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

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.

SUBMITTER: Serin I

PROVIDER: S-EPMC7526632 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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

Serin Istemi I Sari Nagehan Didem ND Dogu Mehmet Hilmi MH Acikel Sakine Damla SD Babur Gulnıhal G Ulusoy Avni A Onar Mediha Irem MI Gokce Emre Cem EC Altunok Oguz O Yaylaci Mert Feyza F Karakilic Ayse A Baltik Muhammed M Gulesir Begum B

Journal of infection and public health 20200930 11

<h4>Background</h4>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.<h4>Methods</h4>The data from 2217 patients diagnosed as COVID-19 between March 2020 and June 2020 and hospitalized or di ...[more]

PMID: 33071210

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Project description:BackgroundMonocyte-to-lymphocyte ratio (MLR) and lactate dehydrogenase (LDH) levels are circulating biomarkers that provide information about tumor-related inflammation and immune suppression. This study aimed to evaluate the prognostic role of MLR and LDH in metastatic colorectal cancer (mCRC).Material and methodsThis multicentric study analyzed a consecutive cohort of 528 patients with mCRC treated in 2009-2017. The whole population was randomly divided in training and validation cohort. The first was used to identify a threshold for MLR and to create the prognostic model with MLR and MLR-LDH combined (group 1: MLR-LDH low; group 2: MLR or LDH high; group 3: MLR-LDH high). The second cohort was used to validate the model.ResultsAt the median follow-up of 55 months, median overall survival (OS) was 22 months. By multivariate analysis, high MLR >0.49 (hazard ratio [HR], 2.37; 95% confidence interval [C.I.], 1.39-4.04), high LDH (HR, 1.73; 95% C.I., 1.03-2.90) in the first model, group 2 (HR, 2.74; 95% C.I.; 1.62-4.66), and group 3 (HR, 3.73; 95% C.I., 1.94-7.18) in the combined model, had a worse prognosis in terms of OS. These data were confirmed both in the validation set and then in the whole cohort.ConclusionMLR and LDH are circulating cost-effective biomarkers, readily available in clinical practice, that can be useful for predicting the prognosis of patients with mCRC.Implications for practiceHigh monocyte-to-lymphocyte ratio (MLR) and lactate dehydrogenase (LDH) levels could be a sign of a tumor's recruitment of suppressive and inflammatory cells worsening prognosis of different types of cancer, including colorectal cancer (CRC). Currently, no data are available for metastatic CRC regarding a cutoff definition for MLR or the prognostic impact of MLR and MLR-LDH combined. The present study showed in the training cohort and confirmed in the validation and whole cohort that MLR is a reliable and independent laboratory biomarker, which is easy to use, to predict clinical outcomes in patients with mCRC. Moreover, MLR and composite MLR-LDH could potentially result in an incremental improvement in the prognostic value of these biomarkers, being used as stratification tools for patients with mCRC.

Project description:LDH-C4 is a lactate dehydrogenase that catalyzes the conversion of pyruvate to lactate. In mammals, ldh-c was originally thought to be expressed only in testis and spermatozoa. Plateau pika (Ochotona curzoniae), which belongs to the genus Ochotona of the Ochotonidea family, is a hypoxia tolerant mammal living 3000-5000 m above sea level on the Qinghai-Tibet Plateau, an environment which is strongly hypoxic. Ldh-c is expressed not only in testis and sperm but also in somatic tissues of plateau pika. In this study, the effects of N-propyl oxamate and N-isopropyl oxamate on LDH isozyme kinetics were compared to screens for a selective inhibitor of LDH-C4. To reveal the role and physiological mechanism of LDH-C4 in skeletal muscle of plateau pika, we investigated the effect of N-isopropyl oxamate on the pika exercise tolerance as well as the physiological mechanism. Our results show that Ki of N-propyl oxamate and N-isopropyl oxamate for LDH-A4, LDH-B4, and LDH-C4 were 0.094 mmol/L and 0.462 mmol/L, 0.119 mmol/L and 0.248 mmol/L, and 0.015 mmol/L and 0.013 mmol/L, respectively. N-isopropyl oxamate is a powerful selective inhibitor of plateau pika LDH-C4. In our exercise tolerance experiment, groups treated with inhibitors had significantly lower swimming times than the uninhibited control group. The inhibition rates of LDH, LD, and ATP were 37.12%, 66.27%, and 32.42%, respectively. Our results suggested that ldh-c is expressed in the skeletal muscle of plateau pika, and at least 32.42% of ATP in the skeletal muscle is catalyzed by LDH-C4 by anaerobic glycolysis. This suggests that pika has reduced dependence on oxygen and enhanced adaptation to hypoxic environment due to increased anaerobic glycolysis by LDH-C4 in skeletal muscle. LDH-C4 in plateau pika plays the crucial role in anaerobic glycolysis and generates ATP rapidly since this is the role of LDH-A4 in most species on plain land, which provide evidence that the native humans and animals in Qinghai-Tibet plateau can adapt to the hypoxia environment.

Dataset Information

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

Publications

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

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