Association of Neutrophil-Lymphocytes Ratio (NLR) and D-Dimer Levels with COVID-19 Mortality

Muhammad Aidil Aulia Ramadhan, Endang Sawitri, Sri Wahyunie

Abstract


Coronavirus Disease 2019 (COVID-19) is a disease caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Due to the severity and transmission of SARS-CoV-2, exploration of risk factors for mortality in COVID-19 patients as early as possible becomes very important for appropriate actions and interventions and to improve the cure and quality of prognosis of COVID-19 patients. This study aimed to determine association of NLR and D-dimer with COVID-19 patient mortality. An analytical observational study with a cross-sectional study approached using 90 data from medical records of adult COVID-19 patients who were hospitalized at Abdoel Wahab Sjahranie Hospital Samarinda from July to December 2021. Statistical analysis using Spearman’s correlation, p <0,05 was significant. The results showed male patients = 51 and female patients = 39. The mean age of survived patients = 52 years and deceased patients = 50 years. Median neutrophil count of survived patients = 5.5 x 103/μl and deceased patients = 6.95 x 103/μl. Median lymphocyte count of survived patients = 1.11 x 103/μl and deceased patients = 1.03 x 103/μl. Median NLR of survived patients = 4.99 and deceased patients = 6.14. The median of D-dimer level of survived patients = 1.08 μg/ml and deceased patients = 1.83 μg/ml. The association of NLR with COVID-19 mortality showed p = 0.031; r = 0.228. The association of D-dimer levels with COVID-19 mortality showed p < 0.001; r = 0.416. It was concluded that NLR and D-dimer levels each had a significant relationship with mortality in COVID-19 patients.


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References


Park SE. Epidemiology , virology , and clinical features of severe acute respiratory syndrome -coronavirus-2 ( SARS-CoV-2 ; Coronavirus Disease-19 ). CEP [Internet]. 2020;63(4):119–24. Available from: www.e-cep.org

Asakura H, Ogawa H. COVID-19-associated coagulopathy and disseminated intravascular coagulation. Int J Hematol [Internet]. 2021;113(1):45–57. Available from: https://doi.org/10.1007/s12185-020-03029-y

Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet [Internet]. 2020;395(10223):507–13. Available from: http://dx.doi.org/10.1016/S0140-6736(20)30211-7

Ye W, Chen G, Li X, Lan X, Ji C, Hou M, et al. Dynamic changes of D-dimer and neutrophil-lymphocyte count ratio as prognostic biomarkers in COVID-19. Respir Res. 2020;21(1):1–7.

Mathew D, Giles JR, Baxter AE, Oldridge DA, Greenplate AR, Wu JE, et al. Deep immune profiling of COVID-19 patients reveals distinct immunotypes with therapeutic implications. Science (80- ). 2020;369(6508).

Yang A-P, Liu J, Tao W, Li H. The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients. Int Immunopharmacol [Internet]. 2020 Jul;84(January):106504. Available from: https://linkinghub.elsevier.com/retrieve/pii/S156757692030494X

Efrina D, Priyanto H, Andayani N, Arliny Y, Yanti B. Neutrophil To Lymphocyte Ratio as A Marker of Covid-19 Disease Severity in Banda Aceh, Indonesia. J Respirologi Indones. 2021;41(4):1–7.

Favresse J, Lippi G, Roy PM, Chatelain B, Jacqmin H, ten Cate H, et al. D-dimer: Preanalytical, analytical, postanalytical variables, and clinical applications. Crit Rev Clin Lab Sci [Internet]. 2018;55(8):548–77. Available from: https://doi.org/10.1080/10408363.2018.1529734

Ge YL, Liu CH, Wang N, Xu J, Zhu XY, Su CS, et al. Elevated Plasma D-Dimer in Adult Community-Acquired Pneumonia Patients is Associated with an Increased Inflammatory Reaction and Lower Survival. Clin Lab. 2019 Jan;65(1).

Zhang N, Xu X, Zhou LY, Chen G, Li Y, Yin H, et al. Clinical characteristics and chest CT imaging features of critically ill COVID-19 patients. Eur Radiol. 2020;30(11):6151–60.

Selanno Y, Widaningsih Y, Esa T, Arif M. Analysis of Neutrophil Lymphocyte Ratio and Absolute Lymphocyte Count as Predictors of Severity of COVID-19 Patients. 2021;27(2):184–9.

Damar Çakırca T, Torun A, Çakırca G, Portakal RD. Role of NLR, PLR, ELR and CLR in differentiating COVID-19 patients with and without pneumonia. Int J Clin Pract. 2021;75(11):2–7.

Sukrisman L, Sinto R, Priantono D. Hematologic profiles and correlation between absolute lymphocyte count and neutrophil/ lymphocyte ratio with markers of inflammation of covid-19 in an indonesian national referral hospital. Int J Gen Med. 2021;14:6919–24.

Tatum D, Taghavi S, Houghton A, Stover J, Toraih E, Duchesne J. Neutrophil-to-Lymphocyte Ratio and Outcomes in Louisiana COVID-19 Patients. Shock. 2020;54(5):652–8.

Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, et al. Dysregulation of Immune Response in Patients with COVID-19 in Wuhan, China. SSRN Electron J. 2020;

Mubarak AR, Esa T, Widaningsih Y, Bahrun U. D-Dimer Analysis in COVID-19 Patients. Indones J Clin Pathol Med Lab. 2021;28(1):5–9.

Wang Z, Gao X, Miao H, Ma X, Ding R. Understanding COVID-19-associated coagulopathy: From PIC to SIC or DIC. J Intensive Med [Internet]. 2021;1(1):35–41. Available from: https://doi.org/10.1016/j.jointm.2021.03.002

McGonagle D, O’Donnell JS, Sharif K, Emery P, Bridgewood C. Immune mechanisms of pulmonary intravascular coagulopathy in COVID-19 pneumonia. Lancet Rheumatol [Internet]. 2020;2(7):e437–45. Available from: http://dx.doi.org/10.1016/S2665-9913(20)30121-1

Becker RC. COVID-19 update: Covid-19-associated coagulopathy. J Thromb Thrombolysis [Internet]. 2020;50(1):54–67. Available from: https://doi.org/10.1007/s11239-020-02134-3

Poudel A, Poudel Y, Adhikari A, Aryal BB, Dangol D, Bajracharya T, et al. D-dimer as a biomarker for assessment of COVID-19 prognosis: D-dimer levels on admission and its role in predicting disease outcome in hospitalized patients with COVID-19. PLoS One [Internet]. 2021;16(8 August 2021):1–13. Available from: http://dx.doi.org/10.1371/journal.pone.0256744

Gupta N, Zhao YY, Evans CE. The stimulation of thrombosis by hypoxia. Thromb Res [Internet]. 2019;181:77–83. Available from: https://doi.org/10.1016/j.thromres.2019.07.013

Joly BS, Siguret V, Veyradier A. Understanding pathophysiology of hemostasis disorders in critically ill patients with COVID ‑ 19. Intensive Care Med [Internet]. 2020;1–4. Available from: https://doi.org/10.1007/s00134-020-06088-1




DOI: http://dx.doi.org/10.30872/j.kes.pasmi.kal.v5i2.7697

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