ABSTRACT

The world has experienced the COVID-19 pandemic since December 2019 with high morbidity and mortality rate. Patients infected with COVID-19 show varying degrees of severity ranging from asymptomatic, mild, moderate, severe, and critical. Simple laboratory tests such as Neutrophil to Lymphocyte Ratio (NLR) can describe the severity of COVID-19 patients. This study aims to prove the correlation of NLR with the severity of   COVID-19 patients at Undata Palu Hospital. The research method uses analytical surveys with a cross sectional approach and uses secondary data, namely patient medical records from June to December 2021 and included 30 patients. Five patients with mild severity (16.6%), 25 patients with moderate severity (66.7%) and five patients with severe severity (16.7%). The median value for NLR at each level of severity is for mild degrees of 3.8, moderate degrees of 6.1 and severe degrees of 9.2. The results of the study obtained a very strong postitif correlation between NLR values and the severity of COVID-19 infection (r = 0.794) and the average value of NLR is 6.4. The conclusion of this study is that the higher the NLR score, the higher the severity in COVID-19 patients.

Keywords: COVID-19, NLR, Patient

ABSTRAK

Dunia mengalami pandemik COVID-19 sejak desember 2019 dengan angka morbiditas dan mortalitas yang cukup tinggi. Pasien COVID-19 menunjukan derajat keparahan yang berbeda-beda mulai dari tanpa gejala, ringan, sedang, berat, dan kritis. Pemeriksaan laboratorium yang sederhana seperti Neutrophil to Lymphocyte Ratio (NLR) dapat menggambarkan derajat keparahan pasien COVID-19 . Penelitian ini bertujuan untuk membuktikan korelasi NLR dengan derajat keparahan pasien COVID-19 di RSUD Undata Palu. Metode penelitian menggunakan survei analitik dengan pendekatan cross sectional dan menggunakan data sekunder yaitu rekam medik pasien pada bulan Juni hingga Desember 2021 dengan subyek sebanyak 30 pasien. Pasien yang memiliki derajat keparahan ringan berjumlah lima pasien (16,6%), sedang berjumlah 25 pasien (66,7%) dan berat berjumlah lima pasien (16,7%). Nilai median untuk NLR pada tiap derajat keparahan adalah derajat ringan adalah 3,8, derajat sedang 6,1 dan untuk derajat berat 9,2. Hasil penelitian  didapatkan korelasi positif sangat kuat antara nilai NLR terhadap derajat keparahan infeksi COVID-19 (r=0,794) dengan nilai rata-rata NLR adalah 6,4. Kesimpulan dari penelitian ini adalah semakin tinggi nilai NLR, maka derajat keparahan semakin tinggi pada pasien COVID-19.

Kata Kunci: COVID-19, NLR, Pasien

Abbas Ka, Lichtman Ha, Pillai S. (2016). Imunologi Dasar Abbas. Dalam: Kalim H, Editor. Imunitas Alami. Singapore: Elsevier; 2016. P.36.

Burhan E., Susanto, D. A, Nasution As, Et Al. (2020). Pedoman Tatalaksana Covid-19. Edisi 3. Pdpi, Perki, Papdi, Perdatin, Idai. 2020; Isbn: 978-623- 92964-9-0.

Boban M. (2021). Novel Coronavirus Disease (Covid‐19) Update On Epidemiology, Pathogenicity, Clinical Course And Treatments. International Journal Of Clinical Practice. 2021 Apr;75(4).

Gao Yd, Ding M, Dong X, Zhang Jj, Kursat Azkur A, Azkur D, Et Al. (2021). Risk Factors For Severe And Critically Ill Covid‐19 Patients: A Review. Allergy. 2021 Feb;76(2):428-55.

Haithami A. (2021). Korelasi News 2 Dan Biomarker Inflamasi Nlr, Crp, Il-6 Terhadap Derajat Penyakit Pasien Covid-19 Di Rsup Haji Adam Malik Medan.

Huang I, Pranata R. (2020). Lymphopenia In Severe Coronavirus Disease-2019 (Covid-19): Systematic Review And Meta-Analysis. J Intensive Care. 2020;8

Hoffbrand, A. V. (2017). Kapita Selekta Hematologi (Terjemahan). Edisi 7. Jakarta: Egc; 2017. P.100.

Jin Y, Yang H, Ji W, Wu W, Chen S, Zhang W, Et Al. (2020). Virology, Epidemiology, Pathogenesis, And Control Of Covid-19. Viruses. 2020 Apr;12(4):372.

Karen Cc, Jeffrey Ha, Steve M, Stephen Ma, Timothy Ma, Barbara D, Et Al. (2016). Mikrobiologi Kedokteran (Terjemahan). Edisi 27. Jakarta: Egc Medical Publisher; 2016. P. 649.

Kumar M, Al Khodor S. (2020). Pathophysiology And Treatment Strategies For Covid-19. Journal Of Translational Medicine. 2020 Dec;18(1):1-9.

Liu Y, Du X, Chen J, Jin Y, Peng L, Wang Hh, Et Al. (2020). Neutrophil-To-Lymphocyte Ratio As An Independent Risk Factor For Mortality In Hospitalized Patients With Covid-19. Journal Of Infection. 2020 Jul 1;81(1):6-12.

Selanno Y, Widaningsih Y, Esa T, Arif M. (2021). Analysis Of Neutrophil Lymphocyte Ratio And Absolute Lymphocyte Count As Predictors Of Severity Of Covid-19 Patients. Indonesian Journal Of Clinical Pathology And Medical Laboratory. 2021 Apr 15;27(2):184-9.

Sommerstein R, Fux Ca, Vuichard-Gysin D, Abbas M, Marschall J, Balmelli C, Et Al. (2020). Risk Of Sars-Cov-2 Transmission By Aerosols, The Rational Use Of Masks, And Protection Of Healthcare Workers From Covid-19. Antimicrobial Resistance & Infection Control. 2020 Dec;9(1):1-8.

South. A. M., Diz Di., Chappell, M. C. (2020). Covid-19, Ace2, And The Cardiovascular Consequences. American Journal Of Physiology-Heart And Circulatory Physiology. 2020 May 1;318(5): P.1084-90.

Sun P, Lu X, Xu C, Sun W, Pan B. (2020). Understanding Of Covid‐19 Based On Current Evidence. Journal Of Medical Virology. 2020 Jun;92(6):548-51.

Vafadar Moradi E, Teimouri A, Rezaee R, Et Al. (2021). Increased Age, Neutrophil-To-Lymphocyte Ratio (Nlr) And White Blood Cells Count Are Associated With Higher Covid-19 Mortality. Am J Emerg Med. 2021;40:11-4.

Who. (2021). Who Coronavirus (Covid-19) Dashboard. World Heath Organization; 2021. Available From: Https://Covid19.Who.Int/

Who. (2021). Indonesia: Who Coronavirus Disease (Covid-19) Dashboard With Vaccination Data; 2021. Available From: Https://Covid19.Who.Int/Region/Searo/Country/Id

Wiersinga Wj, Rhodes A, Cheng Ac, Peacock Sj, Prescott Hc. (2020) Pathophysiology, Transmission, Diagnosis, And Treatment Of Coronavirus Disease 2019 (Covid-19): A Review. Jama. 2020 Aug 25;324(8):782-93.

Yang Ap, Liu Jp, Tao Wq, Li Hm. (2020). The Diagnostic And Predictive Role Of Nlr, D-Nlr And Plr In Covid-19 Patients. International Immunopharmacology. 2020 Jul 1;84:106504.