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. 2020 Nov;13(11):1664-1670.
doi: 10.1016/j.jiph.2020.09.009. Epub 2020 Sep 30.

A new parameter in COVID-19 pandemic: initial lactate dehydrogenase (LDH)/Lymphocyte ratio for diagnosis and mortality

Istemi Serin  1 , Nagehan Didem Sari  2 , Mehmet Hilmi Dogu  3 , Sakine Damla Acikel  4 , Gulnıhal Babur  4 , Avni Ulusoy  5 , Mediha Irem Onar  5 , Emre Cem Gokce  4 , Oguz Altunok  4 , Feyza Yaylaci Mert  4 , Ayse Karakilic  4 , Muhammed Baltik  4 , Begum Gulesir  4
Affiliations

A new parameter in COVID-19 pandemic: initial lactate dehydrogenase (LDH)/Lymphocyte ratio for diagnosis and mortality

Istemi Serin et al. J Infect Public Health. 2020 Nov.

Abstract

Background: COVID-19 (Coronavirus Disease-2019) is a pandemic disease, infecting more than 26.5 million people. Since there is no specific and effective treatment; early diagnosis and optimal isolation of the patient are of vital importance. Real-time polymerase chain reaction-based (RT-PCR) analyses do not achieve sufficient sensitivity in the diagnosis of the disease.

Methods: The data from 2217 patients diagnosed as COVID-19 between March 2020 and June 2020 and hospitalized or discharged with home isolation were retrospectively analyzed. Demographic data, comorbidities, PCR results, initial computed tomography (CT), laboratory values, Lactate Dehydrogenase (LDH)/Lymphocyte ratio, initial treatments and last status were recorded. The diagnostic sensitivity of LDH/Lymphocyte ratio, which is the main purpose of the study, was analyzed statistically.

Results: In order to test the effectiveness of LDH/Lymphocyte ratio for COVID-19 for diagnostic purposes, CT results were considered as gold standard. The area under the curve (AUC) was found to be 0.706 (p < 0.001; cut-off > 0.06) (Sensitivity: 76.4, specificity: 59.60). For the evaluation of LDH/Lymphocyte ratio in terms of survival, AUC was found to be 0.749 (p < 0.001; cut-off > 0.21) (Sensitivity: 70.59, specificity: 73.88).

Conclusion: Studies based on radiological findings have demonstrated that CT involvement has higher sensitivity. LDH/Lymphocyte ratio was analyzed in terms of diagnosis and mortality with using specific CT involvement as gold standard method which was found to be a more sensitive due to PCR false negativity; 0.06 and 0.21 were obtained as cut off values for diagnosis and mortality.

Keywords: COVID- 19; Diagnosis; LDH/Lymphocyte ratio; Mortality; Sensitivity.

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