Prevalence of Anemia in Patients with COPD and Its Potential Impact on Morbidity of COPD Patients


Background: Although COPD is traditionally associated with polycythemia, the systemic inflammation that is now recognized as a feature of COPD makes it a possible cause of Anemia of Chronic Disease (ACD). Preliminary evidences suggest that anemia in COPD may be more prevalent than expected occurring in 10% - 15% of patients. While in states like chronic heart failure and renal insufficiency, anemia has been extensively studied; little attention has been given to it in COPD. Objectives: To see the prevalence of anemia in patients with COPD and its potential impact on morbidity of COPD patients. Design and Setting: A university hospital-based cross-sectional study in Kashmir, India. Methods: Two hundred patients (119 males and 81 females) with spirometery documented COPD were evaluated for frequency of anemia. In addition to routine investigations, erythropoietin levels were done in a subgroup of patients. Results: A total of 36 cases (20 males and 16 females) of anemia were detected giving a frequency of 18%. Normocytic normochromic type of anemia was present in 32 (88.89%) patients while the rest had normocytic hypochromic type of anemia. Majority of patients were in GOLD stage 11 and had decreased serum iron, transferrin saturation and TIBC. Erythropoietin levels were significantly raised in anemic COPD patients compared to non-anemic COPD patients. The various factors significantly associated with anemia were: No. of exacerbations of COPD, No. of hospital admissions, BMI and erythropoietin levels. Conclusion: Anemia occurs frequently in patients of COPD and is associated with increased morbidity in the form of No. of exacerbations and hospital admissions. Correcting anemia in these patients may improve their clinical outcome.


COPD, Anemia

Share and Cite:

Parveen, S. , Rangreze, I. , Ahmad, S. , Mufti, S. and Khan, S. (2014) Prevalence of Anemia in Patients with COPD and Its Potential Impact on Morbidity of COPD Patients. International Journal of Clinical Medicine, 5, 452-458. doi: 10.4236/ijcm.2014.58063.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Weiss, G. and Goodnough, L.T. (2005) Anemia of Chronic Disease. New England Journal of Medicine,352, 1011.
[2] Means Jr., R.T. (2003) Recent Developments in Anemia of Chronic Disease. Current Hematology Reports, 2, 116-121.
[3] Ezekowitz, J.A., MCA Lister, F.A. and Armstrong, P.W. (2003) Anemia Is Common in Heart Failure and Is Associated with Poor Outcomes: Insights from a Cohort of 12065 Patients with New-Onset Heart Failure. Circulation, 107, 223-225.
[4] Augusti, A.G., Noguera, A., Sauleda, J., Sala, E., Pons, J. and Busquets, X. (2003) Systemic Effects of Chronic Obstructive Pulmonary Disease. European Respiratory Journal, 21, 347-360.
[5] Means Jr., R.T. (1999) Advances in the Anemia of Chronic Disease. International Journal of Hematology, 70, 7-12.
[6] Paul, R.A., et al. (2001) Global Strategy for Diagnosis Management and Prevention of Chronic Obstructive Pulmonary Disease NHLB1/WHO Obstructive Lung Disease (GOLD) Workshop Summary. American Journal of Respiratory and Critical Care Medicine, 46, 798-825.
[7] Pruitt, B. (2007) COPD: New Guidelines from the 2006 GOLD Report.
[8] Schols, A.M. (2002) Pulmonary Cachexia. International Journal of Cardiology, 85, 101-110.
[9] John, M., Hoernig, S., Doehner, W., Okonko, D., Witt, C. and Danker, S. (2005) Anemia and Inflammation in COPD. Chest, 127, 825-829.
[10] Cote, C., Zilberberg, M.D., Mody, S.H., Dordelly, L.J. and Celli, B. (2007) Haemoglobin Level and Its Clinical Impact in a Cohort of Patients with COPD. European Respiratory Journal, 29, 923-929.
[11] Similowski, T., Augusti, A., Mac Née, W. and Schonhofer, B. (2006) The Potential Impact of Anemia of Chronic Disease in COPD. European Respiratory Journal, 27, 390-396.
[12] Schonhofer, B., Wenzel, M., Geibel, M. and Kohler, D. (1998) Blood Transfusion and Lung Function in Chronically Anemic Patients with Severe Chronic Obstructive Pulmonary Disease. Critical Care Medicine, 26, 1824-1828.
[13] Zilberberg, M., Cote, C., Mody, S.H., Pharm, D. and Celli, B. (2005) Anemia in Chronic Obstructive Pulmonary Disease (COPD): Association with Supplemental O2 Use and Hospitalizations. American College of Physicians. Chest, 128.
[14] Krishnan, G., Grant, B.J., Muti, P.C., Mishra, A., Ochs-Balcom, H.M., Freudenheim, J.L., Trevisan, M. and Schunemann, M. (2006) Association between Anemia and Quality of Life in a Population Sample of Individuals with Chronic Obstructive Pulmonary Disease. BCM Pulmonary Medicine, 6, 23.
[15] Carroz, K.P. (2007) Anemia in COPD: Should It Be Taken into Consideration? Archivos de Bronconeumología, 43, 392-398.
[16] Ortakoylu, G., Bahadir, A., Alkan, F. and Caglar, E. (2006) Respiratory Medicine, Yedikule Chest Hospital Istanbul, Turkey. Prevalence of Anemia in Patients with COPD. Oral Presentation.
[17] Pinto-Plata, V.M., Cote, C., Cabral, H., Taylor, J. and Celli, B.R. (2004) The 6-min Walk Distance: Change over Time and Value as a Predictor of Survival in Severe COPD. European Respiratory Journal, 23, 28-33.
[18] Park, M.M., Durrani, J. and Zilberberg, M. (2003) Co-Relation of Severity of Anemia with Severity of COPD. American Journal of Respiratory and Critical Care Medicine, 167, A234.

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.