Role of transaminases, CRP and LDH in COVID-19 patients with and without respiratory failure during the disease outbreak

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Bianca Magro, MD Matteo Tacelli, MD Luisa Pasulo, MD Massimo De Giorgio, MD Filippo Leonardi, MD Lucà Maria Grazia, MD Giovanna Gaffuri, MD Michela Triolo, MD, PhD Giampaolo Mangia, MD Domenico Nobile, MD Marco Rizzi, MD Fabiano Di Marco, MD, PhD Roberto Cosentini, MD Andrea Gianatti, MD Stefano Fagiuoli, MD, PhD


BACKGROUND: Sars-Cov-2 pneumonia is a pandemic disease with high morbidity and mortality. In literature transaminases, CRP and LDH were frequently found abnormal but their role has not been clarified.

OBJECTIVES: Aim of this retrospective study is to explore the role of transaminases, CRP and LDH on short-term prognosis of hospitalized COVID-19 patients.

METHODS: patients admitted in hospital for COVID-19 were consecutively recruited. Primary endpoint: evaluate role of transaminases, CRP and LDH on disease progression (DP). Secondary endpoints: find possible risk factors for (1) mortality and (2) CPAP ventilation at day 7. We also analyzed patients without respiratory failure at admission, also a subgroup of patients with liver disease.

RESULTS: 342 patients were included. Median age of patients was 64 years (IQR 55-74), and 35.1% (n=120) was female. At multivariate analysis moderate ALT elevation at Day 1 (p=0.001, OR 2,42, CI95% 1.23-4,73) and CRP at Day 7 (p=0.001, OR 1, CI95% 1-1,1) were predictors of DP; LDH at admission (p=0.05, OR 1, CI95% 1.23-1,1) and moderate AST elevation at day 7 (p=0.04, OR 4,5, CI95% 1.05-19,4) were predictors of CPAP at day 7. At multivariate analysis age (p<0,001, OR 1,12, CI95% 1-1,2) and sex (p=0.01, OR 14, CI95% 1,7-116,7) were predictors of death. Mortality rate of patients with liver disease was 25%(n=3/12).

CONCLUSIONS: Moderate ALT elevation at day 1 and moderate AST elevation at day 7 were respectively, predictors of DP and CPAP at day 7. For patients without respiratory failure, transaminases are not significative for anyone of our outcomes. Age, sex and CRP at day 1 are death risk factors.

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MAGRO, Bianca et al. Role of transaminases, CRP and LDH in COVID-19 patients with and without respiratory failure during the disease outbreak. Medical Research Archives, [S.l.], v. 9, n. 12, dec. 2021. ISSN 2375-1924. Available at: <>. Date accessed: 17 jan. 2022. doi:
Research Articles


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