Lactate Dehydrogenase/Albumin To-Urea Ratio: A Novel Prognostic Maker for Fatal Clinical Complications in Patients with COVID-19 Infection


Objective: To investigate lactate dehydrogenase/Albumin to-urea (LAU) ratio as a potential predictor for COVID-19-induced fatal clinical complications in hospitalized patients. Methods: This is a retrospective study involving blood analyses from 1139 hospitalised COVID-19 infection survivors and 349 deceased cases post-COVID-19 infection. Laboratory tests included complete blood picture, inflammatory markers, and routine organ function tests. Results: The non-survivor group showed lower haemoglobin (p < 0.001), platelet (p < 0.0001) and higher mean corpuscular volume, neutrophil count, neutrophil/lymphocytes ratio (NLR), and LAU (p < 0.001, p < 0.0013, p < 0.001, p < 0.0126) than the patients who survived the infection. The non-survivors also exhibited higher markers for infection-related clinical complications, such as international normalized ratio (INR), D-dimer, urea, total bilirubin, alkaline phosphatase (ALK), creatinine, c-reactive protein (CRP), and serum ferritin levels (all p < 0.05). In addition, LAU ratio was positively correlated with infection prognostic parameters including INR (r = 0.171), D-dimer (r = 0.176), serum urea (r = 0.424), total bilirubin (r = 0.107), ALK (r = 0.115), creatinine (r = 0.365), CRP (r = 0.268), ferritin (r = 0.385) and negatively correlated with serum albumin (r = −0.114) (p ≤ 0.05). LAU ratio had an area under receiver operating characteristic of 0.67 compared to 0.60 with NLR. Conclusion: Patients with a high LAU ratio are at increased risk of mortality due to COVID-19 infection. Therefore, early assessment of this parameter, intensive intervention and close monitoring could improve their prognosis.

Publication DOI:
Divisions: College of Health & Life Sciences > School of Optometry > Optometry
College of Health & Life Sciences > Aston Medical School
College of Health & Life Sciences > Aston Medical School > Translational Medicine Research Group (TMRG)
College of Health & Life Sciences > School of Biosciences > Cellular and Molecular Biomedicine
Additional Information: Copyright © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (
Uncontrolled Keywords: Article,COVID-19,SARS-CoV,prognosis,biomarkers,lactate dehydrogenase,albumin ratios
Publication ISSN: 2077-0383
Last Modified: 14 Jun 2024 07:27
Date Deposited: 16 Jan 2023 13:10
Full Text Link:
Related URLs: https://www.mdp ... 77-0383/12/1/19 (Publisher URL)
http://www.scop ... tnerID=8YFLogxK (Scopus URL)
PURE Output Type: Article
Published Date: 2023-01
Published Online Date: 2022-12-20
Accepted Date: 2022-12-19
Authors: Shokr, Hala
Marwah, Mandeep Kaur (ORCID Profile 0000-0003-4881-003X)
Siddiqi, Hisam
Wandroo, Farooq
Sanchez-Aranguren, Lissette (ORCID Profile 0000-0002-4663-5752)
Ahmad, Shakil (ORCID Profile 0000-0002-9294-0475)
Wang, Keqing (ORCID Profile 0000-0001-6239-6344)
Marwah, Sukhjinder



Version: Published Version

License: Creative Commons Attribution

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