Changes in lactate dehydrogenase on admission throughout the COVID-19 pandemic and possible impacts on prognostic capability

Biomark Med. 2022 Oct;16(14):1019-1028. doi: 10.2217/bmm-2022-0364. Epub 2022 Sep 2.

Abstract

Introduction: The enzyme lactate dehydrogenase (LDH) is a good marker of general hyperinflammation correlated with mortality for COVID-19, and is therefore used in prognosis tools. In a current COVID-19 clinical randomized trial (CRT), the blood level of LDH was selected as an inclusion criterion. However, LDH decreased during the pandemic; hence, the impact of this decrease on the prognostic value of LDH for mortality was evaluated. Methods: Data on LDH levels in 843 patients were obtained and analyzed. Relative risk, standard error and receiver operating characteristic curves were calculated for two cutoff values. Results: Relative risk lost validity and the area under the curve narrowed by trimester during the pandemic. Conclusion: The progressive decrease in LDH impacted the capacity to predict mortality in COVID-19. More studies are needed to validate this finding and its implications.

Keywords: COVID-19; LDH; area under the curve; prognostics; relative risk; sensitivity; specificity; triage.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • COVID-19* / enzymology
  • COVID-19* / epidemiology
  • Humans
  • L-Lactate Dehydrogenase* / metabolism
  • Pandemics
  • Prognosis
  • ROC Curve
  • Retrospective Studies

Substances

  • L-Lactate Dehydrogenase