On-Admission Anemia and Survival Rate in COVID-19 Patients

Background: Anemia often worsens the severity of respiratory illnesses, and few studies have so far elucidated the impact of anemia on COVID-19 infection. This study aimed to evaluate the effect of anemia at admission on the overall survival of COVID-19 patients using AFT models.Methods: This registry-based, single-center retrospective cohort study was conducted in a university hospital in Ilam, the southwest of Iran, between March 2020 and September 2021. AFT models were applied to set the data of 2,441 COVID-19 patients. Performance of AFT models was assessed using AIC and Cox-Snell residual. On-admission anemia was defined as Hb concentration <120 g/l in men, <110 g/l in women, and <100 g/l in pregnant women.Results: The median in-hospital survival times for anemic and non-anemic patients were 27 and 31 days, respectively. Based on the AIC and Cox-Snell residual graph, the Weibull model had the lowest AIC and it was the best fitted model to the data set among AFT models. In the adjusted model, the results of the Weibull model suggested that the anemia (adjusted TR: 1.04; 95% CI: 1.00-1.08; p = 0.03) was the accelerated factor for progression to death in COVID-19 patients. Each unit of increase in hemoglobin in COVID-19 patients enhanced the survival rate by 4%.Conclusion: Anemia is an independent risk factor associated with the risk of mortality from COVID-19 infection. Therefore, healthcare professionals should be more sensitive to the Hb level of COVID-19 patients upon admission.

Anemia and risk of Mortality in COVID-19 infection: Application of accelerated failure time models

Background: Anemia typically worsens the severity of respiratory illnesses, while few studies have so far elucidated the impact of anemia on COVID-19 infection. The aim of this study was to evaluate the effect of anemia at admission on overall survival in patients with COVID-19 infection using accelerated failure time models (AFT). Methods: This is a registry-based, single-center retrospective cohort study of in-patients COVID-19 infection between March 5, 2020, and September 10, 2021, in the university hospital in Ilam, southwest of Iran. In this study, AFT models are applied to the data set of 2441 COVID-19 patients. Performance among AFT models was assessed using Akaike’s Information Criterion (AIC) and visual Cox-Snell residual. Hemoglobin (Hb) concentrations at admission <120 gr/l in men, <110 gr/l in women and <100gr/l in pregnant women were considered anemia. Results: The in-hospital median survival time for anemic and non-anemic patients was 27 and 31 days, respectively. AIC and Cox-Snell residual graph showed that the Weibull model had the lowest AIC and was the best-fitted model to the data set among AFT models. In the adjusted model, the results of the Weibull model showed that the anemia (adjusted Time Ratio;1.04, 95% CI: 1.00 - 1.08, P = 0.03), was the accelerated factor for progression to death in COVID-19 infection. Each additional unit Hb level was shown to increase the 4% survival rate in COVID-19 patients. Conclusion: anemia is an independent risk factor associated with mortality COVID-19 infection, and healthcare professionals should be more sensitive to the Hb levels of COVID-19 patients upon admission. Of great importance was awareness of anemia as a risk factor for mortality in COVID-19 patients.

Hypo- and Hyperphosphatemia at Admission as Independent Factors of Mortality of COVID-19 Patients: Findings from a Retrospective Cohort Study.

Background: Electrolyte imbalances are common in COVID-19 infection and are associated with poor outcomes in hospitalized patients. Objectives: This study examined whether serum phosphate imbalances at admission are associated with mortality in hospitalized COVID-19 patients. Methods: In this registry-based single-center retrospective cohort study, 1349 inpatients with COVID-19 were included from March 2020 to March 2021 in an academic hospital in Ilam (southwest Iran). The Cox proportional hazard (PH) regression model was applied to the data set of COVID-19. Results: The in-hospital median survival time for patients with low, normal, and high serum phosphate levels was 14, 25, and 8 days, respectively. In a multivariate model, adjusted for the other variables, patients with hypophosphatemia (adjusted hazard ratio [HR], 2.53; 95% CI, 1.15 - 5.58; P = 0.02) and hyperphosphatemia (adjusted HR, 1.77; 95% CI, 1.00 - 3.14; P = 0.05) had an increased mortality hazard compared with those who had normal levels of serum phosphate. Conclusions: Our results demonstrate associations of hypophosphatemia and hyperphosphatemia with increased in-hospital mortality in COVID-19 patients. Intensive medical care and more attention must be paid to COVID-19 patients with serum phosphate imbalances at admission.

Immune and bioinformatics identification of T cell and B cell epitopes in the protein structure of SARS-CoV-2: A systematic review.

The beginning of 2020 was marked as the emergence of a COVID-19 outbreak caused by a new coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Currently, there is no vaccine or approved treatment for this infectious virus so the invention of an efficient vaccine is certainly a high priority. Some studies have employed several techniques to facilitate the combination of the immunoinformatics approach and comparative genomic approach in order to determine the potential peptides for designing the T-cell epitope-based peptide vaccine using the 2019-nCoV envelope protein as a target. Via screening the bioimmunoinformatic SARS-CoV2 derived B-cell and T-cell epitopes within the basic immunogenic of SARS-CoV2 proteins, we presented a set of inferred B-cell and T-cell epitopes from the spike (S) and nucleocapsid (N) proteins with high antigenicity and without allergenic property or toxic effects. Our findings provide a screened set of epitopes that can be introduced as potential targets for developing peptide vaccines against the SARS-CoV-2 virus.