Anaemia of acute inflammation: a higher acute systemic inflammatory response is associated with a larger decrease in blood haemoglobin levels in patients with COVID-19 infection

Crooks, Colin J.; West, Joe; Morling, Joanne R.; Simmonds, Mark; Juurlink, Irene; Briggs, Steve; Cruickshank, Simon; Hammond-Pears, Susan; Shaw, Dominick; Card, Timothy R.; Fogarty, Andrew W.

Abstract

AIMS: The study tests the hypothesis that a higher acute systemic inflammatory response was associated with a larger decrease in blood hemoglobin levels in patients with Coronavirus 2019 (COVID-19) infection. METHODS: All patients with either suspected or confirmed COVID-19 infection admitted to a busy UK hospital from February 2020 to December 2021 provided data for analysis. The exposure of interest was maximal serum C-reactive protein (CRP) level after COVID-19 during the same admission. RESULTS: A maximal serum CRP >175mg/L was associated with a decrease in blood haemoglobin (-5.0 g/L, 95% confidence interval: -5.9 to -4.2) after adjustment for covariates, including the number of times blood was drawn for analysis.Clinically, for a 55-year-old male patient with a maximum haemoglobin of 150 g/L who was admitted for a 28-day admission, a peak CRP >175 mg/L would be associated with an 11 g/L decrease in blood haemoglobin, compared with only 6 g/L if the maximal CRP was <4 mg/L. CONCLUSIONS: A higher acute systemic inflammatory response is associated with larger decreases in blood haemoglobin levels in patients with COVID-19. This represents an example of anaemia of acute inflammation, and a potential mechanism by which severe disease can increase morbidity and mortality.

Citation

Crooks, C. J., West, J., Morling, J. R., Simmonds, M., Juurlink, I., Briggs, S., …Fogarty, A. W. (2023). Anaemia of acute inflammation: a higher acute systemic inflammatory response is associated with a larger decrease in blood haemoglobin levels in patients with COVID-19 infection. Clinical Medicine, 23(3), 201-205. https://doi.org/10.7861/clinmed.2022-0436

• Journal Article Type: Article
• Acceptance Date: Mar 26, 2023
• Online Publication Date: May 17, 2023
• Publication Date: 2023-05
• Deposit Date: Mar 29, 2023
• Publicly Available Date: Mar 29, 2023
• Journal: Clinical Medicine
• Print ISSN: 1470-2118
• Electronic ISSN: 1473-4893
• Publisher: Royal College of Physicians
• Peer Reviewed: Peer Reviewed
• Volume: 23
• Issue: 3
• Pages: 201-205
• DOI: https://doi.org/10.7861/clinmed.2022-0436
• Keywords: Anaemia, inflammation, COVID-19, infection
• Public URL: https://nottingham-repository.worktribe.com/output/19001801
• Publisher URL: https://www.rcpjournals.org/content/clinmedicine/early/2023/05/15/clinmed.2022-0436