COVID-19 :Correlation Between CRP and LDH to Disease Severity and Mortality In Hospitalized COVID-19 Patients

Authors

  • Rizal Muldani Tjahyadi Lab/SMF Pulmnologi dan Kedokteran Respirasi Fakultas Kedokteran, Universitas Brawijaya, Malang, Indonesia, Indonesia
  • Triwahju Astuti Lab/SMF Pulmnologi dan Kedokteran Respirasi Fakultas Kedokteran, Universitas Brawijaya, Malang, Indonesia, Indonesia
  • Aditya Sri Listyoko Lab/SMF Pulmnologi dan Kedokteran Respirasi Fakultas Kedokteran, Universitas Brawijaya, Malang, Indonesia, Indonesia

DOI:

https://doi.org/10.36408/mhjcm.v7i1A.467

Keywords:

COVID-19, LDH, CRP, P/F Ratio

Abstract

Background and Objective:COVID–19 is a newly emerging disease and considered an emergency health problem, worldwide.It has a wide range of clinical features, from mild fever to severe respiratory failure that leads to a higher mortality rate. Previous studies state that CRPhas a very strong positive correlation with the diameter of the lung lesion, and in intensive care patients had a higher level of LDH. This study aims to determine the correlation between CRP, LDH and disease severity and mortality in hospitalized COVID-19 patients. Methods: We conducted a retrospective cohort, a single-center study including  69 laboratory-confirmed patients in our hospital in Malang City, Indonesia from April - June 2020. Result: Subjects consisted of 26 patients (37.7%) in the mild-moderate group and 43 patients in severe group (62.3%).Statistical analysis showed CRP and LDH associated with disease severity (p=0.011 and p<0.001). Analysis of CRPand LDH in survivor and non-survivior group showed that CRP and LDH also asscociated with mortality in hospitalized COVID-19 patients (p=0.034 and 0.002). We also evaluate CRP and LDH with degrees of hypoxemia  by assessed P/F ratio. Statistical analysis showed that CRP did not correlate with degrees of hypoxemia (p=0.079) but LDH inverse correlate with degrees of hypoxemia (p<0.001, pearson correlation = -0,489)  Conclusion: In our retrospective cohort study demonstrated LDH and CRP can be a crucial indicator to predict severity and mortality for hospitalized COVID-19 patients and LDH may usefull test for predict early identification of patients who become respiratory failure or ARDS.

Keywords: COVID-19, LDH, CRP, P/F Ratio

Downloads

Download data is not yet available.

References

1. WHO. Novel Coronavirus (2019-nCoV) Situation Report - 1. WHO Bull. 2020;(JANUARY):1-7.
2. Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727-733. doi:10.1056/NEJMoa2001017
3. WHO. Coronavirus Disease 2019 (COVID-19) Situation Report – 43.; 2020.
4. Home?» Info Infeksi Emerging Kementerian Kesehatan RI. https://covid19.kemkes.go.id/. Accessed July 24, 2020.
5. Fan BE, Chong VCL, Chan SSW, et al. Hematologic parameters in patients with COVID-19 infection. Am J Hematol. 2020;95(6):E131-E134. doi:10.1002/ajh.25774
6. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. doi:10.1016/S0140-6736(20)30183-5
7. Chalmers JD, Singanayagam A, Hill AT. C-reactive protein is an independent predictor of severity in community-acquired pneumonia. The American journal of medicine. 2008 Mar 1;121(3):219-25.
8. Lipworth B, Chan R, Kuo CR. Predicting severe outcomes in COVID-19. The Journal of Allergy and Clinical Immunology: In Practice. 2020 Jun 29.
9. Guan W, Ni Z, Hu Y, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382(18):1708-1720. doi:10.1056/NEJMoa2002032
10. Romagnoli S, Peris A, De Gaudio AR, Geppetti P. SARS-CoV-2 and COVID-19: between pathophysiology complexity and therapeutic uncertainty. Physiol Rev. June 2020. doi:10.1152/physrev.00020.2020
11. Sproston NR, Ashworth JJ. Role of C-reactive protein at sites of inflammation and infection. Front Immunol. 2018;9(APR):1-11. doi:10.3389/fimmu.2018.00754
12. Ciubotaru I, Potempa LA, Wander RC. Production of Modified C-Reactive Protein in U937-Derived Macrophages. Exp Biol Med. 2005;230(10):762-770. doi:10.1177/153537020523001010
13. Poggiali E, Zaino D, Immovilli P, et al. Lactate dehydrogenase and C-reactive protein as predictors of respiratory failure in CoVID-19 patients. Clin Chim Acta. 2020;509(January):135-138. doi:10.1016/j.cca.2020.06.012
14. Yan L, Zhang H-T, Goncalves J, et al. An interpretable mortality prediction model for COVID-19 patients. Nat Mach Intell. 2020;2(5):283-288. doi:10.1038/s42256-020-0180-7
15. Tan C, Huang Y, Shi F, et al. C-reactive protein correlates with computed tomographic findings and predicts severe COVID-19 early. J Med Virol. 2020;92(7):856-862. doi:10.1002/jmv.25871
16. Gao Y, Li T, Han M, et al. Diagnostic utility of clinical laboratory data determinations for patients with the severe COVID-19. J Med Virol. 2020;92(7):791-796. doi:10.1002/jmv.25770
17. Wu M-Y, Yao L, Wang Y, et al. Clinical evaluation of potential usefulness of serum lactate dehydrogenase (LDH) in 2019 novel coronavirus (COVID-19) pneumonia. Respir Res. 2020;21(1):171. doi:10.1186/s12931-020-01427-8

Additional Files

Published

2020-08-28

How to Cite

1.
Tjahyadi RM, Astuti T, Listyoko AS. COVID-19 :Correlation Between CRP and LDH to Disease Severity and Mortality In Hospitalized COVID-19 Patients. Medica Hospitalia J. Clin. Med. [Internet]. 2020 Aug. 28 [cited 2024 Nov. 5];7(1A):144-9. Available from: http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/467

Citation Check