Prediction of mortality risk in patients with severe novel coronavirus pneumonla after 28 d by lactate dehydrogenase combined with lactate
Objective To analyze the risk factors of 28 d death in patients with severe novel coronavirus pneumonla infection.Methods The clinical medical records of 136 patients with severe novel coronavirus pneumonia infection in Hainan Hospital Affiliated to Hainan Medical College from December 2022 to April 2023 were retrospectively analyzed.According to whether the patients died within 28 d,they were divided into the survival group(45 cases)and the death group(91 cases).Multivariate logistic regression analysis was used to determine the risk factors of death in patients with severe novel coronavirus pneumonla infection,and the receiver operating characteristic(ROC)curve was used to evaluate the predictive value of each indicator on the risk of death within 28 d.Results Compared with the survival group,the proportion of the non-negative nucleic acid,com-bined with respiratory diseases,malignant tumors,and renal insufficiency of the patients in the death group were more higher.The D-dimer,alanine aminotransferase,glutamic oxalacetic aminotransferase,creatinine,u-rea nitrogen/creatinine ratio,partial pressure of carbon dioxide,troponin,B-type brain natriuretic peptide pre-cursor,creatine kinase isoenzyme,lactate dehydrogenase(LDH)and lactic acid were found to be higher than those in the death group 24 h after admission.The duration of mechanical ventilation(non-invasive and inva-sive)during treatment in the death group was shorter,the coverage of antiviral drugs was cower,and the differences were statistically significant(P＜0.05).Due to the long hospital stay of the survival group,the im-proved etiological examination showed that there were significant differences between the virus combined with bacterial infection,virus combined with fungal infection,virus combined with bacterial combined with fungal triple infection,and multi-drug resistant bacteria compared with the death group(P＜0.05).Binary logistic re-gression analysis showed that novel coronavirus's nucleic acid did not turn negative at admission,combined with respiratory disease,short duration of mechanical ventilation(non-invasive and invasive),and high LDH and high lactate were independent risk factors for 28 d death in patients with severe novel coronavirus pneu-monla infection(P＜0.05).According to the ROC curve,it could be concluded that the accuracy of LDH in predicting the 28 d death risk of severe novel coronavirus pneumonla infection patients was better than that of lactate,while the combined prediction effect of LDH and lactate in predicting the 28 d death risk of severe no-vel coronavirus pneumonla infection patients was better than the two prediction values alone.Conclusion Non-negative nucleic acid,combined with respiratory diseases,malignant tumors,renal insufficiency,and the level of D-dimer,alanine aminotransferase,glutamic oxalacetic aminotransferase,creatinine,urea nitrogen/cre-atinine,partial pressure of carbon dioxide,troponin,B-type brain natriuretic peptide precursor,creatine kinase isoenzyme,high LDH,and high lactic acid examined within 24 h after admission are high risk factors for death in severe novel coronavirus pneumonla infection patients.Hight LDH combined with high lactate has a high predictive value for the 28 d mortality risk of patients.
Severe novel coronavirus pneumoniaLactate dehydrogenaseLactic acidCombine determinePrognosisMortality risk
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