Prognostic value of elevated lactate dehydrogenase in patients with COVID-19: a systematic review and meta-analysis

PurposeThis meta-analysis aimed to evaluate the prognostic performance of elevated lactate dehydrogenase (LDH) in patients with COVID-19.MethodsA systematic literature search was performed using PubMed, Embase and EuropePMC on 19 November 2020. The outcome of interest was composite poor outcome, defined as a combined endpoint of mortality, severity, need for invasive mechanical ventilation and need for intensive care unit care. Severity followed the included studies’ criteria.ResultsThere are 10 399 patients from 21 studies. Elevated LDH was present in 44% (34%–53%) of the patients. Meta-regression analysis showed that diabetes was correlated with elevated LDH (OR 1.01 (95% CI 1.00 to 1.02), p=0.038), but not age (p=0.710), male (p=0.068) and hypertension (p=0.969). Meta-analysis showed that elevated LDH was associated with composite poor outcome (OR 5.33 (95% CI 3.90 to 7.31), p<0.001; I2: 77.5%). Subgroup analysis showed that elevated LDH increased mortality (OR 4.22 (95% CI 2.49 to 7.14), p<0.001; I2: 89%). Elevated LDH has a sensitivity of 0.74 (95% CI 0.60 to 0.85), specificity of 0.69 (95% CI 0.58 to 0.78), positive likelihood ratio of 2.4 (95% CI 1.9 to 2.9), negative likelihood ratio of 0.38 (95% CI 0.26 to 0.55), diagnostic OR of 6 (95% CI 4 to 9) and area under curve of 0.77 (95% CI 0.73 to 0.80). Elevated LDH would indicate a 44% posterior probability and non-elevated LDH would in indicate 11% posterior probability for poor prognosis. Meta-regression analysis showed that age, male, hypertension and diabetes did not contribute to the heterogeneity of the analyses.ConclusionLDH was associated with poor prognosis in patients with COVID-19.PROSPERO registration numberCRD42020221594.

Elevated Levels of Lactate Dehydrogenase Predicts Poor Outcomes for Patients with COVID-19: A Review

In glucose (Glc) metabolism, lactate dehydrogenase (LDH) functions by changing pyruvate into lactate. Lactate dehydrogenase (LDH) release is induced viacell death, suggesting to disease caused by virus or pulmonary deterioration, such as inflammation of the lung triggered by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). A satisfactory evidence exists by binding elevated lactate dehydrogenase (LDH) levels to the development of coronavirus disease 2019 (COVID-19) complications.

Cancer patients with COVID-19: a retrospective study of 51 patients in the district of Piacenza, Northern Italy

Background: Cancer patients are considered a highly fragile group in the current coronavirus disease 2019 (COVID-19) pandemic. Material & methods: In this study, patients with COVID-19 and cancer, hospitalized in Piacenza, Italy, from 4 April to 4 May 2020 were included. Risk factors for death were analyzed. Results: Fifty-one COVID-19 cancer patients were included, of which the median age was 71.02 years (range: 51–86) and 70.59% were male. Cancer types included gastrointestinal (25.49%), genitourinary (25.49%) and lung (23.53%). Forty-five (88.24%) patients received hydroxychloroquine-based therapy. In addition, 25 of 51 patients died (49%): 12 of 51 (23.53%) owing to cancer and 13 of 51 (25.49%) owing to COVID-19. Conclusion: The risks for death were related to later onset of treatment for COVID-19, severe/critical COVID-19, age, elevated basal CRP and elevated lactate dehydrogenase.