Wang Shan, Liu Jia, Hu Song, Mao Yongjun
Shan Wang, Department of Geriatric Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, China.
Jia Liu, Department of Geriatric Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, China.
Pak J Med Sci. 2024 Oct;40(9):2112-2117. doi: 10.12669/pjms.40.9.8728.
Lactate dehydrogenase (LDH) is an enzyme that is responsible for the production of lactic acid, which is a necessary byproduct when the body does not have enough oxygen. LDH levels in the blood can be used as a marker to predict mortality in patients with ARDS, severe COVID-19, and cancer. To analyze the clinical characteristics of COVID-19 in the elderly and the correlation between LDH and respiratory failure in COVID-19 patients, to improve the identification and management of this type of pneumonia by clinicians.
This was a single-center retrospective study. We performed routine laboratory tests in 105 COVID-19 patients admitted to the affiliated hospital of Qingdao University (Qingdao, China) from October 1, 2022 to February 1, 2023. The diagnosis of respiratory failure was established based on the results of blood gas analysis upon admission.
The median age was 79 years. Among all univariable parameters, LDH, neutrophil to lymphocyte ratio (NLR) and Prothrombin Time (PT) were significantly independent risk factors of RF in elderly COVID-19 patients. LDH (AUC=0.829) also had a maximum specificity (96.5%), with the cutoff value of 280.5.
The levels of LDH, NLR, and PT may serve as potential indicators for elderly COVID-19 patients combined with respiratory failure. LDH, NLR and PT assays can be beneficial for patients who need closer respiratory monitoring and more aggressive supportive care to prevent a negative prognosis.
乳酸脱氢酶（LDH）是一种负责产生乳酸的酶，乳酸是身体缺氧时产生的一种必要副产品。血液中的LDH水平可用作预测急性呼吸窘迫综合征（ARDS）、重症新型冠状病毒肺炎（COVID-19）和癌症患者死亡率的标志物。分析老年COVID-19患者的临床特征以及COVID-19患者中LDH与呼吸衰竭之间的相关性，以提高临床医生对这类肺炎的识别和管理能力。
这是一项单中心回顾性研究。我们对2022年10月1日至2023年2月1日期间入住青岛大学附属医院（中国青岛）的105例COVID-19患者进行了常规实验室检查。根据入院时血气分析结果确定呼吸衰竭的诊断。
中位年龄为79岁。在所有单变量参数中，LDH、中性粒细胞与淋巴细胞比值（NLR）和凝血酶原时间（PT）是老年COVID-19患者呼吸衰竭的显著独立危险因素。LDH（曲线下面积[AUC]=0.829）也具有最高的特异性（96.5%），截断值为280.5。
LDH、NLR和PT水平可能作为老年COVID-19合并呼吸衰竭患者的潜在指标。LDH、NLR和PT检测可能有助于需要更密切呼吸监测和更积极支持治疗以防止不良预后的患者。
