Blood lactate concentration in COVID-19: a systematic literature review

Carpenè, Giovanni; Onorato, Diletta; Nocini, Riccardo; Fortunato, Gianmarco; Rizk, John; Henry, Brandon Michael; Lippi, Giuseppe

doi:10.1515/cclm-2021-1115

Cited by 45 publications

(32 citation statements)

References 29 publications

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“…Of note, in a study of 70 consecutive patients, Yang and collaborators reported that patients with severe disease did not have higher blood lactate values than peers with non-severe illness ( 30 ). Nonetheless, consistent with our results, most studies have demonstrated increased lactate levels in severe and non-survivor COVID-19 patients compared with patients with mild disease ( 31 ).…”

Section: Discussionsupporting

confidence: 92%

Circulating pyruvate is a potent prognostic marker for critical COVID-19 outcomes

et al. 2022

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BackgroundCoronavirus-19 (COVID-19) disease is driven by an unchecked immune response to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus which alters host mitochondrial-associated mechanisms. Compromised mitochondrial health results in abnormal reprogramming of glucose metabolism, which can disrupt extracellular signalling. We hypothesized that examining mitochondrial energy-related signalling metabolites implicated in host immune response to SARS-CoV-2 infection would provide potential biomarkers for predicting the risk of severe COVID-19 illness.MethodsWe used a semi-targeted serum metabolomics approach in 273 patients with different severity grades of COVID-19 recruited at the acute phase of the infection to determine the relative abundance of tricarboxylic acid (Krebs) cycle-related metabolites with known extracellular signaling properties (pyruvate, lactate, succinate and α-ketoglutarate). Abundance levels of energy-related metabolites were evaluated in a validation cohort (n=398) using quantitative fluorimetric assays.ResultsIncreased levels of four energy-related metabolites (pyruvate, lactate, a-ketoglutarate and succinate) were found in critically ill COVID-19 patients using semi-targeted and targeted approaches (p<0.05). The combined strategy proposed herein enabled us to establish that circulating pyruvate levels (p<0.001) together with body mass index (p=0.025), C-reactive protein (p=0.039), D-Dimer (p<0.001) and creatinine (p=0.043) levels, are independent predictors of critical COVID-19. Furthermore, classification and regression tree (CART) analysis provided a cut-off value of pyruvate in serum (24.54 µM; p<0.001) as an early criterion to accurately classify patients with critical outcomes.ConclusionOur findings support the link between COVID-19 pathogenesis and immunometabolic dysregulation, and show that fluorometric quantification of circulating pyruvate is a cost-effective clinical decision support tool to improve patient stratification and prognosis prediction.

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Section: Discussionsupporting

confidence: 92%

Circulating pyruvate is a potent prognostic marker for critical COVID-19 outcomes

et al. 2022

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“…[ 41 , 42 ]. Severe COVID-19 is associated with elevation of blood lactate and acidosis [ 43 , 44 ], which enables Candida to restructure its cell wall to mask β-glucans and escape the recognition by the host immune system [ 45 ]. Moreover, an important virulence factor of Candida that helps it evade phagocytosis is the ability to form biofilms, which can be triggered by COVID-19 through increasing oxidative stress and pH imbalance [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

COVID-19-associated fungal infections in Iran: A systematic review

et al. 2022

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Objectives This systematic review aims to summarize the mycological and clinical features of COVID-19-associated fungal infections (CAFIs) in Iran. Methods PubMed, Web of Science, Scopus, Cochrane Library, SID, Magiran, IranDoc, and Google Scholar were searched for Persian and English articles published from January 1, 2020, to November 5, 2021, using a systematic search strategy. Studies on Iranian patients suffering from CAFIs were included in the review. Results Twenty-two studies comprising 169 patients were retrieved. Reported CAFIs included candidiasis (85, 50.30%), mucormycosis (35, 20.71%), aspergillosis (29, 17.16%), fusariosis (6, 3.55%), three cases caused by rare pathogens (Rhodotorula mucilaginosa, Diaporthe foeniculina, and Sarocladium kiliense) and 11 (6.51%) uncharacterized mold infections. The most common underlying diseases were diabetes (67/168, 39.88%), cardiovascular diseases (55/168, 32.74%), and hypertension (43/168, 25.59%). The use of antibiotics (111/124, 89.52%), corticosteroids (93/132, 70.44%), and mechanical ventilation (66, 51.16%) were the most common predisposing factors. Totally, 72 (50.35%) of 143 patients with CAFIs died (data were not available for 26 patients). Conclusion Fungal infections are evident to be a complication of COVID-19 in Iran; thus, clinicians should consider them as a differential diagnosis, especially in patients with comorbidities and previous antibiotic or corticosteroid use.

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“…Several clinical studies found that LDH is a useful biomarker for acute mesenteric ischemia, [ 55 , 56 ]. However, interpretation of the results may be difficult in COVID-19 patients, as both lactate and LDH were also found to be independent risk factors of severe forms of COVID-19 [ 57 , 58 ].…”

Section: Discussionmentioning

confidence: 99%

Acute Mesenteric Ischemia in COVID-19 Patients

Serban

Tribus

Vancea

et al. 2021

JCM

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Acute mesenteric ischemia is a rare but extremely severe complication of SARS-CoV-2 infection. The present review aims to document the clinical, laboratory, and imaging findings, management, and outcomes of acute intestinal ischemia in COVID-19 patients. A comprehensive search was performed on PubMed and Web of Science with the terms “COVID-19” and “bowel ischemia” OR “intestinal ischemia” OR “mesenteric ischemia” OR “mesenteric thrombosis”. After duplication removal, a total of 36 articles were included, reporting data on a total of 89 patients, 63 being hospitalized at the moment of onset. Elevated D-dimers, leukocytosis, and C reactive protein (CRP) were present in most reported cases, and a contrast-enhanced CT exam confirms the vascular thromboembolism and offers important information about the bowel viability. There are distinct features of bowel ischemia in non-hospitalized vs. hospitalized COVID-19 patients, suggesting different pathological pathways. In ICU patients, the most frequently affected was the large bowel alone (56%) or in association with the small bowel (24%), with microvascular thrombosis. Surgery was necessary in 95.4% of cases. In the non-hospitalized group, the small bowel was involved in 80%, with splanchnic veins or arteries thromboembolism, and a favorable response to conservative anticoagulant therapy was reported in 38.4%. Mortality was 54.4% in the hospitalized group and 21.7% in the non-hospitalized group (p < 0.0001). Age over 60 years (p = 0.043) and the need for surgery (p = 0.019) were associated with the worst outcome. Understanding the mechanisms involved and risk factors may help adjust the thromboprophylaxis and fluid management in COVID-19 patients.

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Blood lactate concentration in COVID-19: a systematic literature review

Cited by 45 publications

References 29 publications

Circulating pyruvate is a potent prognostic marker for critical COVID-19 outcomes

Circulating pyruvate is a potent prognostic marker for critical COVID-19 outcomes

COVID-19-associated fungal infections in Iran: A systematic review

Acute Mesenteric Ischemia in COVID-19 Patients

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