Serum Lactate Dehydrogenase Level One Week after Admission Is the Strongest Predictor of Prognosis of COVID-19: A Large Observational Study Using the COVID-19 Registry Japan

Abstract

Clinical features of COVID-19 are diverse, and a useful tool for predicting clinical outcomes based on clinical characteristics of COVID-19 is needed. This study examined the laboratory values and trends that influence mortality in hospitalised COVID-19 patients. Data on hospitalised patients enrolled in a registry study in Japan (COVID-19 Registry Japan) were obtained. Patients with records on basic information, outcomes, and laboratory data on the day of admission (day 1) and day 8 were included. In-hospital mortality was set as the outcome, and associated factors were identified by multivariate analysis using the stepwise method. A total of 8860 hospitalised patients were included. The group with lactate dehydrogenase (LDH) levels >222 IU/L on day 8 had a higher mortality rate compared to the group with LDH levels ≤222 IU/L. Similar results were observed in subgroups formed by age, body mass index (BMI), underlying disease, and mutation type, except for those aged <50 years. When age, sex, BMI, underlying disease, and laboratory values on days 1 and 8 were tested for factors strongly associated with in-hospital mortality, LDH on day 8 was most strongly associated with mortality. LDH level on day 8 was the strongest predictor of in-hospital mortality in hospitalised COVID-19 patients, indicating its potential usefulness in post-treatment decision-making in severe COVID-19 cases.

Inflammatory Markers for Prognosis of COVID-19 Mortality in Hospitalized Indian Patients: A Single-Center Retrospective Study

“…(20)(21)(22)(23)(24) In Japan, serum LDH levels one week after hospital admission were found to be the strongest prognostic marker of in-hospital COVID-19 mortality. (25) Meanwhile, the prognostic performance of D-dimer in predicting mortality in the present study is in line with the dynamic changes revealed for D-dimer as a prognostic marker of COVID-19 mortality. (15,16,26) Hyperferritinemia was found to be one of the best predictors of COVID-19 mortality in the present study.…”

Predicting COVID-19 Hospital Stays with Kolmogorov–Gabor Polynomials: Charting the Future of Care

“…The comorbidities score was significantly higher in patients with longer LOS (p-value < 0.05, Table 1). The cutoffs used for high-risk exposures were provided by the following: age [48], body temperature [49], heart rate [50,51], blood pressure [52], oxygen saturation [53], neutrophils, lymphocytes, hemoglobin, platelets, D-dimer [54], ferritin [55], CRP [56], ESR [57], LDH [58], AST [59], ALT [60], and creatinine [61]. a The Chi-square test was utilized for binary variables to compare proportions between the two independent groups.…”

A comparison study of temporal trends of SARS-CoV2 RNAemia and biomarkers to predict success and failure of high flow oxygen therapy among patients with moderate to severe COVID-19

“…Elevated LDH has been considered as evidence of hypoxic tissue metabolism and lung tissue damage, and correlated to the worse outcome [ 23 – 25 ]. Examining a cohort of 8,860 patients within the extensive Japanese COVID-19 registry highlighted a significant association between the LDH value on admission day 8 and in-hospital mortality [ 24 ]. A machine learning analysis using the same registry also showed that LDH level on admission strongly predicted HFNC failure rate compared to other factors [ 25 ].…”