Association of Hemoglobin Drop with in-hospital Mortality in COVID-19 Patients

3d rendered illustration of many blood cells

A retrospective cohort study was conducted by reviewing the medical records of 6,683 COVID-19 hospitalized patients to investigate the association of hemoglobin drop with increased risk of acute kidney injury (AKI) and in-hospital mortality among patients with COVID-19. The patient reports were classified into two groups, those with hemoglobin drop (≥3 g/dL) and those without hemoglobin drop. The analysis showed that 11.2% of patients had hemoglobin drop by 3g/dL.  The vital signs at admission of patients with hemoglobin drop are significantly different from those without any hemoglobin drop. Though the respiratory rate was 20/min for both groups, oxygen saturation level was 85% for patients with hemoglobin drop and 90% for those without  hemoglobin drop. Moreover, patients with hemoglobin drop had elevated WBC count, hemoglobin, blood urea nitrogen, d-dimer, C reactive protein, and lower eGFR compared to those without hemoglobin drop. Additionally, patients with hemoglobin drop were more likely to receive therapeutic anticoagulation treatment within two days after admission. In-hospital mortality was 40.8% for patients with hemoglobin and AKI was reported in 51.4%. This value was significantly higher when compared to the 20% mortality rate in patients without hemoglobin drop. The prevalence of AKI in patients without hemoglobin drop was only 23.9%.  Furthermore, patients with hemoglobin drop along with AKI had a higher in-hospital mortality rate compared to those with hemoglobin drop but without AKI. 

In conclusion, hemoglobin drop during COVID-19 hospitalization is associated with a higher risk of AKI and in-hospital mortality. Low hemoglobin levels decrease oxygen delivery causing poor tissue oxygenation and are a contributing factor to higher in-hospital mortality. Thus it is advised to closely monitor the hemoglobin levels in COVID-19 patients.

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Ref Link: Indian Journal of Medicine