Lactate dehydrogenase and PaO2/FiO2 ratio at admission helps to predict CT score in patients with COVID-19: An observational study. Issue 1 (January 2023)

• Record Type: Journal Article
• Authors: Russo, Antonio; Pisaturo, Mariantonietta; De Luca, Ilaria; Schettino, Ferdinando; Maggi, Paolo; Numis, Fabio Giuliano; Gentile, Ivan; Sangiovanni, Vincenzo; Rossomando, Anna Maria; Gentile, Valeria; Calabria, Giosuele; Rescigno, Caroliona; Megna, Angelo Salomone; Masullo, Alfonso; Manzillo, Elio; Russo, Grazia; Parrella, Roberto; Dell'Aquila, Giuseppina; Gambardella, Michele; Ponticiello, Antonio; Reginelli, Alfonso; Coppola, Nicola
• Is Part Of: Journal of infection and public health. Volume 16:Issue 1(2023)
• Page Start: 136
• Page End: 142
• Publication Date: 2023-01
• Subjects: CT score -- Pan score -- COVID-19 -- SARS-CoV-2 infection -- Severity of disease; Communicable diseases -- Periodicals; Public health -- Periodicals; Epidemiology -- Periodicals; Nosocomial infections -- Prevention -- Periodicals; Medical microbiology -- Periodicals; 614.4
• DOI: 10.1016/j.jiph.2022.12.009
• Languages: English
• ISSNs: 1876-0341

Abstract

Abstract: Introduction: Since the beginning of the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) pandemic an important tool for patients with Coronavirus Disease 2019 (COVID-19) has been the computed tomography (CT) scan, but not always available in some settings The aim was to find a cut-off that can predict worsening in patients with COVID-19 assessed with a computed tomography (CT) scan and to find laboratory, clinical or demographic parameters that may correlate with a higher CT score. Methods: We performed a multi-center, observational, retrospective study involving seventeen COVID-19 Units in southern Italy, including all 321 adult patients hospitalized with a diagnosis of COVID-19 who underwent at admission a CT evaluated using Pan score. Results: Considering the clinical outcome and Pan score, the best cut-off point to discriminate a severe outcome was 12.5. High lactate dehydrogenase (LDH) serum value and low PaO2/FiO2 ratio (P/F) resulted independently associated with a high CT score. The Area Under Curve (AUC) analysis showed that the best cut-off point for LDH was 367.5 U/L and for P/F 164.5. Moreover, the patients with LDH> 367.5 U/L and P/F < 164.5 showed more frequently a severe CT score than those with LDH< 367.5 U/L and P/F> 164.5, 83.4%, vs 20%, respectively. Conclusions: A direct correlation was observed between CT score value and outcome of COVID-19, such as CT score and high LDH levels and low P/F ratio at admission. Clinical or laboratory tools that predict the outcome at admission to hospital are useful to avoiding the overload of hospital facilities. Highlights: ● prognostic factors of severe disease in COVID-19 are need to stratify patients. ● a cut off of 12.5 at CT score predicts severe outcome in patients with COVID-19. ● P/F and LDH value at admission can predict worse CT severity score.