and severe categories.
- The results showed that as anemia severity increased, so did the risk of cardiac arrest or stroke, particularly noting that moderate/severe anemia raised the risk by 32% compared to those with normal hemoglobin levels.
Article Abstract
Objectives: Anemia has been associated with an increased risk of both cardiac arrest and stroke, frequent complications of COVID-19. The effect of hemoglobin level at ICU admission on a composite outcome of cardiac arrest or stroke in an international cohort of COVID-19 patients was investigated.
Design: Retrospective analysis of prospectively collected database.
Setting: A registry of COVID-19 patients admitted to ICUs at over 370 international sites was reviewed for patients diagnosed with cardiac arrest or stroke up to 30 days after ICU admission. Anemia was defined as: normal (hemoglobin ≥ 12.0 g/dL for women, ≥ 13.5 g/dL for men), mild (hemoglobin 10.0-11.9 g/dL for women, 10.0-13.4 g/dL for men), moderate (hemoglobin ≥ 8.0 and < 10.0 g/dL for women and men), and severe (hemoglobin < 8.0 g/dL for women and men).
Patients: Patients older than 18 years with acute COVID-19 infection in the ICU.
Interventions: None.
Measurements And Main Results: Of 6926 patients (median age = 59 yr, male = 65%), 760 patients (11.0%) experienced stroke (2.0%) and/or cardiac arrest (9.4%). Cardiac arrest or stroke was more common in patients with low hemoglobin, occurring in 12.8% of patients with normal hemoglobin, 13.3% of patients with mild anemia, and 16.7% of patients with moderate/severe anemia. Time to stroke or cardiac arrest by anemia status was analyzed using Cox proportional hazards regression with death as a competing risk. Covariates selected through clinical knowledge were age, sex, comorbidities (diabetes, hypertension, obesity, and cardiac or neurologic conditions), pandemic era, country income, mechanical ventilation, and extracorporeal membrane oxygenation. Moderate/severe anemia was associated with a higher risk of cardiac arrest or stroke (hazard ratio, 1.32; 95% CI, 1.05-1.67).
Conclusions: In an international registry of ICU patients with COVID-19, moderate/severe anemia was associated with increased hazard of cardiac arrest or stroke.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11343536 | PMC |
| http://dx.doi.org/10.1097/CCE.0000000000001143 | DOI Listing |
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