Value of Neutrophil-Lymphocyte Ratio (NLR), Monocyte-Lymphocyte Ratio (MLR), Absolute Lymphocyte Count (ALC) and Procalcitonin in Patients in Covid-19 Monitoring (PDP) at Dr. Saiful Anwar Malang Hospital

Abstract

Background: The Covid-19 pandemic which is currently sweeping the world is an infectious disease that has only recently been identified and provides challenges for experts in dealing with and overcoming its spread. Fast and precise diagnostics are needed for the appropriate management of Covid-19. The value of the neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), absolute lymphocyte count (ALC) have been investigated for their potential and ability as a diagnostic and prognostic approach. In Indonesia alone the spread of Covid-19 is quite high and alarming. Evidence of characteristics and clinical manifestation of Covid-19 is imperative. 
 Methods: This study was an observational analytic study of hematological laboratory parameters that measured the values of NLR, MLR, ALC, and procalcitonin in patients under Covid-19 monitoring. All data were obtained from the medical records of patients treated in the isolation ward of the emerging and re-emerging infectious disease at Dr. Saiful Anwar Hospital Malang. This study also compared these variables between groups of patients confirmed by Covid-19 and those that were not confirmed, in order to identify the characteristics of patients in Covid-19 monitoring at Dr. Saiful Anwar Hospital Malang.
 Results: From 40 study subjects, the average age of all subjects was 49.58 ± 16.42 years. The confirmed cases of Covid-19 tend to be younger compared to the unconfirmed, in the age range of 15-49 years . The majority of the sex of the study subjects were male, with the predominance of the female in the confirmed patient group. The most prominent complaints are coughing and shortness of breath, while the most common co-morbidity is hypertension. The NLR, MLR, ALC, and procalcitonin values of patients confirmed Covid-19 did not differ significantly from those unconfirmed. The length of stay between the two groups was 7.8 ± 2.44 days for Covid-19 confirmed patients and 5.65 ± 3.08 days for unconfirmed Covid-19 patients.
 Conclusion: The results of this study show that patients with suspicion of Covid-19 in Dr. Saiful Anwar Hospital Malang are dominated by young adults . There were no significant differences of NLR, MLR, ALC, and Procalcitonin in either confirmed and non-confirmed Covid-19 patients.