Original Article

To investigate the relation between LDH and CRP levels and mortality of COVID-19 (SARS-CoV-2) patients admitted in SURGERY ICU at Shariati Hospital from 19 February 2020 till 19 February 2021

Abstract

Objective:

The aim of this study is to investigate the relation between LDH and CRP levels and mortality of COVID-19 (SARS-CoV-2) patients admitted in SURGERY ICU at Shariati Hospital from 19 February 2020 till 19 February 2021

Methods:

Our study is a cross-sectional descriptive study . There are 81 patients that are enrolled in this study. We studied the lab reports including CBC parameters (WBC, neutrophils count, neutrophil percentage ) other inflammatory markers ESR and CRP and we also study the medical records of cases for collecting the details about age, gender , length of stay in SURGERY ICU, BMI, fever, survival status, comorbidity, intubation and NIV that was referred to Shariati hospital Tehran from  19 February 2020 (30-11-1398) till 19 February 2021(1-12-1399) regarding the relation between LDH and CRP levels and mortality of COVID-19 (SARS-CoV-2) patients admitted in SURGERY ICU.

The data obtained was analyzed by the SPSS software and the significance value of < 0.05 was considered.

Result:

In this study, the information of 81 patients was considered. The data comes from medical records of Shariati hospital, Tehran. We took 11 variables to compare data of different patients that were recorded in registry and system of medical records in Shariati hospital, Tehran.

This study population included 81 patients, out of which 41 were female patients and 40 were male patients from age 25 to 89. In total 80.2% had mild disease vs 18.5% who had severe disease . 65 patients survived and 16 were admitted to the SURGERY ICU with endotracheal intubation and later on died. The length of stay in SURGERY ICU is 1-25 days. Out of 81 patients 52 (62.4%)have comorbidity and 29 (35.8%) don't have comorbidity. 12 patients (14.8%) receive NIV and 69 patients (85.2%) don't receive NIV. Most of the patients don't have fever.

The minimum and maximum level of CRP are 4 and 416 respectively and for LDH are 9 and 2401 respectively.

The prognostic factors for the severity of COVID-19 infection identified in this study (CRP and LDH) help predict the course of the disease at an early stage. Elevated concentrations of CRP and LDH at admission were found to be associated with a higher risk for COVID-19 severity as they are significant (p-value =0.049 and 0.048 respectively).

Conclusion:

In this study laboratory investigation showed the SURGERY ICU patients to be having significantly higher values of inflammatory markers CRP and LDH than the non-SURGERY ICU patients. LDH and CRP were superior and an effective biomarker in predicting the severity of COVID-19.

1. World Health Organization. Coronavirus Disease 2019(COVID-19) Situation Report 46, 6 March 2020.
2. Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, RenR, Leung KS, Lau EH, Wong JY, Xing X. Earlytransmission dynamics in Wuhan, China, of novelcoronavirus-infected pneumonia. N Engl J Med. 2020 Jan 29. https://doi.org/10.1056/NEJMoa2001316
3. World Health Organization. Coronavirus Disease 2019(COVID-19) Situation Report 46, 6 March 2020.
4. World Health Organization. Coronavirus Disease 2019(COVID-19) Situation Report 68, 28 March 2020.
5. World Health Organization. Coronavirus Disease 2019 (COVID-19) Situation Report 68, 28 March 2020.
6. C, et al. Clinical features of patients infected with2019 novel coronavirus in Wuhan, China. Lancet.2020;395:497-506. https://doi.org/10.1016/S0140-6736(20)30183-5
7. Panteghini M, Bais R. Serum enzymes. In: Rifai N,Horvath AR, Wittwer CT, editors. Tietz textbook ofclinical chemistry and molecular diagnostics, 6th ed.St. Louis: Elsevier Saunders; 2018:404-34 pp.
8. Huijgen HJ, Sanders GT, Koster RW, Vreeken J, BossuytPM. The clinical value of lactate dehydrogenase in serum: a quantitative review. Eur J Clin Chem Clin Biochem. 1997;35:569-
9. Kishaba T, Tamaki H, Shimaoka Y, Fukuyama H, Yamashiro S. Staging of acute exacerbation in patients with idiopathic pulmonary fibrosis. Lung.2014;192:141-149. https://doi.org/10.1007/s00408-013-9530-0
10. Shi J, Li Y, Zhou X, Zhang Q, Ye X, Wu Z, et al. Lactate dehydrogenase and susceptibility to deterioration of mild COVID-19 patients: A multicenter nested case-control study. BMC Med. 2020;18(1):168. doi:
11.1186/s12916-020-01680-9. https://doi.org/10.1186/s12916-020-01633-7 11. Ridker PM, Danielson E, Fonseca FA, Genest J, Gotto AM Jr, Kastelein JJ, et al. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med. 2008;359(21):2195-207. https://doi.org/10.1056/NEJMoa0807646
12. Sharma SK, Agarwal S, Gupta D, Joshi K, Mishra HK.Aetiology, outcomes & predictors of mortality in acute respiratory distress syndrome from a tertiary care centre in North India. Indian J Med Res. 2016;143(6):782-92.https://doi.org/10.4103/0971-5916.192063
13. Bajwa EK, Januzzi JL, Gong MN, Thompson BT,Christiani DC. Plasma C-reactive protein levels are associated with improved outcome in ARDS.Chest. 2009;136(2):471-80. https://doi.org/10.1378/chest.08-2413
14. Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med. 2020;46(5):846-8. https://doi.org/10.1007/s00134-020-05991-x
15. Fajgenbaum DC, June CH. Cytokine storm. N Engl J Med. 2020;383(23):2255-73. https://doi.org/10.1056/NEJMra2026131
16. Li C, Ye J, Chen Q, Hu W, Wang L, Fan Y, et al. Elevated Lactate Dehydrogenase (LDH) level as an independent risk factor for the severity and mortality of COVID-19.Aging (Albany NY). 2020;12(15):15670-81. https://doi.org/10.18632/aging.103770
17. Bilgir F, Çalık Ş, Demir İ, Bilgir O. Roles of certain biochemical and hematological parameters in predicting mortality and ICU admission in COVID-19 patients. Rev Assoc Med Bras. 2021;67:67-73. https://doi.org/10.1590/1806-9282.67.suppl1.20200 788
18. Muhammad R, Ogunti R, Ahmed B, Munawar M,Donaldson S, Sumon M, et al. Clinical characteristics and predictors of mortality in minority patients hospitalized with COVID-19 infection. J Racial Ethn Health Disparities. 2022;1-11. https://doi.org/10.1007/s40615-020-00961-x
19. Akdogan D, Guzel M, Tosun D, Akpinar O. Diagnostic and early prognostic value of serum CRP and LDH levels in patients with possible COVID-19 at the first admission. J Infect Dev Ctries. 2021;15(6):766-72. https://doi.org/10.3855/jidc.14072
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IssueVol 7 No 2 (2024) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ajs.v7i2.16364
Keywords
SARS-CoV-2 lab results LDH CRP lung lesions
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How to Cite
1.
mohammadiafrakoti nima, talebi kahdouei mohammdsadegh, khajehnasiri alireza, heroababdi arash, haji mollarabei samaneh, aghaei fatemeh. To investigate the relation between LDH and CRP levels and mortality of COVID-19 (SARS-CoV-2) patients admitted in SURGERY ICU at Shariati Hospital from 19 February 2020 till 19 February 2021. AJS. 2024;7(2):47-51.