Elevated Lactate Dehydrogenase (LDH) level as an independent risk factor for the severity and mortality of COVID-19

Abstract

Early identification of severe patients with coronavirus disease 2019 (COVID-19) is very important for individual treatment. We included 203 patients with COVID-19 by propensity score matching in this retrospective, case-control study. The effects of serum lactate dehydrogenase (LDH) at admission on patients with COVID-19 were evaluated. We found that serum LDH levels had a 58.7% sensitivity and 82.0% specificity, based on a best cut-off of 277.00 U/L, for predicting severe COVID-19. And a cut-off of 359.50 U/L of the serum LDH levels resulted in a 93.8% sensitivity, 88.2% specificity for predicting death of COVID-19. Additionally, logistic regression analysis and Cox proportional hazards model respectively indicated that elevated LDH level was an independent risk factor for the severity (HR: 2.73, 95% CI: 1.25-5.97; P=0.012) and mortality (HR: 40.50, 95% CI: 3.65-449.28; P=0.003) of COVID-19. Therefore, elevated LDH level at admission is an independent risk factor for the severity and mortality of COVID-19. LDH can assist in the early evaluating of COVID-19. Clinicians should pay attention to the serum LDH level at admission for patients with COVID-19.

An Artificial Intelligence Model to Predict the Mortality of COVID-19 Patients at Hospital Admission Time Using Routine Blood Samples: Development and Validation of an Ensemble Model

“…Regarding blood chemistry, hs-CRP is a major biomarker that represents acute phase inflammation [ 2 , 10 , 14 - 17 ]. LDH is related to cell damage, so elevated LDH is an independent risk factor for the severity and mortality of COVID-19 [ 2 , 8 - 11 ].…”

“…Regarding blood chemistry, hs-CRP is a major biomarker that represents acute phase inflammation [ 2 , 10 , 14 - 17 ]. LDH is related to cell damage, so elevated LDH is an independent risk factor for the severity and mortality of COVID-19 [ 2 , 8 - 11 ]. Hypoalbuminemia [ 18 , 20 , 21 ], hypocalcemia [ 31 - 33 ], and elevated aspartate aminotransferase [ 18 ] are highly associated with severe COVID-19 infection requiring hospitalization in the intensive care unit.…”

“…In a pandemic situation, the most important issue in the management of patients diagnosed with COVID-19 is to select patients at risk of high mortality in the early period of disease and to provide appropriate treatments [ 2 ]. Particularly, the condition of patients at high risk can rapidly deteriorate.…”

“…Moreover, in decision tree algorithms, such as an XGBoost and a random forest (RF), when multiple features have the same gain during the split, a branch in a tree is made by randomly selecting features among them. Second, numerous studies have shown that the disease progression of COVID-19 is not only associated with LDH [ 2 , 8 - 11 ], lymphocyte [ 12 , 13 ], and hs-CRP [ 2 , 10 , 14 - 17 ] but also with other blood-based biomarkers, such as neutrophil counts [ 16 , 18 , 19 ], albumin [ 18 , 20 , 21 ], and prothrombin activity [ 18 , 22 - 24 ]. In our study, we developed an AI model using 28 biomarkers for predicting the mortality of COVID-19 patients.…”

Evaluation the relationship of left ventricular global longitudinal strain and laboratory parameters in discharged patients with COVID-19: A follow-up study

“…Previous studies demonstrated that there was an association between LDH values and worse outcomes in COVID-19 patients. Li et al found that elevated serum LDH at admission remained a more independent risk factor among the other in ammatory markers for COVID-19 severity and mortality [23]. Therefore, we suggest that elevated serum LDH levels in both acute and chronic phase may be used as an important tool in determining clinical outcomes and prognosis in COVID-19.…”