Correlation between Neutrophile to Lymphocyte Ratio and D-dimer with COVID-19 Severity

Authors

  • Citra Suhesty Poltekkes Tanjungkarang
  • Wimba Widagdho Dinutanayo Poltekkes Tanjungkarang
  • Maria Tuntun Poltekkes Tanjungkarang
  • Hidayat Hidayat RSUD Dr. H. Abdul Moeloek

DOI:

https://doi.org/10.26630/jk.v14i2.3775

Keywords:

Illness severity, Immune system, NLR.

Abstract

SARS-CoV-2, a lung-damaging virus, is what causes COVID-19. While a decline in lymphocyte counts suggests immune system harm, a rise in neutrophil counts reflects the severity of the inflammatory response. A high NLR value results from an increase in neutrophils and a decrease in lymphocytes. On the other hand, when plasmin breaks down fibrin to dissolve blood clots, it creates pieces called D-dimers. ARDS is predicted by an elevated D-dimer level. The study's objective was to ascertain how the severity of COVID-19 patients at Dr. H. Abdul Moeloek in 2021 related to NLR and D-dimer levels. Analytical research with a retrospective design is being conducted. The Rank Spearman correlation test and Pearson Chi-Square analyzed medical record data for COVID-19 patients. The study was carried out in Dr. H. Abdul Moeloek in June 2022. 205 COVID-19 patients who underwent NLR and D-dimer testing and were categorized based on the severity of the condition served as the study's subjects. The test findings revealed a substantial connection between NLR and D-dimer (r=0.583), demonstrating a strong and favorable link. NLR and illness severity showed a significant relationship (r=0.49). D-dimer and illness severity also showed a strong connection (r=0.51).

References

Bertolin, A. J., Dalcoquio, T. F., Salsoso, R., de M. Furtado, R. H., Kalil-Filho, R., Hajjar, L. A., ... & Nicolau, J. C. (2021). Platelet reactivity and coagulation markers in patients with COVID-19. Advances in Therapy, 38(7), 3911-3923. https://doi.org/10.1007/s12325-021-01803-w

Del Carpio-Orantes, L., García-Méndez, S., & Hernández-Hernández, S. N. (2020). Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic immune-inflammation index in patients with COVID-19-associated pneumonia. Gaceta medica de Mexico, 156(6), 527-531.

Dinas Kesehatan Kota Bandar Lampung. (2022). Data Covid-19 Kota Bandar Lampung. https://covid19.bandarlampungkota.go.id.

Dinas Kesehatan Provinsi Lampung, 2022. Website Informasi Covid-19 Pemerintah Provinsi Lampung. https://covid19.lampungprov.go.id

Fu, J., Kong, J., Wang, W., Wu, M., Yao, L., Wang, Z., et al. (2020). The clinical implication of dynamic neutrophil to lymphocyte ratio and D-dimer in COVID-19: A retrospective study in Suzhou, China. Thrombosis research, 192, 3-8.

Hu, B., Huang, S., & Yin, L. (2021). The cytokine storm and COVIDâ€19. Journal of Medical Virology, 93(1), 250–256.

Joly, B. S., Siguret, V., & Veyradier, A. (2020). Understanding the pathophysiology of hemostasis disorders in critically ill patients with COVID-19. Intensive care medicine, 46(8), 1603-1606.

Levi, M., Thachil, J., Iba, T., & Levy, J. H. (2020). Coagulation abnormalities and thrombosis in patients with COVID-19. The Lancet Haematology, 7(6), e438-e440.

Liu, J., Liu, Y., Xiang, P., Pu, L., Xiong, H., Li, C., et al. (2020). The neutrophil-to-lymphocyte ratio predicts severe illness in patients with the 2019 novel coronavirus in the early stage. MedRxiv. https://doi.org/10.1186/s12967-020-02374-0

Liu, Y., Du, X., Chen, J., Jin, Y., Peng, L., Wang, H. H., et al. (2020). Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19. Journal of Infection, 81(1), e6-e12.

Ma, A., Cheng, J., Yang, J., Dong, M., Liao, X., & Kang, Y. (2020). Neutrophil-to-lymphocyte ratio as a predictive biomarker for moderate-severe ARDS in severe COVID-19 patients. Critical care, 24(1), 1-4.

Ministry of Health RI , 2022. Laporan Mingguan Penanganan Pandemi. https://covid19.kemkes.go.id/dashboard/covid-19

Ozen, M., Yilmaz, A., Cakmak, V., Beyoglu, R., Oskay, A., Seyit, M., & Senol, H. (2021). D-Dimer as a potential biomarker for disease severity in COVID-19. The American Journal of Emergency Medicine, 40, 55-59.

Qin, C., Zhou, L., Hu, Z., Zhang, S., Yang, S., Tao, Y., et al. (2020). Dysregulation of immune response in patients with coronavirus 2019 (COVID-19) in Wuhan, China. Clinical infectious diseases, 71(15), 762–768.

Sayed, A. A., Allam, A. A., Sayed, A. I., Alraey, M. A., & Joseph, M. V. (2021). The use of neutrophil-to-lymphocyte ratio (NLR) as a marker for COVID-19 infection in Saudi Arabia: a case-control retrospective multicenter study. Saudi Medical Journal, 42(4), 370. https://doi.org/10.15537%2Fsmj.2021.42.4.20200818

Weitz, J. I., Fredenburgh, J. C., & Eikelboom, J. W. (2017). A test in context: D-dimer. Journal of the American College of Cardiology, 70(19), 2411-2420.

World Health Organization. (2020). Coronavirus disease (COVID-19) situation. Geneva, CH: World Health Organization.

Yang, A. P., Liu, J. P., Tao, W. Q., & Li, H. M. (2020). The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients. International immunopharmacology, 84, 106504.

Yao, Y., Cao, J., Wang, Q., Shi, Q., Liu, K., Luo, Z., et al. (2020). D-dimer as a biomarker for disease severity and mortality in COVID-19 patients: a case-control study. Journal of Intensive Care, 8(1), 1-11.

Zhou, F., Yu, T., Du, R., Fan, G., Liu, Y., Liu, Z., et al. (2020). Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet, 395(10229), pp. 1054–1062.

Downloads

Additional Files

Published

20-09-2023

Issue

Vol. 14 No. 2 (2023): Jurnal Kesehatan

Section

Articles

License

Authors who publish in this journal agree to the following terms:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC BY-SA 4.0) that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
  2. Authors can enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.