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ORIGINAL ARTICLE   Open accessopen access

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

DOI: 10.23736/S2532-1285.22.00143-4

Copyright © 2022 THE AUTHORS

This is an open access article distributed under the terms of the CC BY-NC-ND 4.0 license which allows users to copy and distribute the manuscript, as long as this is not done for commercial purposes and further does not permit distribution of the manuscript if it is changed or edited in any way, and as long as the user gives appropriate credits to the original author(s) and the source (with a link to the formal publication through the relevant DOI) and provides a link to the license.

lingua: Inglese

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

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