Lactate dehydrogenase (LDH) catalyzes the reversible conversion of L-lactate and pyruvate and is present in the cytoplasm of all human tissues with higher concentrations in liver, heart and skeletal muscle.
Increased LDH activities are found in a variety of pathological conditions such as myocardial infarction, liver diseases, blood diseases, and cancer or muscle diseases. [1]
Increased serum LDH values are one of the abnormal diagnostic parameters in COVID-19 patients with a severe or fatal course of disease [2 - 5]. Potential clinical and biological significance of elevated LDH are pulmonary injury, as well as widespread organ damage. [6]
By empirically using cut-off levels for LDH and ASAT, Ferrari et al. was able to identify COVID-19 positivity/negativity in almost 70% of patients. With the right panel of analytes and appropriate cut-offs, it could be possible to identify COVID-19 patients with high accuracy in future. A simple blood test could be an inexpensive, fast and easy alternative to rRT-PCR and especially beneficial for developing countries and countries suffering from shortage of rRT-PCR reagents. [7]
In addition, Yuan et al. found that a decrease in LDH and creatine kinase (CK) was correlated with viral mRNA elimination, especially in virus mRNA positive patients. So far, no antiviral therapy has been proved to be effective for treatment of COVID-19. By predicting viral clearance and therefore a favorable response to treatment, monitoring of serum LDH and CK levels could be an easy method to validate potential therapeutic measures. [8]
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References
1. Thomas L. Clinical laboratory diagnostics. 1st ed. Frankfurt: TH-Books Verlagsgesellschaft;1998. 89–94.
2. Rodriguez-Morales AJ, et al. Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis. Travel medicine and infectious disease, 2020, p. 101623.
3. Henry BM, et al. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis. Clinical Chemistry and Laboratory Medicine (CCLM) 1.ahead-of-print. 2020.
4. Zhou F, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The lancet. 2020.
5. Lippi G, Plebani M. Laboratory abnormalities in patients with COVID-2019 infection. Clinical Chemistry and Laboratory Medicine (CCLM) 1.ahead-of-print. 2020.
6. Lippi G, Plebani M. The critical role of laboratory medicine during coronavirus disease 2019 (COVID-19) and other viral outbreaks. Clinical Chemistry and Laboratory Medicine (CCLM) 1.ahead-of-print. 2020.
7. Ferrari D, et al. Routine blood tests as a potential diagnostic tool for COVID-19. Clinical Chemistry and Laboratory Medicine (CCLM) 1.ahead-of-print. 2020.
8. Yuan J, et al. The correlation between viral clearance and biochemical outcomes of 94 COVID-19 infected discharged patients. Inflammation Research. 2020: 1-8.
Isabella Wieland