Assessment of Methemoglobin, Hemoglobin, Ferritin and Lactate dehydrogenase in COVID-19 Patients

Abstract

Today world is trying to cope with the biggest pandemic caused by Coronavirus disease 2019 (COVID-19). The disease is graded as mild, moderate, serious and critical illness. Very few studies are done with methemoglobin along with other parameters for the assessment of the severity of COVID-19 disease. The objectives of the study were to estimate methemoglobin (Met-Hb), hemoglobin (Hb), ferritin and lactate dehydrogenase (LDH) levels in patients with COVID-19 disease and to investigate the interaction between these parameters and the severity of the disease. This observational study was conducted in three groups of COVID-19 patients- moderate, severe and critical, each group containing 30 patients, between June 2021 and September 2021 in the biochemistry department of a tertiary care hospital. For all patients, Met-Hb, Hb, ferritin, and LDH levels were estimated on the 2nd-3rd day of hospital admission. Patients in the critical group were older and had significantly high values of Met-Hb, ferritin and LDH and significantly low values of Hb (P<0.05). In multivariate ordinal regression analysis, older age (OR-3.08; 95%CI:1.19-7.19;P-0.019), higher values of LDH (OR-8.66; 95%CI:2.53-29.5; P-0.001) and ferritin (OR-3.08; 95%CI:1.09-8.7;P-0.033) were independently associated with severity of the disease. A cut-off value of 410.50 U/L for LDH predicted the severity of the disease with 90% sensitivity and 88.3% specificity. In conclusion, higher levels of LDH and ferritin were related to the severity of the disease in COVID-19 cases. Although Met-Hb showed a minimal increase without any association with severity, it may be an underlying cause of hypoxia that may go unnoticed. So, monitoring of all these parameters should be done at intervals.

Keywords

• covid-19
• methemoglobin (met-hb)
• hemoglobin(hb)
• ferritin
• lactate dehydrogenase (ldh)