A New Parameter in COVID-19 Pandemic: Initial Lactate Dehydrogenase (LDH)/Lymphocyte Ratio for Diagnosis and Mortality

Serin, Istemi; Sari, Nagehan Didem; Dogu, Mehmet Hilmi; Acikel, Sakine Damla; Babur, Gulnıhal; Ulusoy, Avni; Onar, Mediha Irem; Gokce, Emre Cem; Altunok, Oguz; Yaylaci Mert, Feyza; Karakilic, Ayse; Baltik, Muhammed; Gulesir, Begum

BACKGROUND: COVID-19 (Coronavirus Disease-2019) is a pandemic disease, infecting more than 26.5 million people. Since there is no specific and effective treatment; early diagnosis and optimal isolation of the patient are of vital importance. Real-time polymerase chain reaction-based (RT-PCR) analyses do not achieve sufficient sensitivity in the diagnosis of the disease. METHODS: The data from 2217 patients diagnosed as COVID-19 between March 2020 and June 2020 and hospitalized or discharged with home isolation were retrospectively analyzed. Demographic data, comorbidities, PCR results, initial computed tomography (CT), laboratory values, Lactate Dehydrogenase (LDH) / Lymphocyte ratio, initial treatments and last status were recorded. The diagnostic sensitivity of LDH / Lymphocyte ratio, which is the main purpose of the study, was analyzed statistically. RESULTS: In order to test the effectiveness of LDH / Lymphocyte ratio for COVID-19 for diagnostic purposes, CT results were considered as gold standard. The area under the curve (AUC) was found to be 0.706 (p < 0.001; cut-off> 0.06) (Sensitivity: 76.4, specificity: 59.60). For the evaluation of LDH / Lymphocyte ratio in terms of survival, AUC was found to be 0.749 (p < 0.001; cut-off> 0.21) (Sensitivity: 70.59, specificity: 73.88). CONCLUSION: Studies based on radiological findings have demonstrated that CT involvement has higher sensitivity. LDH / Lymphocyte ratio was analyzed in terms of diagnosis and mortality with using specific CT involvement as gold standard method which was found to be a more sensitive due to PCR false negativity; 0.06 and 0.21 were obtained as cut off values for diagnosis and mortality.