Neutrophil-to-Lymphocyte Ratio and Covid-19 Symptom-based Severity at Admission

Abstract

Background: Increased Neutrophil-to-Lymphocyte Ratio (NLR) is an independent risk factor for mortality in Covid-19 patients and is considered as an early warning sign of Covid-19 severity. This study aimed to observe the differences in NLR at admission between patients with mild, moderate, and severe symptoms of Covid-19 treated in a referral hospital in Banda Aceh, Indonesia.Methods: A total of 114 patients with Covid-19 admitted to a referral hospital in Banda Aceh, Indonesia, during March–September 2020 were included in this study. Demographic information and baseline laboratory data, including the NLR, were collected. Descriptive and inferential statistics were used to analyze the data. Results: The median NLR at admission was higher among patients with moderate to severe symptoms than those with mild symptoms [6.54 (2.80–97.00, IQR 4.81–9.44) vs 2.27 (0.79–5.07, IQR 1.43-2.98), p <0.001]. Covid-19 patients who died had a higher NLR than those who survived [10.88 (4.17–47.50, IQR 7.00–15.17) vs 6.15 (2.80–97.00, IQR 4.63–8.50), p 0.02]. Patients with moderate-severe symptoms had an initial NLR of 4.63–8.50 and decreased to 2.75–5.43 at the end of the treatment had a greater chance of survival. There was an increased probability of death in patients with moderate-severe symptoms whose initial NLR was 7.00–15.17, which was then elevated to 14.33–23.25.Conclusion: Different NLR at admission is seen among Covid-19 patients with mild and moderate-severe symptoms, leading to significantly different outcomes. The NLR can be used as a simple parameter to determine the severity of the disease and predict the outcome of Covid-19 patients.

Comparison of Leukocyte, Neutrophil, and Lymphocyte Levels in Child Patients that Experienced Breathlessness with COVID-19 and Non-COVID-19 (2020–2021) in Medan, Indonesia

“…Intensive Care Unit in a hospital in the city of Banda Aceh from March to September 2020, it was found that COVID-19 patients change in neutrophil and lymphocyte levels can be used to determine the probability of mortality and morbidity. In COVID-19 patients where 16.6% had high levels of neutrophils and lymphocytes, it was recognized that further research was needed to examine at-risk demographics and COVID-19 19 such as diabetes, hypertension, and obesity to strengthen the findings of this study [11].…”

Lower GCS is Related to Poor Outcome among Acute Stroke Patients with COVID-19 in A Tertiary Referral Hospital in Indonesia

“…(14) The potential role of NLR to predict the prognosis of COVID-19 has also been demonstrated by various studies in Indonesia and also outside Indonesia. (15)(16)(17) In the other study, median NLR at admission was higher among subjects with moderate to severe symptoms than the subjects with mild symptoms [6.54 (2.80-97.00) vs. 2.27 (0.79-5.07); p<0.001]. (15) Similar findings are also observed in another study, where the median NLR at admission is also higher among severe cases compared with non-severe cases (5.6 vs. 3.0; p=0.007).…”

“…(15)(16)(17) In the other study, median NLR at admission was higher among subjects with moderate to severe symptoms than the subjects with mild symptoms [6.54 (2.80-97.00) vs. 2.27 (0.79-5.07); p<0.001]. (15) Similar findings are also observed in another study, where the median NLR at admission is also higher among severe cases compared with non-severe cases (5.6 vs. 3.0; p=0.007). ( 17) Moreover, NLR has excellent accuracy in predicting the severity of COVID-19, with AUC of 0.856 and optimal cut-off value of 3.17.…”

Description of Hematological Routine in Patients Infected Covid-19 Before and After Convalence Plasma Therapy

“…Pada kasus pneumonia dijumpai jumlah leukosit tinggi yang berasal dari sepsis Hoser et al (2012). Begitu pula pada penelitian Fuad et al (2021) menemukan peningkatan Neutrofil Limfosit Range pada pasien Covid-19.…”