Impact of serum lactate dehydrogenase on the short-term prognosis of COVID-19 with pre-existing cardiovascular diseases

Abstract

Background Patients with coronavirus disease 2019 (COVID-19) and underlying cardiovascular comorbidities have poor prognoses. Our aim was to identify the impact of serum lactate dehydrogenase (LDH), which is associated with mortality in acute respiratory distress syndrome, on the prognoses of patients with COVID-19 and underlying cardiovascular comorbidities. Methods Among 1,518 patients hospitalized with COVID-19 enrolled in the CLAVIS-COVID (Clinical Outcomes of COVID-19 Infection in Hospitalized Patients with Cardiovascular Diseases and/or Risk Factors study), 515 patients with cardiovascular comorbidities were analyzed. Patients were divided into tertiles based on LDH levels at admission [tertile 1 (T1), <235 U/L; tertile 2 (T2), 235-355 U/L; and tertile 3 (T3); ≥356 U/L]. We investigated the impact of LDH levels on the in-hospital mortality. Results The mean age was 70.4±30.0 years, and 65.3% were male. There were significantly more in-hospital deaths in T3 than in T1 and T2 [n=50 (29.2%) vs. n=15 (8.7%), and n=24 (14.0%), respectively; p <0.001]. Multivariable analysis adjusted for age, comorbidities, vital signs, and laboratory data including D-dimer and high-sensitivity troponin showed T3 was associated with an increased risk of in-hospital mortality (adjusted hazard ratio, 3.04; 95% confidence interval, 1.50–6.13; p =0.002). Conclusions High serum LDH levels at the time of admission are associated with an increased risk of in-hospital death in patients with COVID-19 and known cardiovascular disease and may aid in triage of these patients.

Relationship Between Platelet Count and In-hospital Mortality in Adult Patients With COVID-19: A Retrospective Cohort Study

“…Similar to other studies, we found age ( 21 ), male gender ( 28 ), and underlying chronically illness ( 29 ) were risk factors of in-hospital mortality of patients with COVID-19. Our study also found that D-dimer, representing thrombotic risk ( 30 ), and LDH, representing systemic inflammation ( 31 ), were also associated with prognosis in multivariable logistic regression analysis. These results suggest that age, sex, underlying chronically illness, D-dimer, and LDH deserve further study.…”

Lactate Dehydrogenase Predicts Hemorrhagic Transformation in Patients with Acute Ischemic Stroke

“…Since it reflected cardiomyocyte necrosis, LDH was historically used to diagnose myocardial infarction [12,29]. Additionally, LDH is a generic sign of acute or chronic tissue injury and is considered an inflammatory marker [30]. Infection with COVID-19, chronic obstructive pulmonary disease, acute lung injury, and pulmonary embolism have been reported to be associated with elevated blood LDH levels [30][31][32].…”

“…Additionally, LDH is a generic sign of acute or chronic tissue injury and is considered an inflammatory marker [30]. Infection with COVID-19, chronic obstructive pulmonary disease, acute lung injury, and pulmonary embolism have been reported to be associated with elevated blood LDH levels [30][31][32]. Previous research has shown that LDH was not only associated with activating certain proto-oncogenes but also played a critical role in the maintenance of tumor invasiveness, metastatic potential, chemoresistance, and radioresistance [6,[33][34][35].…”

The Impact of Therapeutic Plasma Exchange on Inflammatory Markers and Acute Phase Reactants in Patients with Severe SARS-CoV-2 Infection

“…In a pooled analysis by Henry et al containing nine studies with 1532 patients, it was found that elevated LDH values were associated with a sixfold increased risk of developing severe COVID-19 and a 16-fold increase in mortality rate [ 56 ]. According to Masumoto et al, serum LDH values > 355U/L at admission were associated with an increased risk of death in patients with COVID-19 and cardiac comorbidities [ 57 ].…”