Abstract
Introduction. The prevalence and prognostic implications of anemia in patients infected by the SARS-CoV-2 remains unclear. We performed a systematic review and meta-analysis to assess the prevalence and mortality risk in COVID-19 patients with anemia. Methods. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed in abstracting data and assessing validity. We searched MEDLINE and Scopus to locate all the articles published up to 1 September 2021, reporting data on the adjusted OR (aOR) for mortality among COVID-19 patients with anemia. The pooled prevalence of anemia among COVID-19 patients was calculated using a random effects model and presenting the related 95% confidence interval (CI), while the mortality risk was estimated using the Mantel-Haenszel random effects models with odds ratio (aOR) and related 95% CI. Statistical heterogeneity was measured using the Higgins I2 statistic. Results. Five studies, enrolling 9.623 COVID-19 patients [3.707 males (38.5%)], met the inclusion criteria and were included in the final analysis. The pooled prevalence of anemia was 25.6% of cases (95% CI: 8.3–56.5%), with high heterogeneity (I2 = 98.9%). Meta-regression showed that the anemia prevalence was influenced by a direct correlation with age (p = 0.007) and chronic kidney disease (p = 0.004) as moderating variables. Conversely, an inverse relationship was observed with male gender (p < 0.0001). Anemia was significantly associated with higher risk of short-term mortality (aOR: 1.69, 95% CI: 1.28–2.24, p < 0.001), with low heterogeneity (I2 = 0%). Conclusions. Anemia represents a major comorbidity in about 25% of COVID-19 patients and it is associated with about 70% higher risk of short-term mortality.
Highlights
IntroductionOver the last two years, several analyses have demonstrated that the prognosis of patients with COVID-19 infection is closely related to the burden of associated comorbidities, such as arterial hypertension (HT), atrial arrhythmias, diabetes mellitus (DM) and more generally to cardiovascular disease (CVDs) [1,2,3,4,5]
The prevalence and prognostic implications of anemia in patients infected by the SARS-CoV-2 remains unclear
Over the last two years, several analyses have demonstrated that the prognosis of patients with COVID-19 infection is closely related to the burden of associated comorbidities, such as arterial hypertension (HT), atrial arrhythmias, diabetes mellitus (DM) and more generally to cardiovascular disease (CVDs) [1,2,3,4,5]
Summary
Over the last two years, several analyses have demonstrated that the prognosis of patients with COVID-19 infection is closely related to the burden of associated comorbidities, such as arterial hypertension (HT), atrial arrhythmias, diabetes mellitus (DM) and more generally to cardiovascular disease (CVDs) [1,2,3,4,5]. Few investigations, often achieving conflicting results, have focused their attention on the association between anemia in COVID-19 patients and the related risk of short-term mortality [6,7]. Recent studies have demonstrated that pre-existing anemia represents a risk factor for severe COVID-19 infection [8,9]. Anemia remains a global health concern, representing a significant risk factor for hospitalization and/or mortality, especially in those patients infected by the SARS-CoV-2 virus who present other comorbidities associated with a poor prognosis [10,11,12]. In the present study we estimated the pooled prevalence and the influence of anemia on short-term mortality, defined as in-hospital mortality, in COVID-19 patients by a systematic review and meta-analysis of the available data
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