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Multicenter Study
. 2020 Jun 3;18(1):168.
doi: 10.1186/s12916-020-01633-7.

Lactate dehydrogenase and susceptibility to deterioration of mild COVID-19 patients: a multicenter nested case-control study

Jichan Shi  1 , Yang Li  2 , Xian Zhou  2 , Qiran Zhang  2 , Xinchun Ye  1 , Zhengxing Wu  1 , Xiangao Jiang  1 , Hongying Yu  3 , Lingyun Shao  2 , Jing-Wen Ai  2 , Haocheng Zhang  2 , Bin Xu  2 , Feng Sun  4 , Wenhong Zhang  2   5
Affiliations
Multicenter Study

Lactate dehydrogenase and susceptibility to deterioration of mild COVID-19 patients: a multicenter nested case-control study

Jichan Shi et al. BMC Med. .

Abstract

Background: Coronavirus disease 2019 (COVID-19) has infected more than 4 million people within 4 months. There is an urgent need to properly identify high-risk cases that are more likely to deteriorate even if they present mild diseases on admission.

Methods: A multicenter nested case-control study was conducted in four designated hospitals in China enrolling confirmed COVID-19 patients who were mild on admission. Baseline clinical characteristics were compared between patients with stable mild illness (stable mild group) and those who deteriorated from mild to severe illness (progression group).

Results: From Jan 17, 2020, to Feb 1, 2020, 85 confirmed COVID-19 patients were enrolled, including 16 in the progression group and 69 in the stable mild group. Compared to stable mild group (n = 69), patients in the progression group (n = 16) were more likely to be older, male, presented with dyspnea, with hypertension, and with higher levels of lactase dehydrogenase and c-reactive protein. In multivariate logistic regression analysis, advanced age (odds ratio [OR], 1.012; 95% confidence interval [CI], 1.020-1.166; P = 0.011) and the higher level of lactase dehydrogenase (OR, 1.012; 95% CI, 1.001-1.024; P = 0.038) were independently associated with exacerbation in mild COVID-19 patients.

Conclusion: Advanced age and high LDH level are independent risk factors for exacerbation in mild COVID-19 patients. Among the mild patients, clinicians should pay more attention to the elderly patients or those with high LDH levels.

Keywords: COVID-19; Lactate dehydrogenase; SARS-CoV-2; Severe pneumonia.

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Conflict of interest statement

All authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The flow chart of this study
Fig. 2
Fig. 2
Kaplan-Meier curves for diseases progression according to levels of LDH (a) and age (b). a Patients with LDH above the normal range were at significantly high risk of disease progress than those with normal levels of LDH (hazard ratio [HR], 8.31; 95% CI, 2.96–23.3, P < 0.001). b Patients aged 50 or older were at increased risk than patients whose age were younger than 50 (HR, 3.56; 95% CI, 1.35–10.2; P = 0.011). Abbreviation: LDH, lactase dehydrogenase
See this image and copyright information in PMC

References

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