Rasio Neutrofil Limfosit Mengindikasikan Derajat Keparahan COVID-19

Authors

  • Leny Luckytasari Universitas Islam Bandung
  • Usep Abdullah Husin Kedokteran, Universitas Islam Bandung
  • Ratna Dewi Indi Astuti Kedokteran, Universitas Islam Bandung

DOI:

https://doi.org/10.29313/jrk.v3i2.2960

Keywords:

COVID-19, Gejala Sedang dan Berat, NLR

Abstract

Abstract. The higher the inflammatory response, the more severe the symptoms of COVID-19. One indicator of inflammation is the NLR (Neutrophil Lymphocyte Ratio). The aim of this study is to analyze the differences in NLR in patients with moderate and severe clinical degrees of COVID-19. This research method is observational with a cross-sectional design using a simple random sampling technique. Data is taken from the medical records of COVID-19 patients who were hospitalized at RS-Al Islam Bandung for the period June-July 2021, obtained 605 medical records that met the inclusion criteria and 100 samples were taken to meet the minimum sample size. Data analysis is performed using Mann Whitney and obtained a p value of 0.000 (<0.05). This shows that there is a significant difference in NLR in the moderate and severe clinical degree groups. Patients with moderate clinical degree of COVID-19 had a NLR of 3.6, while patients with severe clinical degrees had an NLR of 9. A high NLR value was affected by an increase in the number of neutrophils and a decrease in the number of lymphocytes. An increase in the number of neutrophils is caused by an increase in the inflammatory response, while a decrease in the number of lymphocytes indicates damage to the immune system, so a high NLR value can indicate an increase in the severity of the disease.

Abstrak. Semakin tinggi respon inflamasi maka menyebabkan gejala COVID-19 yang lebih berat. Salah satu indikator inflamasi adalah NLR (Neutrophil Lymphocyte Ratio). Tujuan penelitian ini yaitu untuk menganalisis perbedaan NLR pada pasien COVID-19 derajat klinis sedang dan berat. Metode penelitian ini yaitu observasional dengan desain potong lintang menggunakan teknik pemilihan sampel simple random sampling. Data diambil dari rekam medis pasien COVID-19 yang dirawat inap di RS-Al Islam Bandung periode Juni─Juli 2021, didapatkan 605 rekam medis yang memenuhi kriteria inklusi dan diambil 100 sampel untuk memenuhi jumlah minimal besar sampel. Analisis data dilakukan dengan menggunkan Mann Whitney didapatkan p value sebesar 0.000 (< 0.05). Hal ini menunjukkan terdapat adanya perbedaan NLR yang signifikan pada kelompok derajat klinis sedang dan berat. Pada pasien COVID-19 derajat klinis sedang memiliki NLR sebesar 3,6, sedangkan pada pasien derajat klinis berat memiliki NLR sebesar 9. Nilai NLR yang tinggi dipengaruhi oleh peningkatan jumlah neutrofil dan penurunan jumlah limfosit. Peningkatan jumlah neutrofil disebabkan karena peningkatan respon inflamasi, sedangkan penurunan jumlah limfosit mengindikasikan adanya kerusakan sistem imun, sehingga nilai NLR yang tinggi dapat mengindikasikan peningkatan keparahan penyakit.

References

World Health Organization. Coronavirus disease (COVID-19). WHO. 2020.

Ciotti M, Ciccozzi M, Terrinoni A, Jiang WC, Wang C Bin, Bernardini S. The COVID-19 pandemic. Critical Reviews in Clinical Laboratory Sciences. Taylor and Francis Ltd. 2020:365–88.

Shereen MA, Khan S, Kazmi A, Bashir N, Siddique R. COVID-19 infection: Origin, transmission, and characteristics of human coronaviruses. Vol. 24, Journal of Advanced Research. Elsevier B.V.; 2020:91–8.

Hu B, Guo H, Zhou P, Shi ZL. Characteristics of SARS-CoV-2 and COVID-19. Vol. 19, Nature Reviews Microbiology. Nature Research; 2021:141–54.

Fitriyana S, Respati T, Sartika D. The Source of Stress of Students During Pandemic COVID-19 : a Qualitative Study. GMHC. 2021;9(22):76–80.

World Health Organization. Coronavirus disease COVID-19 situation reports. WHO. 2021.

Kementerian Kesehatan Republik Indonesia. Situasi COVID-19 (Kumulatif). Kemkes. 2021.

Menteri Kesehatan RI. Keputusan Menteri Kesehatan RI no.01.07/Menkes/413/2020 Tentang Pedoman, Pencegahan dan Pengendalian COVID-19. 2020:8–105.

National Institutes of Health. Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19). Nih, 2019. 2021:29–53.

Wang Y, Zhao J, Yang L, Hu J, Yao Y. Value of the Neutrophil-Lymphocyte Ratio in Predicting COVID-19 Severity: A Meta-analysis. Dis Markers. 2021:1–10.

Kerboua KE. NLR: A Cost-effective Nomogram to Guide Therapeutic Interventions in COVID-19. Immunol Invest. 2021;50(1):92–100.

Pramana IGAASP, Masyuni PUS, Surawan IDP. Nilai rasio neutrofil-limfosit sebagai prediktor kasus COVID-19 serangan berat pada pasien dewasa. Intisari Sains Medis. 2021;12(2):530–3.

Fuad M, Oehadian A, Prihatni D, Marthoenis M. Neutrophil to Lymphocyte Ratio and Covid-19 Symptom-based Severity at Admission. Althea Med J. 2021;8(1):1–6.

Yang AP, Liu J ping, Tao W qiang, Li H ming. The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients. Int Immunopharmacol. 2020;84(February):106-504.

Eslamijouybari M, Heydari K, Maleki I, Moosazadeh M, Hedayatizadeh-Omran A, Vahedi L, et al. Neutrophil to Lymphocyte and Platelet to Lymphocyte Ratios in COVID-19 Patients and Control Group and Relationship with Disease Prognosis. Casp J Intern Med. 2020;11(Suppl 1):S531–5.

Sinurat TR, Dinutanayo WW, Aditya, Purnomo A. Perbandingan Derajat Keparahan Terhadap Jumlah Neutrofil, Limfosit Dan Neutrophile To Lymphocyte Ratio (NLR) Pada Pasien Covid-19. Jurnal Vokasi Kesehatan. 2022 Juli 31;8(2):134-139.

Wolff D, Nee S, Hickey NS, Marschollek M. Risk factors for Covid-19 severity and fatality: a structured literature review. Vol. 49, Infection. Springer Science and Business Media Deutschland GmbH; 2021:15–28.

Hidayani WR. Faktor Faktor Risiko Yang Berhubungan Dengan COVID 19 : Literature Review. J Untuk Masy Sehat. 2020 Oct 31;4(2):120–34.

Putra IBPEW, Putra IWGM, Rusni NW, Masyeni S. Perbedaan Karakteristik Pasien Suspek Negatif Covid-19 Dan Terkonfirmasi Positif Covid-19 Di RSUD Sanjiwani Tahun 2020. Surabaya Biomedical Journal. 2022 Mei 31;1(3):137-146.

Sitorus RJ, Yudi Antara N, Elviani R, Ahmad Z, Hudari H, Sangalang R V. Risk Factor for Mortality in COVID-19 Patients in Mohammad Hoesin Hospital, Palembang, Indonesia. J Ilmu Kesehat Masy. 2021;12(1):69–76.

Wang C, Deng R, Gou L, Fu Z, Zhang X, Shao F dkk. Preliminary Study To Identify Severe From Moderate Cases Of COVID-19 Using Combined Hematology Parameters. Ann Transl Med. 2020 May 8;8(9):1-15.

Yusuf Y, Nurisyah S, Rhasyim AA, Amru K, Kadir AQ, Mutia AZ dkk. Evaluasi Rasio Netrofil Limfosit (RNL) untuk diagnosis COVID-19 pada Pasien di RS Tadjuddin Chalid, Makassar, Indonesia. Bionature. 2021 Oktober;22(2):79-85.

Mus R, Abbas M, Sunaidi Y, Studi P, Teknologi D, Medis L, et al. Studi Literatur : Tinjauan Pemeriksaan Laboratorium pada Pasien COVID ‑ 19. 2020;5(4):242–250.

Fitriani NI. Tinjauan Pustaka Covid-19: Virologi, Patogenesis, dan Manifestasi Klinis. J Med Malahayati. 2021;4(3):194–201.

Scheuer C, Boot E, Carse N, Clardy A, Gallagher J, Heck S. Disentangling inclusion in physical education lessons: Developing a resource toolkit for teachers. Phys Educ Sport Child Youth with Spec Needs Res – Best Pract – Situat. 2021;343–54.

Yufani H, Rikarni, Rofinda ZD. Limfopenia dan Rasio Neutrofil-Limfosit Pada Infeksi Severe Acute Respiratory Syndrome Coronavirus 2. Jurnal Kesehatan Andalas. 2021;10(3):178-182.

Amanda DA. Rasio Neutrofil Limfosit Pada Covid-19; Sebuah Tinjauan Literatur. Wellness And Healthy Magazine. 2020 Agustus;2(2):219-223

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Published

2023-12-24