It is important to predict the severity of COVID-19 during the pandemic. Both Neutrophil Lymphocyte Ratio (NLR) andAbsolute Lymphocyte Count (ALC) are two easy, low-cost, and fast inflammatory markers, which positively correlate with theseverity of COVID-19. The purpose of this research was to analyze the value of NLR and ALC as predictors of COVID-19severity. This research was a retrospective study using medical record data of 376 COVID-19 patients duringApril-September 2020 at the Hasanuddin University Hospital and Makassar City Regional Hospital. Patients were classifiedinto non-severe and severe COVID-19. Neutrophil lymphocyte ratio and ALC values were determined based on routineblood test (Sysmex XS-800i) results, statistical analysis using Independent T-test, while NLR and ALC diagnostic values wereanalyzed with Receiver Operating Characteristics (ROC) curve to obtain the cut-off value, p < 0.05 was significant. Thesamples consisted of 372 non-severe and 49 severe COVID-19 patients. Neutrophil lymphocyte ratio value in non-severe(4.02±5.22) was significantly different from severe COVID-19 (9.81±7.06) (p < 0.001), similar to ALC in non-severe(2.00±0.83x103/μL) and severe COVID-19 (1.22±0.78x103/μL) (p < 0.001). Receiver operating characteristics curve showedthat NLR had a sensitivity of 91.8% and specificity of 66.4% with a cut-off ≥ 3.17 with Negative Predict Value (NPV) of 98.2%and Positive Predict Value (PPV) of 29.0%; while ALC had a sensitivity of 81.6% and specificity of 64.8% at cut-off≤ 1.74x103/μL with NPV of 95.9% and PPV of 25.8%. Increased NLR and decreased ALC in severe COVID-19 patientsoccurred due to an increased inflammatory response resulting in a decreased cellular immunity. Receiver operatingcharacteristics curve showed a cut-off for NLR of 3.17 and ALC of 1.74x103/μL, indicating an optimum sensitivity andspecificity. It was concluded that NLR and ALC can be used as predictors of COVID-19 severity with a cut-off ≥ 3.17 and≤ 1.74x103/μL, respectively.

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The COVID-19 incidence is increasing around the world. Some countries are experiencing worsening conditions, evendeaths. One coagulation marker that noticeably increases in COVID-19 patients is D-dimer. This study aimed to analyzeD-dimer levels of COVID-19 patients. Retrospective study using medical records of 84 COVID-19 patients, conducted fromApril to August 2020 at UNHAS Hospital. Patients were grouped based on the severity of the disease as non-severe andsevere. D-dimer levels were measured using the Alere Triage® D-dimer with the fluorescent immunoassay method. Thestatistical test used was Mann-Whitney, D-dimer prognostic levels were calculated with ROC analysis to get the cut-off.Significant if the p < of 0.05. The sample consisted of 74 non-severe and ten severe COVID-19 patients, mostly in the 30-39age group. D-dimer levels in non-severe (0.31±0.38 μg/L) significantly differ from severe group (3.09±2.56 μg/L) (p<0.001).The Receiver Operating Characteristics (ROC) curve showed D-dimer sensitivity and specificity of 90.0% and 89.2%,respectively at the ≥ 0.80 μg/L cut-off, Negative Predictive Value (NPV) of 98.5%, and Positive Predictive Value (PPV) of52.9%. D-dimer levels increased in severe COVID-19 patients due to an increased inflammatory response resulting inexcessive thrombin. The ROC D-dimer curve indicated a cut-off rate of 0.80 μg/L, providing optimal sensitivity andspecificity. D-dimer has a significant difference in non-severe and severe COVID-19 patients and shows good value todetermine the severity of COVID-19 disease with a cut-off value ≥ 0.80 μg /L.

BACKGROUND<br />High-sensitivity C-reactive protein (hsCRP) has been widely accepted as a predictor of future cardiovascular risk that reflects a microinflammatory state. Obesity linked to microinflammation increases the prevalence of metabolic disorders and cardiovascular diseases. This study aimed to determine the association between several obesity indices namely body mass index (BMI), waist circumference (WC), body fat percentage (fat), and visceral fat (VF) with hsCRP in non-diabetic adults. <br /><br />METHODS<br />This was a cross-sectional study performed on 80 non-diabetic adults with ages ranging from 20-40 years. The obesity indices BMI, WC, body fat percentage, and VF were measured. We then measured the hsCRP levels using an immunoturbidimetric method. Simple and multiple linear regression tests were used to analyze the association between obesity indices and hsCRP levels. <br /><br />RESULTS<br />Mean of log BMI, log WC, and log VF was 1.41 ± 0.08 kg/m2, 1.93 ± 0.06 cm, and 0.95 ± 0.27 units, respectively. Simple linear regression tests showed that log BMI (â=3.506; p&lt;0.001), log WC (â=3.672; p&lt;0.001), log VF (â=0.833; p&lt;0.001), and log systolic blood pressure (â=3.739; p=0.024) had a significant positive correlation with log hsCRP levels. Further multiple linear regression test showed that log BMI (â=3.772; Beta=0.674; p&lt;0.001) had the greater effect on log hsCRP levels compared to other indices. <br /><br />CONCLUSIONS    <br />BMI had a greater influence on hsCRP levels compared to other obesity indices in non-diabetic adults. Body mass index can be used as a better index in predicting hsCRP levels compared to other indices.

AbstractIntroduction. The prevalence of obesity is increasing worldwide in high, low, and middle-income countries such as Indonesia. Obesity rate is higher in females in Indonesia. Obesity has important contribution in the occurrence of insulin resistance (IR) and type 2 diabetes mellitus. Several anthropometric measurements such as waist circumference (WC), body mass index (BMI), body mass (BM), total body fat percentage (Fat%) and visceral fat (VF) are related to IR. This study aimed to investigate which of those measurements could be used as a better predictor of IR in non-menopausal Indonesian adult females.Methods. Total of 80 non-menopausal Indonesian adult females ranging from 21-40 years were recruited in this study. Insulin resistance was measured by using Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) equation. Subjects with HOMA-IR index >75th percentile with cut-off 2.74 were defined as IR. Waist circumference, BMI and BM were measured, while TF and VF were measured by bioelectrical impedance analysis (BIA).Results. HOMA-IR had significant correlation with WC (r = 0.563, p<0.001), BMI (r = 0.537, p<0.001), BM (r = 0.515, p<0.001), VF (r = 0.515, p<0.001), Fat% (r = 0.490, p<0.001). The area under curve of VF (0.809), BMI (0.807), WC (0.805), and BM (0.799) are slightly larger than and Fat% (0.766).Conclusion. Insulin resistance had strong correlation with all anthropometric measurements, but the correlation was less significant with Fat%.

Strategies for schizophrenic treatment still have been developed in order to increase their effectively, based on latest findings in the etio-pathology. Coincidence of hyperbilirubinemia, especially related to Gilbert’s Syndrome (GS), and schizophrenia/other psychiatric disorders, was reported in several studies although the pattern of this alteration is still controversial.  Bilirubin could induce microglia to release pro-inflammatory cytokine that cause neuroinflammation, one of hypothetic etio-pathogenesis has been the most extensively studied recently. However, no data have been presented about this phenomenon in Indonesia. Therefore, this study aims to investigate plasma bilirubin concentration in psychotic spectrum.This study is cross sectional design that we examined both the total bilirubin and direct bilirubin of every psychotic patient admitted for the first time to Rumah Sakit Khusus Daerah (RSKD) Provinsi Sulawesi Selatan over a period of July—December 2012, by using health people as control. Diagnostic determination was set based on International Classification of Diseases (ICD) 10. Patients suffering from any disease such as anemia (decreased hemoglobin), liver diseases (elevated liver enzymes), or substance abuse were excluded.            From 73 samples, we found that plasma UCB level was significantly elevated, higher in psychotic patients, especially schizophrenic group, than in the control. Total bilirubin rate was slightly increased in schizophrenic group compare to the others and two samples in this group showed hyperbilirubinemia. Further investigations are needed to ensure that whether the elevated UCB was related to GS and whether this condition has inflammatory effect.

Acute appendicitis is inflammation of the vermiformis appendix due to lumen obstruction followed by bacterial infection. Acute appendicitis is classified into two types of disease, namely complicated and uncomplicated. Acute inflammation of the appendix requires immediate surgical action to prevent complications; therefore, a further laboratory test is required. This study was retrospective research which analyzed several hematologic parameters (WBC, Neutrophils, NLR, RDW, PLTMPV, PDW) and serum bilirubin levels. Data were statistically analyzed using Independent-t and Mann-Whitney test. Univariate logistic regression test was used to evaluate the correlation of hematologic parameters and significant serum bilirubin levels with the diagnosis of complicated and uncomplicated appendicitis. The cut-off value and diagnosis value were measured using Receiver Operating Characteristic (ROC) curve analysis. This study involved 173 subjects categorized into 67 complicated and 106 uncomplicated acute appendicitis patients. Whole blood count and neutrophil counts were significantly higher in complicated acute appendicitis (p <0.05). Similarly, NLR and PLT were significantly higher in complicated acute appendicitis (p <0.001), p > 0.05 was obtained in RDW-CV, MPV and PDW values. The higher serum bilirubin levels were reported in patients with complicated acute appendicitis compared to uncomplicated acute appendicitis (p <0.001). Logistic regression test results showed significant PLT parameters with p <0.001, while there was no significance of hematologic parameters such as WBC, neutrophil, NLR, RDW-CV, MPV, PDW and bilirubin levels. Area under curve results on the ROC curve showed 74.4% PLT with sensitivity and specificity of 97.17% and 40.29%, respectively. From the analysis of hematologic parameters and measurement of serum bilirubin levels, only the PLT parameter can be used as one of the parameters for the diagnosis of complicated appendicitis with high sensitivity but low specificity. It was recommended to perform prospective studies with more subjects.

The Neutrophil-Lymphocyte Ratio (NLR) and procalcitonin are used to indicate systemic inflammation in variousmedical disorders. Both parameters were determined in this study to predict the severity of acute pancreatitis. This studywas a cross-sectional study using a retrospective approach to patients diagnosed with acute pancreatitis by using medicalrecord data from patients at Dr. Wahidin Sudirohusoso Hospital, Makassar, from January 2014 to May 2019. This studycomprised 35 patients hospitalized with acute pancreatitis, with a similar proportion of males and females. This studydiscovered that the mean age in this study was 44.17±12.9 years. The most prevalent cause was Gallstones (77.1%), themost severe degree was mild (54.2%), and the highest outcome was survival (77.1%). The NLR (9.93±11.19, p=0.011)increased in proportion to severity. However, additional analysis based on classification of disease severity revealed thatonly mild-severe NLR was significant (p=0.005). Procalcitonin (8.13±11.25, p=0.001) increased along with the increaseddisease severity, and the subsequent analysis showed that the distribution of severity was similar. The NLR can predict theseverity of acute pancreatitis but is less effective than procalcitonin. This study required a more proportional subjectpopulation and consideration of other factors.