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Mapping Metabolism: Monitoring Lactate Dehydrogenase Activity Directly in Tissue
Published on: June 21, 2018
Diagnostic value of lactate dehydrogenase in COVID-19: A systematic review and meta-analysis
Bartosz Fialek1, Michal Pruc2, Jacek Smereka2,3
1Rheumatology Department, Marshal Jozef Pilsudski Memorial Hospital, Plonsk, Poland.
Insights
Elevated lactate dehydrogenase (LDH) levels indicate a poor prognosis in patients with coronavirus disease 2019 (COVID-19). Higher LDH is linked to increased mortality and disease severity, highlighting its role as a critical biomarker.
Area of Science:
- Biochemistry
- Clinical Medicine
- Epidemiology
Background:
- Coronavirus disease 2019 (COVID-19) poses a significant global health challenge.
- Identifying reliable biomarkers for COVID-19 severity is crucial for patient management.
- Lactate dehydrogenase (LDH) is an enzyme released from damaged cells, potentially indicating tissue injury.
Purpose of the Study:
- To systematically review and meta-analyze the association between lactate dehydrogenase (LDH) levels and COVID-19 severity.
- To evaluate LDH as a prognostic marker for adverse outcomes in COVID-19 patients.
- To compare LDH levels across different severity strata of COVID-19.
Main Methods:
- Systematic review and meta-analysis of relevant studies.
- Literature search conducted across Embase, PubMed, Web of Science, Scopus, and Cochrane Central Register.
- Data analysis performed using RevMan V.5.4 or STATA V.14 software.
Main Results:
- A total of 264 records were included in the meta-analysis.
- Significantly lower LDH levels were observed in survivors versus non-survivors.
- Lower LDH levels correlated with non-severe COVID-19 compared to severe cases.
- Critical COVID-19 cases exhibited higher LDH levels than severe cases.
- Patients requiring intensive care unit (ICU) admission had markedly higher LDH levels.
Conclusions:
- Elevated lactate dehydrogenase (LDH) is significantly associated with poor outcomes in COVID-19.
- LDH serves as a valuable biomarker for assessing COVID-19 severity and predicting prognosis.
- Monitoring LDH levels can aid in clinical decision-making for COVID-19 patients.
Background:
This meta-analysis outlines the role of elevated lactate dehydrogenase (LDH) levels in assessing the severity of coronavirus disease 2019 (COVID-19).
Methods:
The current study was designed as a systematic review and meta-analysis. Embase, Pub- Med, Web of Science, Scopus and Cochrane Central Register of Controlled Trials were searched to identify the usefulness of LDH as a marker of COVID-19 severity. All extracted data were analyzed using RevMan V.5.4 or STATA V.14 software.
Results:
A total of 264 records were selected for this meta-analysis. Pooled analysis showed that LDH levels were statistically significantly lower in the group of survivors compared to patients who died in hospital (standardized mean differences [SMD] = -3.10; 95% confidence interval [CI]: -3.40 to -2.79; I2 = 99%; p < 0.001). Lower LDH levels were observed in non-severe groups compared to severe course of COVID-19 (SMD = -2.38; 95% CI: -2.61 to -2.14; I2 = 99%; p < 0.001). The level of LDH was statistically significantly lower in the severe group compared to the critical group (SMD = -1.48; 95% CI: -2.04 to -0.92; I2 = 98%; p < 0.001). Patients who did not require treatment in the intensive care unit (ICU) showed significantly lower levels of LDH compared to patients who required treatment in the ICU (SMD = -3.78; 95% CI: -4.48 to -3.08; I2 = 100%; p < 0.001).
Conclusions:
This meta-analysis showed that elevated LDH was associated with a poor outcome in COVID-19.
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