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Microbes & Immunity Anemia among COVID-19 patients in Ethiopia

1. Introduction or Hematologic abnormality,” and “COVID-19,” or
SARS-CoV-2,” or “Coronavirus 2019,” or “Severe acute
Coronavirus disease 2019 (COVID-19) is a viral infectious respiratory syndrome coronavirus 2,” and “Ethiopia.” This
disease caused by severe acute respiratory syndrome systematic review and meta-analysis have been registered
coronavirus 2 (SARS-CoV-2). As of now, COVID-19 with PROSPERO under the number CRD42024508873.
has resulted in 6 million deaths worldwide. The global
economic burden of COVID-19 was estimated to be 2.2. Selection criteria and exclusion criteria
between US $77 billion and US $2.7 trillion in 2019. It All types of population-based studies conducted in
was first discovered in Wuhan, Hubei province, China, Ethiopia that reported the prevalence of anemia among
following the initial cases of this respiratory viral illness. COVID-19 patients in the country and were published
The World Health Organization (WHO) declared in peer-reviewed journals until 2024 were included in
COVID-19 a global pandemic on March 11, 2020. 1,2
this review. The study population consisted of Ethiopian
COVID-19 infection begins as a respiratory tract COVID-19 patients. Studies that only reported results
infection but is considered a systemic disease that as mean, median, and interquartile range were excluded,
significantly causes inflammation, platelet activation, as well as studies based on secondary data and poster
hypercoagulability, endothelial dysfunction, constriction representation such as review articles, conference abstracts,
of blood vessels, stasis, hypoxia, muscle immobilization, case reports, and editorials.
and hematopoietic system over time, leading to various
hematological complications. Anemia is now recognized 2.3. Data extraction and quality assessment
3,4
as an independent prognostic risk factor for COVID-19, The systematic review process involved importing
and hemoglobin levels can be used in laboratory diagnosis articles to Endnote 20, screening titles and abstracts, and
5
for risk stratification in patient care. In addition, appraising full texts. Discrepancies were resolved through
COVID-19 patients without anemia are less likely to have discussion and consensus. Data were summarized in an
one or more comorbidities compared to those with severe Excel spreadsheet, and study quality was assessed using JBI
COVID-19 illness who do have anemia. 6 critical appraisal tools. Key study characteristics, such as
Anemia is a significant worldwide public health issue the first author’s name, publication year, study year, setting,
that impacts both developed and developing countries. sample size, and the number of COVID-19 patients
As of 2021, the global prevalence of anemia was estimated with anemia, were extracted. Descriptive statistics were
at 1.92 billion (24.3%) across all age groups. COVID-19 employed for data analysis, with any discrepancies resolved
7
patients exhibit a higher prevalence of anemia compared to through author discussion. The results were presented
control groups. Among patients with laboratory-confirmed in tables and figures for a clear presentation. This review
8
COVID-19, the global prevalence of anemia was reported to aims to provide a comprehensive summary of anemia
9
8
be 61%. In Ethiopia, COVID-19 has caused 7574 deaths, prevalence in COVID-19 patients and may guide future
yet there is limited data on the prevalence of anemia among research and clinical practice.
COVID-19 patients in the country. Therefore, this review 2.4. Outcome of interest
aims to assess the national prevalence of anemia among
COVID-19 patients in Ethiopia. The primary outcome of interest is the pooled prevalence
of anemia, defined by the WHO as a hemoglobin value of
2. Methods <12 g/dL for females and <13 g/dL for males. 11

2.1. Search strategy 2.5. Statistical analysis and synthesis
This review was conducted following the preferred Overall, the study methodology involved presenting results
reporting items for systematic review and meta-analysis in percentages with 95% confidence intervals (CI), using
guidelines. A literature search was performed on narrative synthesis for included studies. A summary table
10
international scientific research databases such as Google was created to outline the characteristics of the studies,
Scholar, PubMed/MEDLINE, Cochrane Library, and the and a meta-analysis was conducted using a random-effects
Ethiopian Journal of Health Development for studies restricted maximum likelihood (REML) model in STATA
published before 2024. The reference lists of published version 17. Heterogeneity among studies was assessed using
articles were also searched to identify relevant unpublished I² statistics, and publication bias was qualitatively analyzed
studies. The search utilized a combination of keywords and through Funnel plots, Begg’s, and Egger’s tests. Subgroup
medical subject headings terms, including “Anemia” or analyses were also conducted to identify potential sources
“Hemoglobin,” or “Hematocrit,” “Hematological profile,” of heterogeneity.

Volume 2 Issue 2 (2025) 119 doi: 10.36922/mi.3504