Lactate dehydrogenase predicts disease progression outcome in COVID-19 patients treated with Azvudine

Manyun Mao; Yating Dian; Yuming Sun; Wangqing Chen; Wu Zhu; Guangtong Deng

doi:10.3389/fcimb.2023.1237277

Lactate dehydrogenase predicts disease progression outcome in COVID-19 patients treated with Azvudine

Front Cell Infect Microbiol. 2023 Oct 18:13:1237277. doi: 10.3389/fcimb.2023.1237277. eCollection 2023.

Authors

Manyun Mao^{1

2

3

4

5}, Yating Dian^{1

2

3

4

5}, Yuming Sun^{2

3

4

5

6}, Wangqing Chen^{1

2

3

4

5}, Wu Zhu^{1

2

3

4

5}, Guangtong Deng^{1

2

3

4

5}

Affiliations

¹ Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.
² National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, Hunan, China.
³ Furong Laboratory, Changsha, Hunan, China.
⁴ Hunan Key Laboratory of Skin Cancer and Psoriasis, Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China.
⁵ National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China.
⁶ Department of Plastic and Cosmetic Surgery, Xiangya Hospital, Central South University, Changsha, China.

Abstract

Background: Azvudine has been approved in China for the treatment of COVID-19 patients. Previous studies have suggested a correlation between high levels of lactate dehydrogenase (LDH) and the severity of COVID-19. However, the impact of LDH levels in COVID-19 patients receiving Azvudine treatment remains unclear.

Methods: In this retrospective cohort study, we analyzed the data of 351 hospitalized COVID-19 patients who were consecutively treated with Azvudine, with or without high LDH levels. The clinical features, treatment strategies and prognosis data were collected and analyzed.

Results: Among the 351 hospitalized patients with COVID-19 treated with Azvudine (119 with high-LDH levels), the median age was 69 years (range 58-78), and 213 (60.7%) were male. Common symptoms included cough (86.0%), expectoration (73.5%), fever (69.8%), polypnea (47.6%) and poor appetite (46.4%). Patients with high LDH levels exhibited significantly elevated leucocyte and neutrophil counts, elevated level of myocardial enzymes, as well as higher levels of inflammatory markers such as interleukin-6, interleukin-10, procalcitonin, C reactive protein, ferritin, and prolonged erythrocyte sedimentation rate upon admission. COVID-19 patients with high-LDH levels had higher rates of corticosteroid therapy, non-invasive and invasive mechanical ventilation, worsened and death (2.5% vs. 0%). The Cox proportional hazard model demonstrated that high LDH levels (adjusted hazard ratio = 5.27; 95% confidence interval: 1.19, 14.50) were associated with a more unfavorable composite disease progression outcome among COVID-19 patients treated with Azvudine, after accounting for potential confounding variables.

Conclusion: High-LDH levels predict a worse composite disease progression outcome in COVID-19 patients treated with Azvudine.

Keywords: COVID-19; SARS-CoV-2; azvudine; lactate dehydrogenase; prognosis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
COVID-19*
Disease Progression
Female
Humans
L-Lactate Dehydrogenase
Male
Middle Aged
Retrospective Studies
SARS-CoV-2

Substances

azvudine
L-Lactate Dehydrogenase

Grants and funding

This work was supported by the National Natural Science Foundation of China (Grant Nos. 82102803, 82272849 to GD), Natural Science Foundation of Hunan Province (Grant Nos. 2021JJ40976 to GD).