A new parameter in COVID-19 pandemic: initial lactate dehydrogenase (LDH)/Lymphocyte ratio for diagnosis and mortality

Abstract

Background COVID-19 (Coronavirus Disease-2019) is a pandemic disease, infecting more than 26.5 million people. Since there is no specific and effective treatment; early diagnosis and optimal isolation of the patient are of vital importance. Real-time polymerase chain reaction-based (RT-PCR) analyses do not achieve sufficient sensitivity in the diagnosis of the disease. Methods The data from 2217 patients diagnosed as COVID-19 between March 2020 and June 2020 and hospitalized or discharged with home isolation were retrospectively analyzed. Demographic data, comorbidities, PCR results, initial computed tomography (CT), laboratory values, Lactate Dehydrogenase (LDH) / Lymphocyte ratio, initial treatments and last status were recorded. The diagnostic sensitivity of LDH / Lymphocyte ratio, which is the main purpose of the study, was analyzed statistically. Results In order to test the effectiveness of LDH / Lymphocyte ratio for COVID-19 for diagnostic purposes, CT results were considered as gold standard. The area under the curve (AUC) was found to be 0.706 (p < 0.001; cut-off> 0.06) (Sensitivity: 76.4, specificity: 59.60). For the evaluation of LDH / Lymphocyte ratio in terms of survival, AUC was found to be 0.749 (p < 0.001; cut-off> 0.21) (Sensitivity: 70.59, specificity: 73.88). Conclusion Studies based on radiological findings have demonstrated that CT involvement has higher sensitivity. LDH / Lymphocyte ratio was analyzed in terms of diagnosis and mortality with using specific CT involvement as gold standard method which was found to be a more sensitive due to PCR false negativity; 0.06 and 0.21 were obtained as cut off values for diagnosis and mortality.

Prognostic Value of a Novel Parameter in Patients with Infective Endocarditis

“…LDH, lymphocyte, and LWR are inexpensive, easy to get, and automated factors that timely and effectively forecast the prognosis of the patients with different sicknesses [ 13 – 17 ]. Previous researches suggested that the performance (accuracy/precision) of the combination of LDH and lymphocyte (LDH/lymphocyte) was better than that of LDH and lymphocyte alone [ 5 ]. However, regarding the value of LDH/lymphocyte and L-LWR in the prognosis of patients with IE, it is still blank.…”

“…The lymphocyte percentage (LWR) was an effective prognostic tool for patients with colorectal cancer [ 4 ]. Lactate dehydrogenase/lymphocyte (LDH/lymphocyte) is associated with mortality in COVID-19 patients [ 5 , 6 ]. However, there is no study that assessed the role of LDH/lymphocyte or LDH/LWR (named as L-LWR) in IE patients.…”

The enzymes in COVID-19: A review

“…Another author pointed LDH as a more effective marker for severe disease when compared to lymphocyte counts and D-dimer [ 31 ], with more sensitivity and specificity. Another author studied the LDH/lymphocyte ratio to evaluate worse COVID-19 outcomes [ 131 ]. According to this study, the ratio can be used to facilitate diagnosis, since PCR has shown a great number of false negatives.…”

Enigma of COVID-19: is “multisystem inflammatory syndrome in adults” (MIS-A) predictable?

“…A previous study at our center has shown that the LDH / lymphocyte ratio (LLR) can be used in the early diagnosis of COVID-19 and predicting mortality [ 20 ]. Based on this, we aimed to determine the effect of LLR on the development of MIS-A, early detection of critical patients and mortality in COVID-19 and MIS-A.…”