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.
Highlights
Since the end of 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19)caused by a novel coronavirus later named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1]
Studies have shown that patients with severe COVID-19 have elevated serum Lactate dehydrogenase (LDH) levels [7, 8], but no study has evaluated its effect on the severity and mortality of COVID-19
We found that the elevated serum LDH (HR: 40.50, 95% confidence intervals (95% CI): 3.35-449.28; P=0.003) remained an independent risk factor for the mortality of COVID-19 (Table 4)
Summary
Since the end of 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19)caused by a novel coronavirus later named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1]. Early identification of severe COVID-19 is very important for individual or precise management, including antiviral, organ support and intensive care unit (ICU) care, to improve the prognosis. It has been reported that elevated serum LDH levels are associated with poor prognosis in various diseases, especially in tumors and inflammation [4,5,6]. Studies have shown that patients with severe COVID-19 have elevated serum LDH levels [7, 8], but no study has evaluated its effect on the severity and mortality of COVID-19. This multicenter retrospective, case-control study aimed to explore whether the serum LDH levels at admission can assist in evaluating the severity and mortality of COVID-19
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