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[LDH-neutrophil-lymphocyte index as a predictor of 28-day mortality in patients with COVID-19]
Víctor Manuel Rojas-Sahagún1, Francisco Javier Núñez-Martínez1, Blanca Elena Verazaluce-Rodríguez2
1Instituto Mexicano del Seguro Social, Centro Médico Nacional del Bajío, Hospital de Especialidades No. 1, Servicio de Medicina Interna. León, Guanajuato, México.
Insights
The LDHNL index, calculated from initial lab tests, predicts 28-day mortality in COVID-19 patients. Higher LDHNL index values correlate with increased mortality risk in hospitalized individuals.
Area of Science:
- Infectious Diseases
- Hematology
- Clinical Chemistry
Context:
- Coronavirus disease 2019 (COVID-19) is a global health crisis.
- Disease severity and prognosis vary significantly among patients.
- Neutrophil/lymphocyte ratio (NLR) and lactate dehydrogenase (LDH) are established prognostic markers.
Purpose:
- To evaluate the LDH-neutrophil-lymphocyte (LDHNL) index as an early predictor of 28-day mortality in hospitalized COVID-19 patients.
- To determine if laboratory tests within 24 hours of admission can forecast mortality risk.
Summary:
- A retrospective cohort study included adult COVID-19 patients admitted between March 2020 and March 2021.
- The study analyzed the association between the LDHNL index and 28-day mortality.
- Higher LDHNL index levels were significantly associated with increased mortality (p < 0.05).
Impact:
- The LDHNL index serves as a valuable tool for early risk stratification of COVID-19 patients.
- This biomarker can aid clinicians in predicting mortality and managing patient care.
- Early identification of high-risk patients allows for timely intervention and resource allocation.
Background:
Coronavirus disease 2019 (COVID-19) represents the greatest health crisis of our times; it was declared by WHO a pandemic in March 2020. The risk of presenting a severe disease is inter-individual, since it varies according to age, comorbidities, and immunological status, in addition to the type of SARS-CoV-2 variant. The neutrophil/lymphocyte ratio (NLR) and lactic dehydrogenase (LDH) are widely used markers to assess the severity and predict the course of the disease in patients with COVID-19, with a direct relationship of higher value-worse prognosis.
Objective:
To verify if the LDH-neutrophil-lymphocyte index calculated from laboratory tests taken within the first 24 hours of admission is useful as a predictor of 28-day mortality in adult patients diagnosed with COVID-19.
Material And Methods:
Retrospective and analytical cohort study. All consecutive patients over 16 years of any gender, admitted to a tertiary care center from March 2020 to March 2021, who had a diagnosis of COVID-19 with a positive PCR for SARS-CoV-2, were included.
Results:
Higher levels of the LDHNL index were associated with higher mortality in patients hospitalized for COVID-19 (Q2 vs. Q1: RR 1.52 [1.24-1.87], p < 0.05; Q3 vs. Q1: RR 1.87 [1.55-2.25], p < 0.05; and Q4 vs. Q1: RR 2.74 [2.22-3-39], p < 0.05).
Conclusions:
The serum LDHNL index taken in the first 24 hours of admission can help to predict early the risk of mortality in hospitalized patients with COVID-19.
