tetano
Editor, Senior Moderator
Crit Care Explor
. 2024 Aug 22;6(9):e1143.
doi: 10.1097/CCE.0000000000001143. eCollection 2024 Sep 1. Impact of Hemoglobin Levels on Composite Cardiac Arrest or Stroke Outcome in Patients With Respiratory Failure Due to COVID-19
Shi Nan Feng[SUP] 1 [/SUP], Thu-Lan Kelly[SUP] 2 [/SUP], John F Fraser[SUP] 3 4 [/SUP], Gianluigi Li Bassi[SUP] 3 5 [/SUP], Jacky Suen[SUP] 3 [/SUP], Akram Zaaqoq[SUP] 6 [/SUP], Matthew J Griffee[SUP] 7 [/SUP], Rakesh C Arora[SUP] 8 9 [/SUP], Nicole White[SUP] 2 3 [/SUP], Glenn Whitman[SUP] 1 [/SUP], Chiara Robba[SUP] 2 [/SUP], Denise Battaglini[SUP] 2 [/SUP], Sung-Min Cho[SUP] 1 [/SUP]; COVID-19 Critical Care Consortium (CCCC)
Affiliations
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.
. 2024 Aug 22;6(9):e1143.
doi: 10.1097/CCE.0000000000001143. eCollection 2024 Sep 1. Impact of Hemoglobin Levels on Composite Cardiac Arrest or Stroke Outcome in Patients With Respiratory Failure Due to COVID-19
Shi Nan Feng[SUP] 1 [/SUP], Thu-Lan Kelly[SUP] 2 [/SUP], John F Fraser[SUP] 3 4 [/SUP], Gianluigi Li Bassi[SUP] 3 5 [/SUP], Jacky Suen[SUP] 3 [/SUP], Akram Zaaqoq[SUP] 6 [/SUP], Matthew J Griffee[SUP] 7 [/SUP], Rakesh C Arora[SUP] 8 9 [/SUP], Nicole White[SUP] 2 3 [/SUP], Glenn Whitman[SUP] 1 [/SUP], Chiara Robba[SUP] 2 [/SUP], Denise Battaglini[SUP] 2 [/SUP], Sung-Min Cho[SUP] 1 [/SUP]; COVID-19 Critical Care Consortium (CCCC)
Affiliations
- PMID: 39172625
- DOI: 10.1097/CCE.0000000000001143
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.