Abstract
Background
Patients with coronavirus disease 2019 (COVID-19) and underlying cardiovascular comorbidities have poor prognoses. Our aim was to identify the impact of serum lactate dehydrogenase (LDH), which is associated with mortality in acute respiratory distress syndrome, on the prognoses of patients with COVID-19 and underlying cardiovascular comorbidities.
Methods
Among 1518 patients hospitalized with COVID-19 enrolled in the CLAVIS-COVID (Clinical Outcomes of COVID-19 Infection in Hospitalized Patients with Cardiovascular Diseases and/or Risk Factors study), 515 patients with cardiovascular comorbidities were analyzed. Patients were divided into tertiles based on LDH levels at admission [tertile 1 (T1), <235 U/L; tertile 2 (T2), 235–355 U/L; and tertile 3 (T3); ≥356 U/L]. We investigated the impact of LDH levels on the in-hospital mortality.
Results
The mean age was 70.4 ± 30.0 years, and 65.3% were male. There were significantly more in-hospital deaths in T3 than in T1 and T2 [n = 50 (29.2%) vs. n = 15 (8.7%), and n = 24 (14.0%), respectively; p < 0.001]. Multivariable analysis adjusted for age, comorbidities, vital signs, and laboratory data including D-dimer and high-sensitivity troponin showed T3 was associated with an increased risk of in-hospital mortality (adjusted hazard ratio, 3.04; 95% confidence interval, 1.50–6.13; p = 0.002).
Conclusions
High serum LDH levels at the time of admission are associated with an increased risk of in-hospital death in patients with COVID-19 and known cardiovascular disease and may aid in triage of these patients.
【저자키워드】 severe acute respiratory syndrome coronavirus 2, Coronavirus disease 2019, acute respiratory distress syndrome, C-reactive protein, lactate dehydrogenase, Low-density lipoprotein, chronic obstructive pulmonary disease, Hemoglobin A1c, COVID-19coronavirus disease 2019, SARS-CoV-2severe acute respiratory syndrome coronavirus 2, ARDSacute respiratory distress syndrome, CRPC-reactive protein, COPDchronic obstructive pulmonary disease, LDHlactate dehydrogenase, CKcreatinine kinase, creatinine kinase, eGFRestimated glomerular filtration rate, estimated glomerular filtration rate, HbA1chemoglobin A1c, LDLlow-density lipoprotein, qSOFAquick sequential organ failure assessment, quick sequential organ failure assessment, 【초록키워드】 COVID-19, coronavirus disease, Mortality, Comorbidities, LDH, cardiovascular disease, D-dimer, cardiovascular, serum, clinical, male, Patient, age, vital signs, Admission, patients, in-hospital mortality, acute respiratory distress, Analysis, In-hospital death, cardiovascular comorbidities, Factor, 95% confidence interval, adjusted hazard ratio, increased risk, laboratory data, syndrome, Result, enrolled, analyzed, identify, significantly more, investigated, adjusted, cardiovascular comorbidity, patients hospitalized, patients with COVID-19, serum lactate, with COVID-19, 【제목키워드】 COVID-19, Prognosis, cardiovascular disease, Impact, serum lactate,