ORIGINAL ARTICLE   Open access

Italian Journal of Emergency Medicine 2022 August;11(2):95-103

DOI: 10.23736/S2532-1285.22.00143-4

Copyright © 2022 THE AUTHORS

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language: English

Correlation of LDH with duration of illness, disease severity, ventilatory support and lung fibrosis in covid-19 pneumonia: a single center experience of 1000 cases in tertiary care setting in India

Shital PATIL ¹ ✉, Manojkumar BHADAKE ², Ganesh NARWADE ¹, Rajesh PATIL ²

¹ Department of Pulmonary Medicine, MIMSR Medical College, Latur, India; ² Department of Internal Medicine, MIMSR Medical College, Latur, India

BACKGROUND: Robust data of LDH is available as prognostic marker in hematology, malignancy, pneumocystis pneumonia, and we have analyzed its usefulness in COVID-19 pneumonia in predicting severity of illness, response to treatment and final outcome. Multicentric, prospective, observational and interventional study included 1000 COVID-19 cases confirmed with RT PCR. All cases were assessed with lung involvement documented and categorized on HRCT thorax, oxygen saturation, inflammatory marker as LDH at entry point and follow-up. Age, gender, Comorbidity and use BIPAP/NIV and outcome as with or without lung fibrosis as per CT severity were key observations. Statistical analysis is done by using χ² Test.
METHODS AND RESULTS: Age (<50 and >50 years) and gender (male versus female) has significant association with LDH in predicting severity of covid-19 pneumonia (P<0.00001 and P<0.010, respectively). CT severity score at entry point with LDH level has significant association (P<0.00001); LDH level has significant association with duration of illness (P<0.00001); comorbidities has significant association with normal and abnormal LDH level respectively (P<0.00001); LDH level has significant association with oxygen saturation (P<0.00001); BIPAP/NIV requirement during treatment in critical care setting has significant association with LDH level (P<0.00001); timing of BIPAP/NIV requirement during course of covid-19 pneumonia in critical care setting has significant association with LDH level (P<0.00001). Follow-up LDH titer during hospitalization as compared to entry point normal and abnormal LDH has significant association in post-covid lung fibrosis respectively (P<0.00001).
CONCLUSIONS: LDH is easily available and universally acceptable inflammatory marker in covid-19 pandemic and documented very crucial role in predicting severity of illness and assessing response to treatment during hospitalization. Follow-up LDH titer during hospitalization and at discharge can be used as early predictor of post-covid lung fibrosis.

KEY WORDS: COVID-19; Pneumonia; L-lactate dehydrogenase; Oxygen saturation; Post-acute COVID-19 syndrome; Pulmonary fibrosis