scholarly journals Increased levels of lactate dehydrogenase and hypertension are associated with severe illness of COVID-19

2022 ◽  
Vol 10 (1) ◽  
pp. 128-135
Author(s):  
Zhen-Mu Jin ◽  
Ji-Chan Shi ◽  
Mo Zheng ◽  
Que-Lu Chen ◽  
Yue-Ying Zhou ◽  
...  
2020 ◽  
Vol 16 (1) ◽  
pp. 7-14 ◽  
Author(s):  
David M Nemer ◽  
Bryan R Wilner ◽  
Alicia Burkle ◽  
Jose Aguilera ◽  
Joseph Adewumi ◽  
...  

BACKGROUND: The clinical characteristics and outcomes associated with non–intensive care unit (non-ICU) hospitalizations for coronavirus disease 2019 (COVID-19) outside disease epicenters remain poorly characterized. METHODS: Systematic analysis of all non-ICU patient hospitalizations for COVID-19 completing discharge between March 13 and May 1, 2020, in a large US health care system utilizing off-site central monitoring. Variables of interest were examined in relation to a composite event rate of death, ICU transfer, or increased oxygen requirement to high-flow nasal cannula, noninvasive ventilation, or mechanical ventilation. RESULTS: Among 350 patients (age, 64 ± 16 years; 55% male), most (73%) required 3 L/min or less of supplemental oxygen during admission. Telemetry was widely utilized (79%) yet arrhythmias were uncommon (14%) and were predominantly (90%) among patients with abnormal troponin levels or known cardiovascular disease. Ventricular tachycardia was rare (5%), nonsustained, and not associated with hydroxychloroquine/azithromycin treatment. Adverse events occurred in 62 patients (18%), including 22 deaths (6%), 48 ICU transfers (14%), and 49 patients with increased oxygen requirement (14%) and were independently associated with elevated C-reactive protein (odds ratio, 1.09 per 1 mg/dL; 95% CI, 1.01-1.18; P = .04) and lactate dehydrogenase (OR, 1.006 per 1U/L; 95% CI, 1.001-1.012; P = .03) in multivariable analysis. CONCLUSION: Among non–critically ill patients hospitalized within a nonepicenter health care system, overall survival was 94% with the development of more severe illness or death independently associated with higher levels of C-reactive protein and lactate dehydrogenase on admission. Clinical decompensation was largely respiratory-related, while serious cardiac arrhythmias were rare, which suggests that telemetry can be prioritized for high-risk patients.


2020 ◽  
Author(s):  
Xiong Yibai ◽  
Tian Yaxin ◽  
Liu Bin ◽  
Ruan Lianguo ◽  
Lu Cheng ◽  
...  

Abstract Objective Early triage of patients with coronavirus disease 2019 (COVID-19) is pivotal in managing the disease. However, data on the risk factors for the development of severe disease remains scant. Here, we report a clinical risk score system for severe illness and highlight possible protective factors, which might inform proper treatment strategies.Methods We conducted a retrospective, single-center, observational study at the JinYinTan Hospital from January 24,2020 to March 31, 2020. We evaluated the demographic, clinical, and laboratory data and performed a 3-fold cross-validation to split the data into training set and validation set. We then screened the prognostic factors for severe illness using the Least Absolute Shrinkage and Selection Operator (LASSO) and logistic regression, and finally conducted a risk score to estimate the probability of critical illness in the training set. Data from the validation set were used to validate the score. Furthermore, the clinical factors of those patients who recovered were compared with those who did not recover from the rapidly worsened illness. We then employed logistic regression tools to delineate the possible protective factors.Results A total of 302 patients were included. From 47 potential risk factors, 6 variables were measured as the risk score: sex(female) (OR, 0.372; 95%CI, 0.211-0.655), Chest Computed Tomography abnormality (OR, 1.90; 95%CI, 1.36-2.66), neutrophil value (OR, 1.33; 95%CI, 1.18-1.50), neutrophil to lymphocyte ratio (OR, 1.23; 95%CI, 1.14-1.34), lactate dehydrogenase (OR, 1.01; 95%CI, 1.006-1.012), albumin (OR, 0.77; 95%CI, 0.71-0.84). The mean AUC of development cohort was 0.82 (95% CI, 0.81-0.92) and the AUC of validation cohort was 0.894 (95% CI, 0.78-0.95). Our comparison data from patients who rapidly worsened but recovered with those who did not showed that 4 variables were predictive factors: Prealbumin (OR, 1.028; 95%CI, 1.010-1.057), percentage of lymphocytes (OR, 1.213; 95%CI, 1.062-1.385), lactate dehydrogenase (OR, 0.984; 95%CI, 0.973-0.996), Prothrombin ativity (OR, 1.065; 95%CI, 1.018-1.115).Conclusion and Relevance In this study, we developed a predictive risk score and highlight 4 factors that might predict recovery from suddenly worsened illness. This report may help define the potential of developing critical illness and recovery prospects in patients with rapidly worsened condition.


2012 ◽  
Vol 101 (12) ◽  
pp. 1225-1231 ◽  
Author(s):  
Mathias Karlsson ◽  
Khu T K Dung ◽  
Truong L Thi ◽  
Erik Borgström ◽  
Karin Jonstam ◽  
...  

2001 ◽  
Vol 40 (4) ◽  
pp. 536-540 ◽  
Author(s):  
Finn Edler von Eyben ◽  
Ebbe Lindegaard Madsen ◽  
Ole Blaabjerg ◽  
Per Hyltoft Petersen ◽  
Hans von der Maase ◽  
...  

2006 ◽  
Vol 12 (3) ◽  
pp. 148-151
Author(s):  
Noriko Ihara ◽  
Ikuo Murohashi ◽  
Masako Itho ◽  
Ikuo Amino ◽  
Katsuhiko Yoshida ◽  
...  

Author(s):  
А.В. Солин ◽  
А.Ю. Ляшев ◽  
Ю.Д. Ляшев

Цель исследования - сравнительный анализ влияния селективных агонистов отдельных классов опиоидных рецепторов на белковосинтетическую функцию печени, развитие цитолитического и холестатического синдромов у крыс, подвергшихся частичной гепатэктомии. Методика. Работа выполнена на 152 крысах-самцах Вистар массой 200-250 г. Частичную гепатэктомию выполняли по методу, описанному Higgins G.M. и Anderson R.M. с удалением 70% ткани печени. В плазме крови определяли концентрации общего белка, альбуминов, общего билирубина, активность аланинтрансаминазы (АЛТ), аспартаттрансаминазы (АСТ), лактатдегидрогеназы (ЛДГ) традиционными методами. Опиоиды: DAGO в дозе 6,3 мкг/кг, DSLET в дозе 10,0 мкг/кг, динорфин А (1-13) в дозе 20,1 мкг/кг, вводили внутрибрюшинно ежедневно 1 раз в сутки в течение 5 сут. эксперимента в объеме 0,2 мл. Контрольным животным аналогично вводили физраствор. Результаты. Удаление 70% ткани печени у крыс-самцов Вистар сопровождается развитием печеночной недостаточности, проявляющейся гипербилирубинемией, гипоальбуминемией, гипопротеинемией, повышением активности трансаминаз и лактатдегидрогеназы. Применение селективных агонистов опиоидных рецепторов у крыс, которым моделировали частичную гепатэктомию, оказывало гепатопротективное действие и снижало выраженность проявлений печеночной недостаточности, начиная с 3-х сут. после резекции. Активность трансаминаз, лактатдегидрогеназы и концентрация общего билирубина у животных, которым вводили опиоиды, были существенно ниже, чем в контрольной группе. Содержание общего белка и альбуминов было статистически значимо выше в группах, которые получали исследованные пептиды, по сравнению с контрольной группой на 7-е сут. после частичной гепатэктомии. Наиболее выраженное действие проявлял селективный агонист опиоидных мю-рецепторов DAGO. По нашему мнению, такое влияние пептидов объясняется присущими им антиоксидантным и антигипоксическим эффектами, что снижает повреждающее действие оперативного вмешательства на печень. Более выраженное влияние DAGO связано, по-видимому, с особенностями распределения опиоидных рецепторов или устойчивостью пептида к действию эндопептидаз благодаря модификациям в молекуле пептида. Заключение. Применение опиоидов стимулирует восстановление функциональной активности печени после частичной гепатэктомии. Наибольший эффект отмечается при введении мю-агониста DAGO. Aim. The aim of the study was to compare effects of selective agonists of opioid receptors from different classes on the protein-synthesizing function of liver and development of cytolytic and cholestatic syndromes in rats after partial hepatectomy. Methods. The study was conducted on 152 Wistar male rats weighing 200-250 g. The animals were subjected to partial hepatectomy according to the Higgins and Anderson method. Concentrations of total protein, albumin, total bilirubin, and activities of alanine aminotransferase, aspartate aminotransferase, and lactate dehydrogenase were measured in plasma using standard methods. The opioids, DAGO (6.3 mg/kg), DSLET (10.0 mg/kg), and dynorphin A (1-13) (20.1 mg/kg), were injected in 0.2 ml of saline daily for 5 days. Control animals were injected with 0.2 ml of saline for 5 days. Results. Resection of 70% of liver tissue resulted in development of liver failure as evidenced by hyperbilirubinemia, hypoalbuminemia, hypoproteinemia, and increased transaminase and lactate dehydrogenase activities. Selective agonists of opioid receptors administered to the rats after partial hepatectomy exerted a hepatoprotective effect and alleviated the signs of liver failure beginning from the 3 day after resection. Transaminase and lactate dehydrogenase activities were significantly lower in opioid-treated rats than in the control group. Levels of total protein and albumins were significantly higher in the groups injected with the study peptides compared to the control group on the 7 day after partial hepatectomy. The selective agonist of opioid m-receptors, DAGO, exerted the most pronounced effect. Apparently, the similar effects of peptides were due to their antioxidant and anti-hypoxic action, which alleviated the detrimental effect of liver surgery. The more pronounced effect of DAGO apparently resulted from peculiarities of opioid receptors distribution or peptide resistance to endopeptidase action due to modifications of the peptide molecule. Conclusion. Administration of opioids stimulated restoration of liver functional activity after partial hepatectomy. Injections of the m-agonist, DAGO, produced the most pronounced effect.


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