Anemia and disturbances of iron metabolism are frequently encountered in patients with COVID-19 and associated with an adverse clinical course. We retrospectively analyzed 645 consecutive COVID-19 patients hospitalized at the Innsbruck University Hospital. Pre-existing anemia was associated with increased risk for in-hospital death. We further found that the decline in hemoglobin levels during hospital stay is more pronounced in patients with signs of hyperinflammation upon admission, the latter being associated with a nearly two-fold higher risk for new onset anemia within one week. Anemia prevalence increased from 44.3% upon admission to 87.8% in patients who were still hospitalized after two weeks. A more distinct decrease in hemoglobin levels was observed in subjects with severe disease, and new-onset anemia was associated with a higher risk for ICU admission. Transferrin levels decreased within the first week of hospitalization in all patients, however, a continuous decline was observed in subjects who died. Hemoglobin, ferritin, and transferrin levels normalized in a median of 122 days after discharge from hospital. This study uncovers pre-existing anemia as well as low transferrin concentrations as risk factors for mortality in hospitalized COVID-19 patients, whereas new-onset anemia during hospitalization is a risk factor for ICU admission. Anemia and iron disturbances are mainly driven by COVID-19 associated inflammation, and cure from infection results in resolution of anemia and normalization of dysregulated iron homeostasis.
【저자키워드】 COVID-19, SARS-CoV-2, Anemia, disease severity, outcome, recovery, hyperinflammation, iron deficiency, hemoglobin course, anemia of inflammation, 【초록키워드】 Inflammation, Hospitalized, Mortality, Hospitalization, hospital, Infection, ferritin, risk factor, discharge, metabolism, Prevalence, Clinical course, Transferrin, Patient, ICU admission, hemoglobin, university, Admission, patients, Concentration, severe disease, COVID-19 patient, Hospital stay, In-hospital death, hospitalized COVID-19 patients, higher risk, increased risk, subject, iron homeostasis, decrease, analyzed, died, median, dysregulated, driven by, normalized, patients with COVID-19, still hospitalized, 【제목키워드】 Dynamics, iron, development, with COVID-19,