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

Area of Science:

• Clinical Medicine
• Biochemistry
• Infectious Diseases

Background:

• Early identification of severe coronavirus disease 2019 (COVID-19) cases is crucial for effective patient management.
• Biomarkers are needed to predict COVID-19 severity and mortality risk.
• Serum lactate dehydrogenase (LDH) is an enzyme released from damaged cells, potentially indicating systemic inflammation or organ damage.

Purpose of the Study:

• To evaluate the association between serum lactate dehydrogenase (LDH) levels upon admission and the clinical outcomes of COVID-19 patients.
• To determine if serum LDH can serve as a predictive marker for COVID-19 severity and mortality.

Main Methods:

• Retrospective, case-control study including 203 COVID-19 patients.
• Propensity score matching was used to control for confounding factors.
• Analysis included logistic regression and Cox proportional hazards models to assess LDH as a risk factor.

Main Results:

• Serum LDH levels at admission demonstrated significant predictive value for COVID-19 severity and mortality.
• A cut-off of 277.00 U/L for serum LDH showed 58.7% sensitivity and 82.0% specificity for predicting severe COVID-19.
• A higher cut-off of 359.50 U/L predicted death with 93.8% sensitivity and 88.2% specificity.
• Elevated LDH was identified as an independent risk factor for both severity (HR: 2.73) and mortality (HR: 40.50) in COVID-19 patients.

Conclusions:

• Elevated serum lactate dehydrogenase (LDH) levels at admission are an independent predictor of increased severity and mortality in COVID-19.
• LDH serves as a valuable early indicator for assessing the risk of adverse outcomes in COVID-19 patients.
• Clinicians should consider monitoring serum LDH levels upon admission for all COVID-19 patients to aid in risk stratification.