Predictive Analysis of NLR, Absolute Lymphocyte Count, and CT-Value on The Severity of Covid-19 Patients Analisis Prediksi NLR, Absolute Lymphocyte Count, dan CT-Value Terhadap Derajat Keparahan Pasien Covid-19
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Published:
Jul 31, 2022
Keywords:
Covid-19, CT-Value, Absolute Lymphocyte Count (ALC), NLR, Severity
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Abstract
Laboratory parameters in Covid-19 patients may have a relationship with the clinical severity of the patient on arrival. This study aims to Analyzing the relationship between NLR, ALC, and CT values with the clinical severity of Covid-19 patients on arrival. A total of 101 subjects were collected from medical records of RSI Jemursari Surabaya from April to September 2020. The correlation laboratory parameters (NLR, ALC, and CT-value) with the severity of Covid-19 patients (mild, moderate, severe and critical) were analyzed using One Way Anova and Kruskal Wallis. The relationship of NLR with severity (p-value=0.143), ALC with severity (p-value=0.165), and CT-value with severity (p-value= 0.987). Patients with COVID-19 tend to have a high NLR in all clinical conditions. The mean value of the ALC was within normal limits for all degrees of severity. There is no significant relationship between NLR, ALC, CT-value with the severity of Covid-19 patients.
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Bastiana, Donastin, A., Arista, D. M., & Surya, P. A. (2022). Predictive Analysis of NLR, Absolute Lymphocyte Count, and CT-Value on The Severity of Covid-19 Patients. Medicra (Journal of Medical Laboratory Science/Technology), 5(1), 22-27. https://doi.org/10.21070/medicra.v5i1.1625
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References
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Guan, W., NI, Z., Hu, Y., Liang, W., Ou, C., He, J., Liu, L., Shan, H., Lei, C., Hui, D., Du, B., Li, L., Zeng, G., Yuen, K., Chen, R., Tang, C., Wang, T., Chen, P., Xiang, J., Li, S., Wang, J., Liang, Z., Peng, Y., Wei, L., Liu, Y., Hu, H., Peng, P., Wang, J., Liu, J., Chen, Z., Li, G., Zheng, Z., Qiu, S., Luo. J., Ye, C., Zhu, S., Zhong, N. (2020). Clinical Characteristics of Coronavirus Disease 2019 in China. The New England Journal of Medicine, 382 (18), 1708-1720. doi: 10.1056/NEJMoa2002032
Han, R., Hang, R., Jiang, H., Dong, J., Peng, H., Zhang, D. (2020) Early Clinical and CT manifestations of coronavirus disease 2019 (COVID-19) pneumonia. American Journal of Roentgenology, 215(2), 338-343. doi: 10.2214/AJR.20.22961
Illg, Z., Muller, G., Mueller, M., Nippert, J., Allen, B. (2021). Analysis of absolute lymphocyte count in patients with COVID-19. American Journal of Emergency Medicine, 46, 16-19. doi: 10.1016/j.ajem.2021.02.054
Kementerian Kesehatan Republik Indonesia. (2020). Pedoman Pencegahan dan Pengendalian Coronavirus Disease (COVID-19) Edisi 5 (pp. 91-92). Jakarta: Kemenkes RI.
Levi, M., Thachil, J., Iba, T., Levy, J.H. (2020). Coagulation abnormalities and thrombosis in patients with COVID-19. Lancet Haematology, 7(6), e438-e440. doi: 10.1016/S2352-3026(20)30145-9
Liu, Y., Du X,. Chen, J., Jin, Y., Peng, L., Wang H.H.X., Luo, M., Chen, L., Zhao, Y. (2020). Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19. The British Infection Association, 81(1), e6-e12. doi: 10.1016/j.jinf.2020.04.002
Pirsalehi A., Salari, S., Baghestani, A., Vahidi, M., Khave, LJ., Akbari, ME., Bashash, D. (2020). Neutrophil-to-lymphocyte ratio (NLR) greater than 6,5 may reflect the progression of COVID-19 towards an unfavorable clinical outcome. Iranian Journal of Microbiology, 12(5), 466-474. doi: 10.18502/ijm.v12i5.4609
Shah, S., Singhal, T., Davar, N., Thakkar, P. (2021). No correlation between Ct values and severity of disease or mortality in patients with COVID 19 disease. Indian Journal of Microbiology, 39(1), 116-117. doi: 10.1016/j.ijmmb.2020.10.021
Qin, C., Zhou, L., Hu, Z., Zhang, S., Yang, S., Tau, Y., Xie, C., Ma, K., Shang, K., Wang, W., Tian, D. (2020) Dysregulation of immune response in patients with coronavirus 2019 (COVID-19) in Wuhan, China. Clinical Infection Disease, 71(15), 762-768. doi: 10.1093/cid/ciaa248
Tavakolpour S., Rakhshandehroo T., Wei E.X., Rashidan, M. (2020). Lymphopenia during the COVID-19 infection: What is shows and what can be learned. Immunology Letters. 225, 31-32. doi: 10.1016/j.imlet.2020.06.013
Warny, M., Helby, J., Nordestgaard, B.G., Birgens, H., Bojesen, S.E. (2018). Lymphopenia and risk of infection and infection-related death in 98,344 individuals from a prospective Danish population based study. Public Library of Science, 15 (11), e1002685. doi: 10.1371/journal.pmed.1002685
Xu, H., Zhong, L., Deng, J., Peng, J., Dan, H., Zeng, X., Li, T., Chen, Q. (2020). High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. International Journal of Oral Science. 12, 8. doi: 10.1038/s41368-020-0074-x
Yang, X., Yu, Y., Xu, J., Shu, H., Xia, J., Liu, H., Wu, Y., Zhang, L., Yu, Z., Fang, M., Yu, T., Wang, Y., Pan, S., Zou, X., Yuan, S., Shang, Y. (2020). Clinical course and outcomes of critically ill patients with SARS‐CoV‐2 pneumonia in Wuhan, China: a single‐centered, retrospective, observational study. Lancet Respiratory Medicine, 8(5), 475‐481. doi: 10.1016/S2213-2600(20)30079-5
Yang, A., Liu, J., Tao, W., Li, H. (2020). The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients. International Immunopharmacology, 84, 106504. doi: 10.1016/j.intimp.2020.106504
Zheng Z., Peng, F., Xu, B., Zhao, J., Liu, H., Peng, J., Li, Q., Jiang, C., Zhou, Y., Liu, S., Ye, C., Zhang, P., Xing, Y., Guo, H., Tang, W. (2020). Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis. Journal Infection, 81(2), e16-e25. doi: 10.1016/j.jinf.2020.04.021
Zhou, P., Yang, X., Wang, X., Hu, B., Zhang, L., Zhang, W., Si, H., Zhu, Y., Li, B., Huang, C., Chen, H., Chen, J., Luo, Y., Guo, H., Jiang, R., Liu, M., Chen, Y., Shen, X., Wang, X., Zheng, X., Zhao, K., Chen, Q., Deng, F., Liu, L., Yan, B., Zhan, F., Wang, Y., Xiao, G., Shi, Z., (2020). A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature, 579(7798), 270–273. doi: 10.1038/s41586-020-2012-7