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J Clin Lab Anal . Laboratory markers associated with COVID-19 progression in patients with or without comorbidity: A retrospective study

tetano

Editor, Senior Moderator
J Clin Lab Anal


. 2020 Oct 28;e23644.
doi: 10.1002/jcla.23644. Online ahead of print.
Laboratory markers associated with COVID-19 progression in patients with or without comorbidity: A retrospective study


Zaishu Chen[SUP] 1 [/SUP], Furong Zhang[SUP] 2 [/SUP], Weihua Hu[SUP] 3 [/SUP], Qijian Chen[SUP] 4 [/SUP], Chang Li[SUP] 5 [/SUP], Longlong Wu[SUP] 6 [/SUP], Zhuheng Zhang[SUP] 2 [/SUP], Bin Li[SUP] 2 [/SUP], Qifa Ye[SUP] 7 [/SUP], Jin Mei[SUP] 8 [/SUP], Jiang Yue[SUP] 2 9 [/SUP]



Affiliations

Abstract

Objectives: To investigate laboratory markers for COVID-19 progression in patients with different medical conditions.
Methods: We performed a multicenter retrospective study of 836 cases in Hubei. To avoid the collinearity among the indicators, principal component analysis (PCA) followed by partial least squares discriminant analysis (PLS-DA) was performed to obtain an overview of laboratory assessments. Multivariable logistic regression analysis and multivariable Cox proportional hazards regression analysis were respectively used to explore risk factors associated with disease severity and mortality. Survival analysis was performed in patients with the most common comorbidities.
Results: Lactate dehydrogenase (LDH) and prealbumin were associated with disease severity in patients with or without comorbidities, indicated by both PCA/PLS-DA and multivariable logistic regression analysis. The mortality risk was associated with age, LDH, C-reactive protein (CRP), D-dimer, and lymphopenia in patients with comorbidities. CRP was a risk factor associated with short-term mortality in patients with hypertension, but not liver diseases; additionally, D-dimer was a risk factor for death in patients with liver diseases.
Conclusions: Lactate dehydrogenase was a reliable predictor associated with COVID-19 severity and mortality in patients with different medical conditions. Laboratory biomarkers for mortality risk were not identical in patients with comorbidities, suggesting multiple pathophysiological mechanisms following COVID-19 infection.

Keywords: Coronavirus disease-19 (COVID-19); diabetes; hypertension; lactate dehydrogenase; liver diseases.
 
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