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The prognostic role of red cell distribution width / albumin ratio and lactate dehydrogenase level in patients with COVID-19

Year 2022, Volume: 61 Issue: 1, 38 - 43, 15.03.2022

Burhan Sami Kalın İhsan Solmaz

https://doi.org/10.19161/etd.1085634

Abstract

Aim: COVID-19 is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 and one of the deadliest pandemic situation. Prognostic factors for the COVID-19 are not clearly established. Our primary objective is to evaluate the association between the mortality of COVID-19 and red cell distribution width (RDW)/albumin ratio and lactate dehydrogenase level (LDH).

Materials and Methods: The patients with laboratory or clinical and radiological confirmed COVID-19 infection from March to September 2020 were included. Patients were divided into two groups as the survivors and non-survivors and the differences between two groups were analysed for all parameters. Logistic regression analysis was performed to assign the independent risk factors for mortality.

Results: The study was performed in 1900 cases confirmed by COVID-19 infection. Mortality rate was 5%. Non-survivors had higher LDH and RDW/albumin ratio as compared to survivors (387 [270-545] vs. 236[194-292], p=0.001 and 8.3 [6.5-9.2] vs. 3.4 [3.1-3.9], p=0.001), respectively). In the binary logistic regression analysis, RDW/albumin ratio, LDH, cerebrovascular disease, congestive heart failure and coronary artery disease were found to be independent risk factors for mortality.

Conclusion: LDH and RDW/albumin ratio can be favorable prognostic biomarkers for predicting in hospital mortality in patients with COVID-19 but more studies need to confirm the clinical value associated with illness.

Keywords

COVID-19 lactate dehydrogenase red cell distribution width albumin comorbidity

References

  • Novel Coronavirus–China. Available at: https://www. who.int/csr/don/12-january-2020-novel-coronaviruschina/en/. Accessed May 01, 2020.
  • Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. China medical treatment expert group for Covid-19. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 382: 1708-20.
  • Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395: 497-506.
  • Mission WCJ. Report of the who-china joint mission on coronavirus disease 2019 (Covid-19). (World Health Organization) Retrieved 2020; 8: 1-40. Available at: https://www.who.int/news-room/feature-stories/detail/ who-china-joint-mission-on-coronavirus-disease-2019- (covid-19). Accessed May 01, 2020.
  • Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med 2020; 8: 475- 81.
  • Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. Jama 2020; 323: 1061-9.
  • Phua J, Weng L, Ling L, Egi M, Lim CM, Divatia JV, et al. Intensive care management of coronavirus disease 2019 (COVID-19): challenges and recommendations. Lancet Respir Med 2020; 8: 506-17.
  • Yoo JW, Ju S, Lee SJ, Cho YJ, Lee JD, Kim HC. Red cell distribution width/albumin ratio is associated with 60-day mortality in patients with acute respiratory distress syndrome. Infect Dis (Lond). 2020 Apr; 52 (4): 266-70.
  • Chen L, Lu XY, Zhu CQ. Prognostic value of albumin-red cell distribution width score in patients with severe community-acquired pneumonia. Ann Palliat Med. 2020 May; 9 (3): 759-65.
  • Gabay C, Kushner I. Acute-phase proteins and other systemic responses to inflammation. N Engl J Med. 1999; 340 (6): 448–54.
  • Lee JH, Kim J, Kim K, Jo YH, Rhee J, Kim TY, et al. Albumin and C-reactive protein have prognostic significance in patients with community-acquired pneumonia. J Crit Care. 2011; 26 (3): 287–94.
  • Alsolamy S. Middle East respiratory syndrome: knowledge to date. Crit Care Med. 2015; 43 (6): 1283–90.
  • Al Ghamdi M, Alghamdi KM, Ghandoora Y, Alzahrani A, Salah F, Alsulami A, et al. Treatment outcomes for patients with Middle Eastern Respiratory Syndrome Coronavirus (MERS CoV) infection at a coronavirus referral center in the Kingdom of Saudi Arabia. BMC Infect Dis. 2016; 16 (1): 174.
  • Choi KW, Chau TN, Tsang O, Tso E, Chiu MC, Tong WL, et al. Outcomes and prognostic factors in 267 patients with severe acute respiratory syndrome in Hong Kong. Ann Intern Med. 2003; 139 (9): 715–23.
  • Xi X, Xu Y, Jiang L, Li A, Duan J, Du B, et al. Hospitalized adult patients with 2009 influenza A (H1N1) in Beijing, China: risk factors for hospital mortality. BMC Infect Dis. 2010; 10 (1): 256.
  • Han Y, Zhang H, Mu S, Wei W, Jin C, Tong C, et al. Lactate dehydrogenase, an independent risk factor of severe COVID-19 patients: a retrospective and observational study. Aging (Albany NY). 2020 Jun 24; 12 (12): 11245-58.
  • Wu MY, Yao L, Wang Y, Zhu XY, Wang XF, Tang PJ, et al. Clinical evaluation of potential usefulness of serum lactate dehydrogenase (LDH) in 2019 novel coronavirus (COVID-19) pneumonia. Respir Res. 2020 Jul 6; 21 (1): 171.
  • 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 Jun 3; 18 (1): 168.
  • 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 Aug 14; 12 (15): 15670-81.
  • 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 May; 46 (5): 846-8.
  • Shi S, Qin M, Shen B, Cai Y, Liu T, Yang F, et al. Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China. JAMA Cardiol 2020. JAMA Cardiol. 2020 Jul; 5 (7): 802–10.
  • Nguyen JL, Yang W, Ito K, Matte TD, Shaman J, Kinney PL. Seasonal influenza infections and cardiovascular disease mortality. JAMA Cardiol 2016; 1: 274-81.
  • Mehra MR, Desai SS, Kuy S, Henry TD, Patel AN. Cardiovascular Disease, Drug Therapy, and Mortality in Covid-19. N Engl J Med. 2020 Jun 18; 382 (25): e102.
  • Fan H, Tang X, Song Y, Liu P, Chen Y. Influence of COVID-19 on Cerebrovascular Disease and its Possible Mechanism. Neuropsychiatr Dis Treat. 2020 May 28; 16: 1359-67.
  • Du RH, Liang LR, Yang CQ, Wang W, Cao TZ, Li M, et al. Predictors of mortality for patients with COVID-19 pneumonia caused by SARS-CoV-2: a prospective cohort study. Eur Respir J. 2020 May 7; 55 (5): 2000524.

COVID-19 hastalarında kırmızı hücre dağılım genişliği / albümin oranı ve laktat dehidrogenaz düzeyinin prognostik rolü

Year 2022, Volume: 61 Issue: 1, 38 - 43, 15.03.2022

Burhan Sami Kalın İhsan Solmaz

https://doi.org/10.19161/etd.1085634

Abstract

Amaç: COVID-19, şiddetli akut solunum sendromu koronavirüs 2'nin neden olduğu bulaşıcı bir hastalıktır ve en ölümcül pandemik durumlardan birisidir. COVID-19 için prognostik faktörler net olarak belirlenmemiştir. Bu çalışmada, COVID-19 mortalitesi ile kırmızı hücre dağılım genişliği (RDW) / albümin oranı ve laktat dehidrogenaz seviyesi (LDH) arasındaki ilişkinin değerlendirilmesi amaçlanmıştır.


Gereç ve Yöntem: Mart - Eylül 2020 tarihleri arasında laboratuvar veya klinik ve radyolojik olarak doğrulanmış COVID-19 enfeksiyonu olan hastalar çalışmaya dâhil edildi. Hastalar, sağ kalanlar ve ölenler olarak iki gruba ayrıldı ve iki grup arasındaki farklılıklar tüm parametreler için analiz edildi. Mortalite açısından bağımsız risk faktörlerini belirlemek için lojistik regresyon analizi yapıldı.

Bulgular: Çalışma, COVID-19 enfeksiyonu doğrulanan 1900 vaka üzerinde gerçekleştirildi. Ölüm oranı %5’idi. Ölen hastalar, sağ kalanlara kıyasla daha yüksek LDH ve RDW / albümin oranına sahipti (387 [270-545] ve 236 [194-292], p=0.001 ve 8,3 [6,5-9,2] ve 3,4 [3,1-3,9], p=0,001), sırası ile). Lojistik regresyon analizinde RDW/albümin oranı, LDH, serebrovasküler hastalık, konjestif kalp yetmezliği ve koroner arter hastalığı mortalite açısından bağımsız risk faktörleri olarak bulundu.

Sonuç: LDH ve RDW / albümin oranı, COVID-19 hastalarında hastane mortalitesini tahmin etmek için prognostik biyobelirteçler olabilir ancak bu parametrelerin klinik değerlerinin daha fazla çalışma ile doğrulanması gerekir.

Keywords

COVID-19 laktat dehidrogenaz kırmızı hücre dağılım genişliği albümin komorbidite

References

  • Novel Coronavirus–China. Available at: https://www. who.int/csr/don/12-january-2020-novel-coronaviruschina/en/. Accessed May 01, 2020.
  • Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. China medical treatment expert group for Covid-19. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 382: 1708-20.
  • Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395: 497-506.
  • Mission WCJ. Report of the who-china joint mission on coronavirus disease 2019 (Covid-19). (World Health Organization) Retrieved 2020; 8: 1-40. Available at: https://www.who.int/news-room/feature-stories/detail/ who-china-joint-mission-on-coronavirus-disease-2019- (covid-19). Accessed May 01, 2020.
  • Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med 2020; 8: 475- 81.
  • Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. Jama 2020; 323: 1061-9.
  • Phua J, Weng L, Ling L, Egi M, Lim CM, Divatia JV, et al. Intensive care management of coronavirus disease 2019 (COVID-19): challenges and recommendations. Lancet Respir Med 2020; 8: 506-17.
  • Yoo JW, Ju S, Lee SJ, Cho YJ, Lee JD, Kim HC. Red cell distribution width/albumin ratio is associated with 60-day mortality in patients with acute respiratory distress syndrome. Infect Dis (Lond). 2020 Apr; 52 (4): 266-70.
  • Chen L, Lu XY, Zhu CQ. Prognostic value of albumin-red cell distribution width score in patients with severe community-acquired pneumonia. Ann Palliat Med. 2020 May; 9 (3): 759-65.
  • Gabay C, Kushner I. Acute-phase proteins and other systemic responses to inflammation. N Engl J Med. 1999; 340 (6): 448–54.
  • Lee JH, Kim J, Kim K, Jo YH, Rhee J, Kim TY, et al. Albumin and C-reactive protein have prognostic significance in patients with community-acquired pneumonia. J Crit Care. 2011; 26 (3): 287–94.
  • Alsolamy S. Middle East respiratory syndrome: knowledge to date. Crit Care Med. 2015; 43 (6): 1283–90.
  • Al Ghamdi M, Alghamdi KM, Ghandoora Y, Alzahrani A, Salah F, Alsulami A, et al. Treatment outcomes for patients with Middle Eastern Respiratory Syndrome Coronavirus (MERS CoV) infection at a coronavirus referral center in the Kingdom of Saudi Arabia. BMC Infect Dis. 2016; 16 (1): 174.
  • Choi KW, Chau TN, Tsang O, Tso E, Chiu MC, Tong WL, et al. Outcomes and prognostic factors in 267 patients with severe acute respiratory syndrome in Hong Kong. Ann Intern Med. 2003; 139 (9): 715–23.
  • Xi X, Xu Y, Jiang L, Li A, Duan J, Du B, et al. Hospitalized adult patients with 2009 influenza A (H1N1) in Beijing, China: risk factors for hospital mortality. BMC Infect Dis. 2010; 10 (1): 256.
  • Han Y, Zhang H, Mu S, Wei W, Jin C, Tong C, et al. Lactate dehydrogenase, an independent risk factor of severe COVID-19 patients: a retrospective and observational study. Aging (Albany NY). 2020 Jun 24; 12 (12): 11245-58.
  • Wu MY, Yao L, Wang Y, Zhu XY, Wang XF, Tang PJ, et al. Clinical evaluation of potential usefulness of serum lactate dehydrogenase (LDH) in 2019 novel coronavirus (COVID-19) pneumonia. Respir Res. 2020 Jul 6; 21 (1): 171.
  • 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 Jun 3; 18 (1): 168.
  • 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 Aug 14; 12 (15): 15670-81.
  • 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 May; 46 (5): 846-8.
  • Shi S, Qin M, Shen B, Cai Y, Liu T, Yang F, et al. Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China. JAMA Cardiol 2020. JAMA Cardiol. 2020 Jul; 5 (7): 802–10.
  • Nguyen JL, Yang W, Ito K, Matte TD, Shaman J, Kinney PL. Seasonal influenza infections and cardiovascular disease mortality. JAMA Cardiol 2016; 1: 274-81.
  • Mehra MR, Desai SS, Kuy S, Henry TD, Patel AN. Cardiovascular Disease, Drug Therapy, and Mortality in Covid-19. N Engl J Med. 2020 Jun 18; 382 (25): e102.
  • Fan H, Tang X, Song Y, Liu P, Chen Y. Influence of COVID-19 on Cerebrovascular Disease and its Possible Mechanism. Neuropsychiatr Dis Treat. 2020 May 28; 16: 1359-67.
  • Du RH, Liang LR, Yang CQ, Wang W, Cao TZ, Li M, et al. Predictors of mortality for patients with COVID-19 pneumonia caused by SARS-CoV-2: a prospective cohort study. Eur Respir J. 2020 May 7; 55 (5): 2000524.
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Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Research Articles
Authors

Burhan Sami Kalın 0000-0003-2624-6175

İhsan Solmaz 0000-0002-6624-8063

Publication Date March 15, 2022
Submission Date April 30, 2021
Published in Issue Year 2022 Volume: 61 Issue: 1

Cite

Vancouver Kalın BS, Solmaz İ. COVID-19 hastalarında kırmızı hücre dağılım genişliği / albümin oranı ve laktat dehidrogenaz düzeyinin prognostik rolü. EJM. 2022;61(1):38-43.
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