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. 2023 Jan 20;42(1):16-26.
doi: 10.5937/jomb0-37234.

Diagnostic performance of lactate dehydrogenase (LDH) isoenzymes levels for the severity of COVID-19

Ilkay Ergenc  1 , Emre Capar  2 , Sengel Buket Erturk  3 , Gunel Bahramzade  4 , Fatih Atalah  2 , Derya Kocakaya  5 , Sait Karakurt  5 , Goncagul Haklar  4 , Zekaver Odabasi  2
Affiliations

Diagnostic performance of lactate dehydrogenase (LDH) isoenzymes levels for the severity of COVID-19

Ilkay Ergenc et al. J Med Biochem. .

Abstract
in English, Serbian

Background: Lactate dehydrogenase (LDH) levels predict coronavirus disease 2019 (COVID-19) severity. We investigated LDH isoenzyme levels to identify the tissue responsible for serum LDH elevation in patients with COVID-19.

Methods: Hospitalised COVID-19 patients with serum LDH levels exceeding the upper reference limit included. LDH isoenzymes were detected quantitatively on agarose gels. The radiological severity of lung involvement on computed tomography was scored as 0-5 for each lobe (total possible score, 0-25). Disease severity was determined using the World Health Organization (WHO) clinical progression scale.

Results: In total, 111 patients (mean age, 59.96 ± 16.14), including 43 females (38.7%), were enrolled. The serum levels of total LDH and all five LDH isoenzymes were significantly higher in the severe group. The levels of all LDH isoenzymes excluding LDH5 positively correlated with the WHO score. LDH3 levels correlated with chest computed tomography findings (r2 = 0.267, p = 0.005). On multivariate analysis, LDH3 was an independent risk factor for the deterioration of COVID-19.

Conclusions: LDH3 appears to be an independent risk factor for deterioration in patients with COVID-19. LDH elevation in patients with COVID-19 predominantly resulted from lung, liver and muscle damage.

Uvod: Nivoi laktat dehidrogenaze (LDH) predviđaju ozbiljnost bolesti korona virusa 2019 (COVID-19). Istraživali smo nivoe LDH izoenzima da bismo identifikovali tkivo odgovorno za povišenje LDH u serumu kod pacijenata sa COVID-19.

Metode: Uključeni su hospitalizovani pacijenti sa COVID-19 sa nivoom LDH u serumu koji prelazi gornju referentnu granicu. LDH izoenzimi su kvantitativno detektovani na agaroznim gelovima. Radiološka težina zahvata pluća na kompjuterizovanoj tomografiji ocenjena je sa 0-5 za svaki režanj (ukupan mogući rezultat, 0-25). Težina bolesti je određena korišćenjem skale kliničke progresije Svetske zdravstvene organizacije (SZO).

Keywords: COVID-19; LDH isoenzymes; coronavirus; lactate dehydrogenase.

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Conflict of interest statement

Conflict of Interest: The authors stated that they have no conflicts of interest regarding the publication of this article.

Figures

Figure 1
Figure 1. Receiver operating curve analysis of the cut-offs for total lactate dehydrogenase (LDH) and LDH isoenzyme levels for discriminating disease severity.
Total LDH levels showed the best area under the curve. The cut-off value of total LDH levels for predicting disease severity was >345U/L (AUC = 0.801, sensitivity = 82.7%, specificity = 69.2%). The cut-off values for LDH1, LDH2, LDH3, LDH4 and LDH5 were >68.8, >117.65, >81.72, >40.85, and >46.95 U/L, respectively.
(AUC, area under the curve)
Figure 2
Figure 2. A boxplot of LDH isoenzymes on electrophoresis.
The mean proportions of LDH1, LDH2, LDH3, LDH4 and LDH5 were 20.58%, 33.42%, 22.53%, 10.00% and 13.63%, respectively. The proportions of LDH3 and LDH5 were higher than expected. (LDH, lactate dehydrogenase)
See this image and copyright information in PMC

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