Li Chang, Ye Jianfang, Chen Qijian, Hu Weihua, Wang Lingling, Fan Yameng, Lu Zhanjin, Chen Jie, Chen Zaishu, Chen Shiyan, Tong Junlu, Xiao Wei, Mei Jin, Lu Hongyun
Department of Cardiology, Hubei No.3 People's Hospital of Jianghan University, Wuhan 430033, Hubei Province, China.
Department of Endocrinology and Metabolism, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000, Guangdong Province, China.
Aging (Albany NY). 2020 Aug 14;12(15):15670-15681. doi: 10.18632/aging.103770.
Early identification of severe patients with coronavirus disease 2019 (COVID-19) is very important for individual treatment. We included 203 patients with COVID-19 by propensity score matching in this retrospective, case-control study. The effects of serum lactate dehydrogenase (LDH) at admission on patients with COVID-19 were evaluated. We found that serum LDH levels had a 58.7% sensitivity and 82.0% specificity, based on a best cut-off of 277.00 U/L, for predicting severe COVID-19. And a cut-off of 359.50 U/L of the serum LDH levels resulted in a 93.8% sensitivity, 88.2% specificity for predicting death of COVID-19. Additionally, logistic regression analysis and Cox proportional hazards model respectively indicated that elevated LDH level was an independent risk factor for the severity (HR: 2.73, 95% CI: 1.25-5.97; P=0.012) and mortality (HR: 40.50, 95% CI: 3.65-449.28; P=0.003) of COVID-19. Therefore, elevated LDH level at admission is an independent risk factor for the severity and mortality of COVID-19. LDH can assist in the early evaluating of COVID-19. Clinicians should pay attention to the serum LDH level at admission for patients with COVID-19.
早期识别新型冠状病毒肺炎（COVID-19）重症患者对于个体治疗非常重要。在这项回顾性病例对照研究中，我们通过倾向评分匹配纳入了203例COVID-19患者。评估了入院时血清乳酸脱氢酶（LDH）对COVID-19患者的影响。我们发现，基于277.00 U/L的最佳截断值，血清LDH水平预测重症COVID-19的敏感度为58.7%，特异度为82.0%。血清LDH水平截断值为359.50 U/L时，预测COVID-19死亡的敏感度为93.8%，特异度为88.2%。此外，逻辑回归分析和Cox比例风险模型分别表明，LDH水平升高是COVID-19严重程度（HR：2.73，95%CI：1.25-5.97；P=0.012）和死亡率（HR：40.50，95%CI：3.65-449.28；P=0.003）的独立危险因素。因此，入院时LDH水平升高是COVID-19严重程度和死亡率的独立危险因素。LDH可协助早期评估COVID-19。临床医生应关注COVID-19患者入院时的血清LDH水平。
