Journal of Clinical and Diagnostic Research. 2023 May, Vol-17(5): OC38-OC41 38 38 DOI: 10.7860/JCDR/2023/63141.18006 Original Article Internal Medicine Section Prevalence of Anaemia and its Association with Severity of COVID-19 among Hospitalised Patients: A Cross-sectional Study INTRODUCTION COVID-19 has emerged as a global pandemic with officially recorded over 628 million cases and over 6.5 million deaths as of November 2022 [1]. India also had to bear a major impact with more than 44 million cases and 0.5 million deaths till date [2]. Haematologic abnormalities in the form of reduced lymphocytes and increased neutrophil:lymphocyte ratio and its association with severity has been extensively studied and reported [3-5]. In a Chinese study in 2021, the association between anaemia and COVID-19 was described [6]. However, the association between haemoglobin levels of patients and their outcome has been less frequently described in the Indian context [7]. There is inadequate data with respect to this association in Indian patients across all classes of severities ranging from mild to severe COVID-19. Haemoglobin level as a risk factor for severe disease has not been studied adequately in the Indian context. The Indian study that has been found on this subject has shown increased severity of disease associated with low haemoglobin levels but it has included only patients from ICUs [7]. So, naturally that study included patients only with severe disease but not the vast majority of the patients with mild or moderate disease who were managed in general wards. This current study included patients from both general wards and ICU so that the subjects belong to all classes of severities and also included those with and without co-morbidities. This present study aimed to analyse the prevalence of anaemia on admission in hospitalised patients of COVID-19 and the association of haemoglobin levels with the severity of COVID-19 and death. MATERIALS AND METHODS This cross-sectional study was conducted on the hospitalised patients admitted between March 2021 and October 2021 in ESI-PGIMSR and ESIC Medical College and Hospital, Joka, Kolkata, West Bengal, India. Ethical clearance was taken from the Institutional Ethics Committee (IEC) for the study {No. 412(Dean Joka)/IEC (Joka)/2022}. Inclusion criteria: All hospitalised patients who were tested positive for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS- CoV-2) virus infection by Reverse Transcription-Polymerase Chain Reaction (RT-PCR) test or Rapid Antigen Test (RAT) were included in the study. Exclusion criteria: Patients who had incomplete data (inadequate documentation of clinical parameters) to determine severity and incomplete investigation reports of complete blood count and patients who left hospital against medical advice were excluded from the study. The number of total exclusions were 36. Procedure: After satisfying the inclusion and exclusion criteria, a total of 203 patients were included in the study. The clinical notes indicating the severity of COVID-19 (mild/moderate/severe) were studied and noted. The classification was based on the official COVID-19 management protocols issued by the Ministry of Health and Family Welfare, Government of India [8]. Mild cases had no shortness of breath or hypoxia, moderate cases had dyspnoea and/or hypoxia (oxygen saturation 90-93% on room air), respiratory rate of more or equal to 24/minutes. Severe cases had features of pneumonitis along with either of Oxygen saturation <90%, respiratory rate >30 and severe respiratory distress. The data studied were the clinical findings including the age, pulse rate, blood ANIRBAN GHOSH 1 , RIMI SOM SENGUPTA 2 , DEBJANI MALLICK 3 , ANIRBAN SARKAR 4 , SAMIR CHAKRABORTY 5 Keywords: Blood count, Co-morbidity, Coronavirus, Death, Severe ABSTRACT Introduction: Coronavirus Disease-2019 (COVID-19) emerged as a global pandemic and was associated with various haematologic abnormalities. There are very few studies from India regarding the association between anaemia and disease severity of COVID-19. Aim: To check the prevalence of anaemia and its association with severity of disease among hospitalised COVID-19 patients. Materials and Methods: This was a cross-sectional study involving 203 patients admitted in general ward and Intensive Care Unit (ICU) of a tertiary care hospital in eastern India. Complete blood count at admission along with other relevant clinical and laboratory parameters was noted. Haematological parameters of the patients were described and then correlated with disease severity and death. Spearman’s correlation and Chi-square test were used to determine the associations. Results: Out of 203 patients with COVID-19,145 (71.4%) had anaemia. The study included 107 males (52.7%) and 96 females (47.3%), of which 77 (80%) females had anaemia compared to 68 (63.5%) males. Co-morbidities were present in 73 patients. Haemoglobin levels were significantly negatively correlated with disease severity (p<0.001). This was even true for patients without any other co-morbidities (p<0.05). Haemoglobin was also negatively correlated with deaths in this study (p<0.05). Conclusion: The prevalence of anaemia in admitted patients of COVID-19 was very high and low haemoglobin levels were associated with more severe disease and death. So, low haemoglobin levels in COVID-19 may be considered as a risk factor for more severe disease and death.