Prognostic value of lactate dehydrogenase for in-hospital mortality in critically ill patients with Covid-19

Eftimova, Biljana and Lazarova, Biljana and Gazepov, Strahil and Naumovska, Zorica (2021) Prognostic value of lactate dehydrogenase for in-hospital mortality in critically ill patients with Covid-19. Knowledge - International Journal, Scientific Papers, 45 (7). pp. 1447-1451. ISSN 2545-4439

Text PROGNOSTIC VALUE OF LACTATE DEHYDROGENASE FOR IN-HOSPITAL.pdf - Published Version Download (991kB)

Abstract

Purpose It is well known that COVID-19 patients may have increased serum lactate dehydrogenase (LDH) levels in the early stage, so LDH has been proved to be a prognostic factor for the severity and poor outcomes of coronavirus disease (COVID-19). The aim of the study was to evaluated the association of LDH and CRP with in-hospital mortality in critically ill patients with COVID-19 and their predictive value for prognosis. Methodology A retrospective study was conducted in order to analyzed the clinical data of 55 critical COVID-19 patients. The patients were diagnosed with PCR test and critical cases met any one of the following criteria: respiratory failure and required mechanical ventilation, the occurrence of shock, and the combined failure of other organs that required intensive care unit monitoring and treatments, according to the diagnostic criteria of critical COVID-19. Clinical data including symptoms, detection of SARS-CoV-2, chest computed tomography (CT) images, CRP and LDH levels in serum were collected. According to chest CT images, we observed the fibrosis stages in all critical patients in this study. Most non-survivors died in the fibrosis stage. Statistical analysis of the data was performed and appropriate parametric and non-parametric test were conducted. Continuous variables were expressed as median (interquartile range) and compared with the Mann-Whitney U test. A pvalue of < 0.05 was considered statistically significant. Stat Graphics centurion 19 was used for statistical analysis.
Results Fifty five patients were enrolled into the study. The mean age was 67 ± 10 years; most of them were male (63.6%). Seventeen patients (31%) survived and 38 patient (69%) have died during the treatment in the ICU in the clinical hospital in Stip. The mean age in the survived group of patients was 66 ± 9 years; most of them were male (76.5%), whereas in the group of non-survivors mean age of patients was 68 ± 10 years with 42.1% women. Our results have suggested that the age does not influents the rate of survival (p=0.4). The obtained results confirmed that the LDH values depend on the gender. Our result have not reached statistical significance but there was evident tendency in higher values in LDH values in female patients on the admission in the ICU with p=0.068. Also the same tendency was confirmed for the influence of the LDH levels on survival of the Covid-19 patients in ICU with p=0.07. Limited number of enrolled patients may explain the tendency and higher number of patients included in the study is expected to confirm the statistical significance in influence of gender on LDH level, as well as influence of the LDH level on severe patient survival in ICU. In all patient population higher CRP values were confirmed (178±132) mg/L in the non-survivors group and (250±103) mg/L in the group of survivors. Our results have confirmed that there was statistically significant difference in the CRP values and rate of survival in ICU Covid-19 patients. There were statistically significant higher CRP values in the group on non-survivors in comparison to the group of survivors (p=0.03). Additionally, non-survivors had fewer days of hospitalization, shorter disease duration, shorter duration of fibrosis, and had dyspnea symptoms at disease onset (P = 0.05).
Conclusions LDH is a prognostic biomarker with acceptable accuracy for predicting in-hospital mortality in critically ill patients with COVID-19. This may help the physicians in the process of effective in identification of patients at high risk of death and rational prioritization of resources it order to initiate more aggressive treatments at an earlier phase to save patients' lives.
Recommendations LDH may play significant role as a biomarker for identification of COVID-19 patient
population at high mortality risk and could help physicians in selection of patients eligible for more aggressive treatment initiation at early stage of ICU-admission.

Item Type:	Article
Uncontrolled Keywords:	increased serum lactate dehydrogenase, covid 19, patients
Subjects:	Medical and Health Sciences > Health sciences
Divisions:	Faculty of Medical Science
Depositing User:	Strahil Gazepov
Date Deposited:	11 May 2021 11:18
Last Modified:	11 May 2021 11:18
URI:	https://eprints.ugd.edu.mk/id/eprint/28068

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