Is Lactate Dehydrogenase An Important Mortality Predictor in Covid-19 Patients with Atrial Fibrillation?

Abstract

INTRODUCTION: Abnormal laboratory parameters can be detected in severe patients with COVID-19, which are associated with adverse outcomes. Increased lactate dehydrogenase (LDH) is usually associated with tissue damage. Cardiovascular disease is a common comorbidity in COVID-19 disease. In the current report, the objective was to examine the relationship between LDH levels and atrial fibrillation (AF) in COVID-19 patients. METHODS: This investigation involved a retrospective and cross-sectional study. A total of 195 consecutive COVID-19 [45 AF (+) and 150 AF (-)] subjects were enrolled in the study. COVID-19 cases were determined from analysis of an oropharyngeal/nasopharyngeal swab using RT-PCR. LDH, procalcitonin, and D-dimer were recorded from the hospital records. RESULTS: Fatal patients had higher LDH levels compared to non-fatal patients (470+-144 vs 404+-60). A significant positive association was determined for LDH and troponin, CRP, and procalcitonin in all study subjects and AF patients. An LDH level of 443 was identified as the cut-off point in mortality of AF patients with a sensitivity and specificity of 73% and 74% (AUC= 0.744), respectively. LDH (OR: 1.009) and age (OR: 1.238) were shown to independently predict mortality in COVID-19-AF patients. DISCUSSION AND CONCLUSION: Increased LDH levels were essential predictor of mortality in COVID-19 subjects with AF. High LDH levels need careful observation to help prevent potential complications in COVID-19 subjects presenting with AF.

Keywords

• covid-19
• lactate dehydrogenase
• atrial fibrillation