目的:贫血与心脏骤停和中风的风险增加有关,COVID-19的常见并发症。在国际COVID-19患者队列中,研究了入住ICU时血红蛋白水平对心脏骤停或中风复合结局的影响。
方法:对前瞻性收集的数据库进行回顾性分析。
方法:对ICU入住后30天内被诊断为心脏骤停或中风的患者,对超过370个国际地点入住ICU的COVID-19患者进行了登记。贫血定义为:正常(女性血红蛋白≥12.0g/dL,男性≥13.5g/dL),轻度(女性血红蛋白10.0-11.9g/dL,男性10.0-13.4g/dL),中度(女性和男性的血红蛋白≥8.0和<10.0g/dL),和严重(女性和男性的血红蛋白<8.0g/dL)。
方法:ICU中18岁以上急性COVID-19感染患者。
方法:无。
结果:在6926例患者中(中位年龄=59岁,男性=65%),760例患者(11.0%)出现卒中(2.0%)和/或心脏骤停(9.4%)。心搏骤停或中风在低血红蛋白患者中更为常见,发生在12.8%血红蛋白正常的患者中,13.3%的轻度贫血患者,16.7%的患者患有中度/重度贫血。使用Cox比例风险回归分析,以死亡为竞争风险,根据贫血状态分析中风或心脏骤停的时间。通过临床知识选择的协变量是年龄,性别,合并症(糖尿病,高血压,肥胖,和心脏或神经系统状况),大流行时代,国家收入,机械通气,和体外膜氧合.中度/重度贫血与心脏骤停或中风的高风险相关(风险比,1.32;95%CI,1.05-1.67)。
结论:在ICUCOVID-19患者的国际注册中,中度/重度贫血与心脏骤停或中风的风险增加相关。
OBJECTIVE: 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.
METHODS: Retrospective analysis of prospectively collected database.
METHODS: 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).
METHODS: Patients older than 18 years with acute COVID-19 infection in the ICU.
METHODS: None.
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.