Prognostic value of lactate dehydrogenase for in-hospital mortality in severe and critically ill patients with COVID-19.
Identifieur interne : 000314 ( Main/Exploration ); précédent : 000313; suivant : 000315Prognostic value of lactate dehydrogenase for in-hospital mortality in severe and critically ill patients with COVID-19.
Auteurs : Xingtong Dong [République populaire de Chine] ; Lu Sun [République populaire de Chine] ; Yan Li [République populaire de Chine]Source :
- International journal of medical sciences [ 1449-1907 ] ; 2020.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Adulte d'âge moyen (MeSH), Betacoronavirus (isolement et purification), Betacoronavirus (pathogénicité), Chine (épidémiologie), Courbe ROC (MeSH), Facteurs de risque (MeSH), Femelle (MeSH), Humains (MeSH), Indice de gravité de la maladie (MeSH), Infections à coronavirus (diagnostic), Infections à coronavirus (mortalité), Infections à coronavirus (sang), Infections à coronavirus (thérapie), Infections à coronavirus (traitement médicamenteux), L-Lactate dehydrogenase (sang), Maladie grave (mortalité), Marqueurs biologiques (sang), Mortalité hospitalière (MeSH), Mâle (MeSH), Pandémies (MeSH), Pneumopathie virale (diagnostic), Pneumopathie virale (mortalité), Pneumopathie virale (sang), Pneumopathie virale (thérapie), Pronostic (MeSH), Sujet âgé (MeSH), Sujet âgé de 80 ans ou plus (MeSH), Valeur prédictive des tests (MeSH), Études rétrospectives (MeSH).
- MESH :
- diagnostic : Infections à coronavirus, Pneumopathie virale.
- isolement et purification : Betacoronavirus.
- mortalité : Infections à coronavirus, Maladie grave, Pneumopathie virale.
- pathogénicité : Betacoronavirus.
- sang : Infections à coronavirus, L-Lactate dehydrogenase, Marqueurs biologiques, Pneumopathie virale.
- thérapie : Infections à coronavirus, Pneumopathie virale.
- traitement médicamenteux : Infections à coronavirus.
- épidémiologie : Chine.
- Adulte, Adulte d'âge moyen, Courbe ROC, Facteurs de risque, Femelle, Humains, Indice de gravité de la maladie, Mortalité hospitalière, Mâle, Pandémies, Pronostic, Sujet âgé, Sujet âgé de 80 ans ou plus, Valeur prédictive des tests, Études rétrospectives.
- Wicri :
- geographic : République populaire de Chine.
English descriptors
- KwdEn :
- Adult (MeSH), Aged (MeSH), Aged, 80 and over (MeSH), Betacoronavirus (isolation & purification), Betacoronavirus (pathogenicity), Biomarkers (blood), China (epidemiology), Coronavirus Infections (blood), Coronavirus Infections (diagnosis), Coronavirus Infections (drug therapy), Coronavirus Infections (mortality), Coronavirus Infections (therapy), Critical Illness (mortality), Female (MeSH), Hospital Mortality (MeSH), Humans (MeSH), L-Lactate Dehydrogenase (blood), Male (MeSH), Middle Aged (MeSH), Pandemics (MeSH), Pneumonia, Viral (blood), Pneumonia, Viral (diagnosis), Pneumonia, Viral (mortality), Pneumonia, Viral (therapy), Predictive Value of Tests (MeSH), Prognosis (MeSH), ROC Curve (MeSH), Retrospective Studies (MeSH), Risk Factors (MeSH), Severity of Illness Index (MeSH).
- MESH :
- chemical , blood : Biomarkers, L-Lactate Dehydrogenase.
- geographic , epidemiology : China.
- blood : Coronavirus Infections, Pneumonia, Viral.
- diagnosis : Coronavirus Infections, Pneumonia, Viral.
- drug therapy : Coronavirus Infections.
- isolation & purification : Betacoronavirus.
- mortality : Coronavirus Infections, Critical Illness, Pneumonia, Viral.
- pathogenicity : Betacoronavirus.
- therapy : Coronavirus Infections, Pneumonia, Viral.
- Adult, Aged, Aged, 80 and over, Female, Hospital Mortality, Humans, Male, Middle Aged, Pandemics, Predictive Value of Tests, Prognosis, ROC Curve, Retrospective Studies, Risk Factors, Severity of Illness Index.
Abstract
Background: Lactate dehydrogenase (LDH) has been proved to be a prognostic factor for the severity and poor outcomes of coronavirus disease 2019 (COVID-19). In most studies, patients with various levels of COVID-19 severity were pooled and analyzed which may prevent accurate evaluation of the relationship between LDH and disease progression and in-hospital death. In this study, we aimed to evaluate the association of LDH with in-hospital mortality in severe and critically ill patients with COVID-19. Methods: This single-center retrospective study enrolled 119 patients. Survival curves were plotted using Kaplan-Meier method and compared by log-rank test. Multivariate Cox regression models were used to determine the independent risk factors for in-hospital mortality. Receiver-operator curves (ROCs) were constructed to evaluate the predictive accuracy of LDH and other prognostic biomarkers. Results: Compared to the survival group, LDH levels in the dead group were significantly higher [559.5 (172, 7575) U/L vs 228 (117, 490) U/L, (P < 0.001)]. In Multivariate Cox regression, it remained an independent risk factor for in-hospital mortality (Hazard ratio 5.985, 95.0%CI: 1.498-23.905; P=0.011). A cutoff value of 353.5 U/L predicted the in-hospital mortality with a sensitivity of 94.4% and a specificity of 89.2% respectively. Conclusion: LDH is a favorable prognostic biomarker with high accuracy for predicting in-hospital mortality in severe and critically ill patients with COVID-19. This may direct physicians worldwide to effectively prioritize resources for patients at high risk of death and to implement more aggressive treatments at an earlier phase to save patients' lives.
DOI: 10.7150/ijms.47604
PubMed: 32922185
PubMed Central: PMC7484664
Affiliations:
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Le document en format XML
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Viral (diagnosis)</term><term>Pneumonia, Viral (mortality)</term><term>Pneumonia, Viral (therapy)</term><term>Predictive Value of Tests (MeSH)</term><term>Prognosis (MeSH)</term><term>ROC Curve (MeSH)</term><term>Retrospective Studies (MeSH)</term><term>Risk Factors (MeSH)</term><term>Severity of Illness Index (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Betacoronavirus (isolement et purification)</term><term>Betacoronavirus (pathogénicité)</term><term>Chine (épidémiologie)</term><term>Courbe ROC (MeSH)</term><term>Facteurs de risque (MeSH)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Indice de gravité de la maladie (MeSH)</term><term>Infections à coronavirus (diagnostic)</term><term>Infections à coronavirus (mortalité)</term><term>Infections à coronavirus (sang)</term><term>Infections à coronavirus (thérapie)</term><term>Infections à coronavirus (traitement 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over</term><term>Female</term><term>Hospital Mortality</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Pandemics</term><term>Predictive Value of Tests</term><term>Prognosis</term><term>ROC Curve</term><term>Retrospective Studies</term><term>Risk Factors</term><term>Severity of Illness Index</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Courbe ROC</term><term>Facteurs de risque</term><term>Femelle</term><term>Humains</term><term>Indice de gravité de la maladie</term><term>Mortalité hospitalière</term><term>Mâle</term><term>Pandémies</term><term>Pronostic</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Valeur prédictive des tests</term><term>Études rétrospectives</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>République populaire de Chine</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><b>Background:</b> Lactate dehydrogenase (LDH) has been proved to be a prognostic factor for the severity and poor outcomes of coronavirus disease 2019 (COVID-19). In most studies, patients with various levels of COVID-19 severity were pooled and analyzed which may prevent accurate evaluation of the relationship between LDH and disease progression and in-hospital death. In this study, we aimed to evaluate the association of LDH with in-hospital mortality in severe and critically ill patients with COVID-19. <b>Methods:</b> This single-center retrospective study enrolled 119 patients. Survival curves were plotted using Kaplan-Meier method and compared by log-rank test. Multivariate Cox regression models were used to determine the independent risk factors for in-hospital mortality. Receiver-operator curves (ROCs) were constructed to evaluate the predictive accuracy of LDH and other prognostic biomarkers. <b>Results:</b> Compared to the survival group, LDH levels in the dead group were significantly higher [559.5 (172, 7575) U/L vs 228 (117, 490) U/L, (<i>P</i> < 0.001)]. In Multivariate Cox regression, it remained an independent risk factor for in-hospital mortality (Hazard ratio 5.985, 95.0%CI: 1.498-23.905; <i>P</i>=0.011). A cutoff value of 353.5 U/L predicted the in-hospital mortality with a sensitivity of 94.4% and a specificity of 89.2% respectively. <b>Conclusion:</b> LDH is a favorable prognostic biomarker with high accuracy for predicting in-hospital mortality in severe and critically ill patients with COVID-19. This may direct physicians worldwide to effectively prioritize resources for patients at high risk of death and to implement more aggressive treatments at an earlier phase to save patients' lives.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32922185</PMID><DateCompleted><Year>2020</Year><Month>09</Month><Day>22</Day></DateCompleted><DateRevised><Year>2020</Year><Month>09</Month><Day>22</Day></DateRevised><Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Electronic">1449-1907</ISSN><JournalIssue CitedMedium="Internet"><Volume>17</Volume><Issue>14</Issue><PubDate><Year>2020</Year></PubDate></JournalIssue><Title>International journal of medical sciences</Title><ISOAbbreviation>Int J Med Sci</ISOAbbreviation></Journal><ArticleTitle>Prognostic value of lactate dehydrogenase for in-hospital mortality in severe and critically ill patients with COVID-19.</ArticleTitle><Pagination><MedlinePgn>2225-2231</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.7150/ijms.47604</ELocationID><Abstract><AbstractText><b>Background:</b> Lactate dehydrogenase (LDH) has been proved to be a prognostic factor for the severity and poor outcomes of coronavirus disease 2019 (COVID-19). In most studies, patients with various levels of COVID-19 severity were pooled and analyzed which may prevent accurate evaluation of the relationship between LDH and disease progression and in-hospital death. In this study, we aimed to evaluate the association of LDH with in-hospital mortality in severe and critically ill patients with COVID-19. <b>Methods:</b> This single-center retrospective study enrolled 119 patients. Survival curves were plotted using Kaplan-Meier method and compared by log-rank test. Multivariate Cox regression models were used to determine the independent risk factors for in-hospital mortality. Receiver-operator curves (ROCs) were constructed to evaluate the predictive accuracy of LDH and other prognostic biomarkers. <b>Results:</b> Compared to the survival group, LDH levels in the dead group were significantly higher [559.5 (172, 7575) U/L vs 228 (117, 490) U/L, (<i>P</i> < 0.001)]. In Multivariate Cox regression, it remained an independent risk factor for in-hospital mortality (Hazard ratio 5.985, 95.0%CI: 1.498-23.905; <i>P</i>=0.011). A cutoff value of 353.5 U/L predicted the in-hospital mortality with a sensitivity of 94.4% and a specificity of 89.2% respectively. <b>Conclusion:</b> LDH is a favorable prognostic biomarker with high accuracy for predicting in-hospital mortality in severe and critically ill patients with COVID-19. This may direct physicians worldwide to effectively prioritize resources for patients at high risk of death and to implement more aggressive treatments at an earlier phase to save patients' lives.</AbstractText><CopyrightInformation>© The author(s).</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Dong</LastName><ForeName>Xingtong</ForeName><Initials>X</Initials><AffiliationInfo><Affiliation>Department of Nephrology, Xuanwu Hospital, Capital Medical University, Changchun Street #45, Xicheng District 100053, Beijing, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sun</LastName><ForeName>Lu</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Department of General Disease, West Campus, Union Hospital Tongji Medical College Huazhong University of Science and Technology, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Li</LastName><ForeName>Yan</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Department of Pulmonary and Critical Care Medicine, Xuanwu Hospital, Capital Medical University, Changchun Street #45, Xicheng District 100053, Beijing, China.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>08</Month><Day>19</Day></ArticleDate></Article><MedlineJournalInfo><Country>Australia</Country><MedlineTA>Int J Med Sci</MedlineTA><NlmUniqueID>101213954</NlmUniqueID><ISSNLinking>1449-1907</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D015415">Biomarkers</NameOfSubstance></Chemical><Chemical><RegistryNumber>EC 1.1.1.27</RegistryNumber><NameOfSubstance UI="D007770">L-Lactate Dehydrogenase</NameOfSubstance></Chemical></ChemicalList><SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName><SupplMeshName Type="Protocol" UI="C000705127">COVID-19 drug treatment</SupplMeshName><SupplMeshName Type="Organism" UI="C000656484">severe acute respiratory syndrome coronavirus 2</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="N">Betacoronavirus</DescriptorName><QualifierName UI="Q000302" MajorTopicYN="N">isolation & purification</QualifierName><QualifierName UI="Q000472" MajorTopicYN="N">pathogenicity</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015415" MajorTopicYN="N">Biomarkers</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="N">blood</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002681" MajorTopicYN="N" Type="Geographic">China</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="N">blood</QualifierName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName><QualifierName UI="Q000401" MajorTopicYN="Y">mortality</QualifierName><QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016638" MajorTopicYN="N">Critical Illness</DescriptorName><QualifierName UI="Q000401" MajorTopicYN="Y">mortality</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017052" MajorTopicYN="Y">Hospital Mortality</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007770" MajorTopicYN="N">L-Lactate Dehydrogenase</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="Y">blood</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="N">Pandemics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, Viral</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="N">blood</QualifierName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000401" MajorTopicYN="Y">mortality</QualifierName><QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011237" MajorTopicYN="N">Predictive Value of Tests</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011379" MajorTopicYN="N">Prognosis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012372" MajorTopicYN="N">ROC Curve</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012720" MajorTopicYN="Y">Severity of Illness Index</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">lactate dehydrogenase</Keyword><Keyword MajorTopicYN="N">multiple organ dysfunction</Keyword><Keyword MajorTopicYN="N">prognostic value</Keyword></KeywordList><CoiStatement>Competing Interests: The authors have declared that no competing interest exists.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>04</Month><Day>30</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>08</Month><Day>09</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>9</Month><Day>14</Day><Hour>5</Hour><Minute>49</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>9</Month><Day>15</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>9</Month><Day>23</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32922185</ArticleId><ArticleId IdType="doi">10.7150/ijms.47604</ArticleId><ArticleId 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