Associations of anemia and blood transfusions with mortality in old, critically ill COVID-19 patients - Results from the prospective COVIP Study

Ralf Erkens; Dragos Duse; Bernhard Wernly; Hans Flaatten; Jesper Fjølner; Raphael Romano Bruno; Georg Wolff; Antonio Artigas; Malte Kelm; Michael Beil; Sigal Sviri; Stefan J Schaller; Kristina Fuest; Wojciech Szczeklik; Kerstin Piayda; Muhammed Elhadi; Michael Joannidis; Helene Korvenius Nedergaard; Sandra Oeyen; Rui Moreno; Susannah Leaver; Dylan W de Lange; Bertrand Guidet; Christian Jung; COVIP study group

doi:10.3233/CH-231790

Associations of anemia and blood transfusions with mortality in old, critically ill COVID-19 patients - Results from the prospective COVIP Study

Ralf Erkens, Dragos Duse, Bernhard Wernly, Hans Flaatten, Jesper Fjølner, Raphael Romano Bruno, Georg Wolff, Antonio Artigas, Malte Kelm, Michael Beil, Sigal Sviri, Stefan J Schaller, Kristina Fuest, Wojciech Szczeklik, Kerstin Piayda, Muhammed Elhadi, Michael Joannidis, Helene Korvenius Nedergaard, Sandra Oeyen, Rui MorenoSusannah Leaver, Dylan W de Lange, Bertrand Guidet, Christian Jung, COVIP study group

Department of Clinical Medicine - Operation og Intensiv, Viborg

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

AIMS: Anemia is common in the old and often observed in critically ill patients. Increased age is associated with higher mortality following a COVID-19 infection, making old patients prone to poor outcomes. We investigated whether anemia at admission to the ICU or the need for blood transfusion was associated with 90-day mortality in older, critically ill COVID-19 patients.

METHODS: In this prospective multicenter study, the 90-day mortality of COVID-19 patients≥70 years treated in 138 intensive care units (ICU) was analyzed. Associations between anemia (WHO definition) at admission and discharge from ICU and the use of red blood cell (RBC) transfusions with mortality were assessed. Hemoglobin thresholds of RBC transfusions in old, critically ill COVID-19 patients were recorded.

RESULTS: In 493 patients (350 anemic, 143 non-anemic), anemia (WHO definition) at the time of ICU admission was not associated with impaired overall survival. Transfusion and severe anemia (hemoglobin≤10 g/dL) at ICU discharge were independently associated with a higher risk of 90-day mortality.

CONCLUSION: The need for red blood cell transfusions and severe anemia at ICU discharge, but not at the timepoint of admission, were independently associated with 90-day mortality in critically-ill old COVID-19 patients.

Original language	English
Journal	Clinical Hemorheology and Microcirculation
Volume	84
Issue	3
Pages (from-to)	309-320
Number of pages	12
ISSN	1386-0291
DOIs	https://doi.org/10.3233/CH-231790
Publication status	Published - Aug 2023

Keywords

Anaemia
COVID-19
frailty
transfusion

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10.3233/CH-231790

Cite this

Erkens, R., Duse, D., Wernly, B., Flaatten, H., Fjølner, J., Bruno, R. R., Wolff, G., Artigas, A., Kelm, M., Beil, M., Sviri, S., Schaller, S. J., Fuest, K., Szczeklik, W., Piayda, K., Elhadi, M., Joannidis, M., Nedergaard, H. K., Oeyen, S., ... COVIP study group (2023). Associations of anemia and blood transfusions with mortality in old, critically ill COVID-19 patients - Results from the prospective COVIP Study. Clinical Hemorheology and Microcirculation, 84(3), 309-320. https://doi.org/10.3233/CH-231790

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title = "Associations of anemia and blood transfusions with mortality in old, critically ill COVID-19 patients - Results from the prospective COVIP Study",

abstract = "AIMS: Anemia is common in the old and often observed in critically ill patients. Increased age is associated with higher mortality following a COVID-19 infection, making old patients prone to poor outcomes. We investigated whether anemia at admission to the ICU or the need for blood transfusion was associated with 90-day mortality in older, critically ill COVID-19 patients.METHODS: In this prospective multicenter study, the 90-day mortality of COVID-19 patients≥70 years treated in 138 intensive care units (ICU) was analyzed. Associations between anemia (WHO definition) at admission and discharge from ICU and the use of red blood cell (RBC) transfusions with mortality were assessed. Hemoglobin thresholds of RBC transfusions in old, critically ill COVID-19 patients were recorded.RESULTS: In 493 patients (350 anemic, 143 non-anemic), anemia (WHO definition) at the time of ICU admission was not associated with impaired overall survival. Transfusion and severe anemia (hemoglobin≤10 g/dL) at ICU discharge were independently associated with a higher risk of 90-day mortality.CONCLUSION: The need for red blood cell transfusions and severe anemia at ICU discharge, but not at the timepoint of admission, were independently associated with 90-day mortality in critically-ill old COVID-19 patients.",

keywords = "Anaemia, COVID-19, frailty, transfusion",

author = "Ralf Erkens and Dragos Duse and Bernhard Wernly and Hans Flaatten and Jesper Fj{\o}lner and Bruno, {Raphael Romano} and Georg Wolff and Antonio Artigas and Malte Kelm and Michael Beil and Sigal Sviri and Schaller, {Stefan J} and Kristina Fuest and Wojciech Szczeklik and Kerstin Piayda and Muhammed Elhadi and Michael Joannidis and Nedergaard, {Helene Korvenius} and Sandra Oeyen and Rui Moreno and Susannah Leaver and {de Lange}, {Dylan W} and Bertrand Guidet and Christian Jung and {COVIP study group}",

year = "2023",

month = aug,

doi = "10.3233/CH-231790",

language = "English",

volume = "84",

pages = "309--320",

journal = "Clinical Hemorheology and Microcirculation",

issn = "1386-0291",

publisher = "I O S Press",

number = "3",

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Erkens, R, Duse, D, Wernly, B, Flaatten, H, Fjølner, J, Bruno, RR, Wolff, G, Artigas, A, Kelm, M, Beil, M, Sviri, S, Schaller, SJ, Fuest, K, Szczeklik, W, Piayda, K, Elhadi, M, Joannidis, M, Nedergaard, HK, Oeyen, S, Moreno, R, Leaver, S, de Lange, DW, Guidet, B, Jung, C & COVIP study group 2023, 'Associations of anemia and blood transfusions with mortality in old, critically ill COVID-19 patients - Results from the prospective COVIP Study', Clinical Hemorheology and Microcirculation, vol. 84, no. 3, pp. 309-320. https://doi.org/10.3233/CH-231790

Associations of anemia and blood transfusions with mortality in old, critically ill COVID-19 patients - Results from the prospective COVIP Study. / Erkens, Ralf; Duse, Dragos; Wernly, Bernhard et al.
In: Clinical Hemorheology and Microcirculation, Vol. 84, No. 3, 08.2023, p. 309-320.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Associations of anemia and blood transfusions with mortality in old, critically ill COVID-19 patients - Results from the prospective COVIP Study

AU - Erkens, Ralf

AU - Duse, Dragos

AU - Wernly, Bernhard

AU - Flaatten, Hans

AU - Fjølner, Jesper

AU - Bruno, Raphael Romano

AU - Wolff, Georg

AU - Artigas, Antonio

AU - Kelm, Malte

AU - Beil, Michael

AU - Sviri, Sigal

AU - Schaller, Stefan J

AU - Fuest, Kristina

AU - Szczeklik, Wojciech

AU - Piayda, Kerstin

AU - Elhadi, Muhammed

AU - Joannidis, Michael

AU - Nedergaard, Helene Korvenius

AU - Oeyen, Sandra

AU - Moreno, Rui

AU - Leaver, Susannah

AU - de Lange, Dylan W

AU - Guidet, Bertrand

AU - Jung, Christian

AU - COVIP study group

PY - 2023/8

Y1 - 2023/8

N2 - AIMS: Anemia is common in the old and often observed in critically ill patients. Increased age is associated with higher mortality following a COVID-19 infection, making old patients prone to poor outcomes. We investigated whether anemia at admission to the ICU or the need for blood transfusion was associated with 90-day mortality in older, critically ill COVID-19 patients.METHODS: In this prospective multicenter study, the 90-day mortality of COVID-19 patients≥70 years treated in 138 intensive care units (ICU) was analyzed. Associations between anemia (WHO definition) at admission and discharge from ICU and the use of red blood cell (RBC) transfusions with mortality were assessed. Hemoglobin thresholds of RBC transfusions in old, critically ill COVID-19 patients were recorded.RESULTS: In 493 patients (350 anemic, 143 non-anemic), anemia (WHO definition) at the time of ICU admission was not associated with impaired overall survival. Transfusion and severe anemia (hemoglobin≤10 g/dL) at ICU discharge were independently associated with a higher risk of 90-day mortality.CONCLUSION: The need for red blood cell transfusions and severe anemia at ICU discharge, but not at the timepoint of admission, were independently associated with 90-day mortality in critically-ill old COVID-19 patients.

AB - AIMS: Anemia is common in the old and often observed in critically ill patients. Increased age is associated with higher mortality following a COVID-19 infection, making old patients prone to poor outcomes. We investigated whether anemia at admission to the ICU or the need for blood transfusion was associated with 90-day mortality in older, critically ill COVID-19 patients.METHODS: In this prospective multicenter study, the 90-day mortality of COVID-19 patients≥70 years treated in 138 intensive care units (ICU) was analyzed. Associations between anemia (WHO definition) at admission and discharge from ICU and the use of red blood cell (RBC) transfusions with mortality were assessed. Hemoglobin thresholds of RBC transfusions in old, critically ill COVID-19 patients were recorded.RESULTS: In 493 patients (350 anemic, 143 non-anemic), anemia (WHO definition) at the time of ICU admission was not associated with impaired overall survival. Transfusion and severe anemia (hemoglobin≤10 g/dL) at ICU discharge were independently associated with a higher risk of 90-day mortality.CONCLUSION: The need for red blood cell transfusions and severe anemia at ICU discharge, but not at the timepoint of admission, were independently associated with 90-day mortality in critically-ill old COVID-19 patients.

KW - Anaemia

KW - COVID-19

KW - frailty

KW - transfusion

U2 - 10.3233/CH-231790

DO - 10.3233/CH-231790

M3 - Journal article

C2 - 37248892

SN - 1386-0291

VL - 84

SP - 309

EP - 320

JO - Clinical Hemorheology and Microcirculation

JF - Clinical Hemorheology and Microcirculation

IS - 3

ER -

Associations of anemia and blood transfusions with mortality in old, critically ill COVID-19 patients - Results from the prospective COVIP Study

Abstract

Keywords

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