RT Journal Article
T1 Blood Hemoglobin Substantially Modulates the Impact of Gender, Morbid Obesity, and Hyperglycemia on COVID-19 Death Risk: A Multicenter Study in Italy and Spain.
A1 Mayneris-Perxachs, Jordi
A1 Russo, Maria Francesca
A1 Ramos, Rafel
A1 de Hollanda, Ana
A1 Arxé, Arola Armengou
A1 Rottoli, Matteo
A1 Arnoriaga-Rodríguez, María
A1 Comas-Cufí, Marc
A1 Bartoletti, Michele
A1 Verrastro, Ornella
A1 Gudiol, Carlota
A1 Fages, Ester
A1 Giménez, Marga
A1 Gil, Ariadna de Genover
A1 Bernante, Paolo
A1 Tinahones, Francisco
A1 Carratalà, Jordi
A1 Pagotto, Uberto
A1 Hernández-Aguado, Ildefonso
A1 Fernández-Aranda, Fernando
A1 Meira, Fernanda
A1 Castro Guardiola, Antoni
A1 Mingrone, Geltrude
A1 Fernández-Real, José Manuel
A1 Obesity-T2DM Covid19 Study Group, 
K1 COVID-19
K1 epidemiology
K1 hemoglobin
K1 hyperglycemia
K1 machine learning
K1 mortality
K1 obesity
AB Hyperglycemia and obesity are associated with a worse prognosis in subjects with COVID-19 independently. Their interaction as well as the potential modulating effects of additional confounding factors is poorly known. Therefore, we aimed to identify and evaluate confounding factors affecting the prognostic value of obesity and hyperglycemia in relation to mortality and admission to the intensive care unit (ICU) due to COVID-19. Consecutive patients admitted in two Hospitals from Italy (Bologna and Rome) and three from Spain (Barcelona and Girona) as well as subjects from Primary Health Care centers. Mortality from COVID-19 and risk for ICU admission were evaluated using logistic regression analyses and machine learning (ML) algorithms. As expected, among 3,065 consecutive patients, both obesity and hyperglycemia were independent predictors of ICU admission. A ML variable selection strategy confirmed these results and identified hyperglycemia, blood hemoglobin and serum bilirubin associated with increased mortality risk. In subjects with blood hemoglobin levels above the median, hyperglycemic and morbidly obese subjects had increased mortality risk than normoglycemic individuals or non-obese subjects. However, no differences were observed among individuals with hemoglobin levels below the median. This was particularly evident in men: those with severe hyperglycemia and hemoglobin concentrations above the median had 30 times increased mortality risk compared with men without hyperglycemia. Importantly, the protective effect of female sex was lost in subjects with increased hemoglobin levels. Blood hemoglobin substantially modulates the influence of hyperglycemia on increased mortality risk in patients with COVID-19. Monitoring hemoglobin concentrations seem of utmost importance in the clinical settings to help clinicians in the identification of patients at increased death risk.
SN 1664-2392
YR 2021
FD 2021-11-02
LK https://hdl.handle.net/10668/26919
UL https://hdl.handle.net/10668/26919
LA en
DS RISalud
RD Apr 10, 2025