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Laboratory markers associated with COVID-19 progression in patients with or without comorbidity: A retrospective
Zaishu Chen1, Furong Zhang2, Weihua Hu3
1Jiayu People's Hospital, Jiayu, China.
Insights
Lactate dehydrogenase (LDH) is a key marker for COVID-19 severity and mortality, especially in patients with comorbidities. Different medical conditions show unique laboratory risk factors for COVID-19 mortality.
Area of Science:
- Infectious Diseases
- Clinical Laboratory Science
- Epidemiology
Background:
- COVID-19 progression and mortality are influenced by patient comorbidities.
- Identifying reliable laboratory markers is crucial for managing COVID-19 severity.
- Understanding disease mechanisms requires analyzing laboratory data in diverse patient groups.
Purpose of the Study:
- To identify laboratory markers predicting COVID-19 severity and mortality.
- To investigate how comorbidities affect the association between laboratory markers and COVID-19 outcomes.
- To explore differences in mortality risk factors among patients with various comorbidities.
Main Methods:
- Multicenter retrospective study of 836 COVID-19 cases.
- Principal Component Analysis (PCA) and Partial Least Squares Discriminant Analysis (PLS-DA) for laboratory data overview.
- Multivariable logistic and Cox regression analyses for risk factor identification; survival analysis for comorbidity groups.
Main Results:
- Lactate dehydrogenase (LDH) and prealbumin correlated with COVID-19 severity, with or without comorbidities.
- In patients with comorbidities, mortality risk was linked to age, LDH, C-reactive protein (CRP), D-dimer, and lymphopenia.
- CRP predicted short-term mortality in hypertension but not liver disease; D-dimer predicted mortality in liver disease.
Conclusions:
- Lactate dehydrogenase (LDH) is a consistent predictor of COVID-19 severity and mortality across different patient conditions.
- Laboratory biomarkers for mortality risk vary among patients with comorbidities, indicating diverse pathophysiological pathways in COVID-19.
Objectives:
To investigate laboratory markers for COVID-19 progression in patients with different medical conditions.
Methods:
We performed a multicenter retrospective study of 836 cases in Hubei. To avoid the collinearity among the indicators, principal component analysis (PCA) followed by partial least squares discriminant analysis (PLS-DA) was performed to obtain an overview of laboratory assessments. Multivariable logistic regression analysis and multivariable Cox proportional hazards regression analysis were respectively used to explore risk factors associated with disease severity and mortality. Survival analysis was performed in patients with the most common comorbidities.
Results:
Lactate dehydrogenase (LDH) and prealbumin were associated with disease severity in patients with or without comorbidities, indicated by both PCA/PLS-DA and multivariable logistic regression analysis. The mortality risk was associated with age, LDH, C-reactive protein (CRP), D-dimer, and lymphopenia in patients with comorbidities. CRP was a risk factor associated with short-term mortality in patients with hypertension, but not liver diseases; additionally, D-dimer was a risk factor for death in patients with liver diseases.
Conclusions:
Lactate dehydrogenase was a reliable predictor associated with COVID-19 severity and mortality in patients with different medical conditions. Laboratory biomarkers for mortality risk were not identical in patients with comorbidities, suggesting multiple pathophysiological mechanisms following COVID-19 infection.
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