School of Life Sciences, Faculty of Science, University of Technology Sydney, Ultimo, New South Wales, Australia.
Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Rev Med Virol. 2023 Nov;33(6):e2477. doi: 10.1002/rmv.2477. Epub 2023 Sep 14.
There's critical need for risk predictors in long COVID. This meta-analysis evaluates the evidence for an association between plasma lactate dehydrogenase (LDH) and long COVID and explores the contribution of LDH to symptoms persistent across the distinct post-acute sequelae of COVID-19 (PASC) domains. PubMed, EMBASE, Web of Science, and Google Scholar were searched for articles published up to 20 March 2023 for studies that reported data on LDH levels in COVID-19 survivors with and without PASC. Random-effect meta-analysis was employed to estimate the standardized mean difference (SMD) with corresponding 95% confidence interval of each outcome. There were a total of 8289 study participants (3338 PASC vs. 4951 controls) from 46 studies. Our meta-analysis compared to the controls showed a significant association between LDH elevation and Resp-PASC [SMD = 1.07, 95%CI = 0.72, 1.41, p = 0.01] but not Cardio-PASC [SMD = 1.79, 95%CI = -0.02, 3.61, p = 0.05], Neuro-PASC [SMD = 0.19, 95%CI = -0.24, 0.61, p = 0.40], and Gastrointestinal-PASC [SMD = 0.45, 95%CI = -1.08, 1.98, p = 0.56]. This meta-analysis suggests elevated LDH can be used for predicting Resp-PASC, but not Cardio-PASC, Neuro-PASC or gastrointestinal-PASC. Thus, elevated plasma LDH following COVID infection may be considered as a disease biomarker.
长新冠患者存在对风险预测因子的迫切需求。本荟萃分析评估了血浆乳酸脱氢酶（LDH）与长新冠之间的关联证据，并探讨了 LDH 对新冠后不同持续性后遗症（PASC）领域症状的贡献。检索了截至 2023 年 3 月 20 日发表的关于报告 COVID-19 幸存者中有无 PASC 患者的 LDH 水平数据的文章，使用随机效应荟萃分析估计每个结局的标准化均数差（SMD）及其相应的 95%置信区间。共有来自 46 项研究的 8289 名研究参与者（3338 名 PASC 患者与 4951 名对照者）。我们的荟萃分析结果表明，与对照组相比，LDH 升高与呼吸 PASC 之间存在显著关联（SMD=1.07，95%CI=0.72，1.41，p=0.01），但与心脏 PASC （SMD=1.79，95%CI=-0.02，3.61，p=0.05）、神经 PASC （SMD=0.19，95%CI=-0.24，0.61，p=0.39）或胃肠道 PASC （SMD=0.45，95%CI=-1.08，1.98，p=0.56）之间无关联。这项荟萃分析表明，升高的 LDH 可用于预测呼吸 PASC，但不能预测心脏 PASC、神经 PASC 或胃肠道 PASC。因此，COVID 感染后血浆 LDH 升高可被视为疾病生物标志物。
