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Elevated α-hydroxybutyrate dehydrogenase as an independent prognostic factor for mortality in hospitalized patients
Zeming Liu1, Jinpeng Li2, Man Li1
1Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Donghu Road 169, Wuhan, 430071, China.
Insights
Elevated alpha-hydroxybutyrate dehydrogenase (α-HBDH) levels indicate a higher risk of severe outcomes and death in COVID-19 patients. Monitoring α-HBDH can help identify individuals needing closer medical attention.
Area of Science:
- Biochemistry
- Infectious Diseases
- Critical Care Medicine
Background:
- Clinical characteristics of COVID-19 patients are well-studied, but underlying mechanisms and prognostic markers require further investigation.
- Cardiovascular disease patients are particularly vulnerable to severe COVID-19 outcomes.
- Identifying reliable biomarkers for COVID-19 severity and prognosis is crucial for patient management.
Purpose of the Study:
- To investigate the association between alpha-hydroxybutyrate dehydrogenase (α-HBDH) levels and disease progression in COVID-19 patients.
- To determine if α-HBDH serves as a predictive marker for in-hospital mortality and disease severity in COVID-19.
- To explore the clinical utility of α-HBDH assessment in stratifying COVID-19 patient risk.
Main Methods:
- Retrospective analysis of 1751 COVID-19 patients from Leishenshan hospital, Wuhan.
- Patients were categorized into elevated and normal α-HBDH groups for comparative analysis.
- Statistical methods included univariate/multivariate regression, survival curves, logistic regression, and ROC analysis.
Main Results:
- Elevated α-HBDH levels were significantly associated with older age and higher in-hospital mortality (5.73% vs. 0.26%).
- Multivariate analysis confirmed α-HBDH as an independent risk factor for mortality (HR: 4.411) and disease severity (OR: 3.759).
- Kaplan-Meier survival curves demonstrated a clear survival difference between patients with normal and elevated α-HBDH levels.
Conclusions:
- Serum α-HBDH is an independent predictor of in-hospital mortality and disease severity in COVID-19 patients.
- α-HBDH assessment can assist clinicians in identifying high-risk COVID-19 individuals.
- This finding highlights the potential role of α-HBDH in managing COVID-19 patients.
Aims:
Many studies have explored the clinical characteristics of patients with coronavirus disease (COVID-19), especially patients with cardiovascular disease. However, associated mechanisms and markers remain to be further investigated. This study aimed to investigate the effect of α-hydroxybutyrate dehydrogenase (α-HBDH) levels on disease progression and prognosis of patients with COVID-19.
Methods And Results:
One thousand seven hundred and fifty-one patients from the Leishenshan hospital in Wuhan were divided into elevated and normal groups by α-HBDH level, and the clinical information between the two groups was compared retrospectively. The main outcome evaluation criteria included in-hospital death and disease severity. Univariate and multivariate regression analyses, survival curves, logistic regression, and receiver operating characteristic curve models were performed to explore the relationship between elevated α-HBDH and the two outcomes. Besides, curve fitting analyses were conducted to analyse the relationship between computed tomography score and survival. Among 1751 patients with confirmed COVID-19, 15 patients (0.87%) died. The mean (SD) age of patients was 58 years in normal α-HBDH group and 66 years in elevated α-HBDH group (P < 0.001). The mortality during hospitalization was 0.26% (4 of 1559) for patients with normal α-HBDH levels and 5.73% (11 of 192) for those with elevated α-HBDH levels (P < 0.001). Multivariate Cox analysis confirmed an association between elevated α-HBDH levels and higher risk of in-hospital mortality [hazard ratio: 4.411, 95% confidence interval (95% CI), 1.127-17.260; P = 0.033]. Multivariate logistic regression for disease severity and α-HBDH levels showed significant difference between both groups (odds ratio = 3.759; 95% CI, 1.895-7.455; P < 0.001). Kaplan-Meier curves also illustrated the survival difference between normal and elevated α-HBDH patients (P < 0.001).
Conclusions:
Our study found that serum α-HBDH is an independent risk factor for in-hospital mortality and disease severity among COVID-19 patients. α-HBDH assessment may aid clinicians in identifying high-risk individuals among COVID-19 patients.
