Asmarawati, Tri Pudy
Airlangga University

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Journal : Indian Journal of Forensic Medicine

Relationship between Neutrophil-Lymphocyte Ratio and Disease Severity in COVID-19 Patients in Isolation Ward of Dr. Soetomo General Teaching Hospital Heri Krisnata Ginting; M. Vitanata Arfijanto; Tri Pudy Asmarawati; S. Ugroseno Yudho Bintoro
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 1 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i1.17558

Abstract

This study was conducted to prove the relationship between the neutrophil-lymphocyte ratio and theseverity of COVID-19. A retrospective cohort study using medical record data of inpatients from Juneto July 2020. Analysis of the NLR relationship and the degree of severity using the Mann Whitney testif the data had an abnormal distribution. Significant if p<0.05 and 95% confidence interval. If there weresignificant results, we try to measure the cut-off of NLR value to predict severe and non-severe clinicalsymptoms. Total study subjects were 110 patients, with a male as many as 65 (59.1%), the median agewas 53.5 years (range 20-88). Most of the comorbidities were diabetes mellitus (35.5%), followed byhypertension (30%). The severity of clinical symptoms was 50% in the non-severe and severe groups,respectively. The NLR value was higher in the severe group. Mann-Whitney test showed significantdifferences in the value of NLR between the severe group and the not severe group with the p-value<0.001. Receiver operating characteristic (ROC) curve analysis area under the curve (AUC) of NLRon day-1 was 0.716 (CI 95%: 0.605 - 0.826), and the cut-off point of the prediction severity diseaseat day-7 was ≥ 6.14 with a sensitivity of 71% and a specificity of 69.1%. The neutrophil-lymphocyteratio value with severe symptoms was higher than the neutrophil ratio value for lymphocytes with nonseveresymptoms in patients with COVID-19.
Predictor of Mortality COVID-19 in Two Referral Hospital in Surabaya, Indonesia Usman Hadi; Bramanton; Tri Pudy Asmarawati; Musofa Rusli; Nasronudin; Brian Eka Rachman; M. Vitanata Arfijanto
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 1 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i1.17659

Abstract

Introduction: World Health Organization had identified COVID-19 in January 2019. This disease is caused by SARS-CoV-2, which spread throughout the world and became a pandemic on March 20, 2020. COVID-19 is still a health problem because it has not clear whether the patients will be cured and survive from the disease or not. This study aims to determine the predictors of mortality from COVID-19 at Dr. Soetomo General Academic Hospital and Universitas Airlangga Hospital in Surabaya, Indonesia.Method: This study was conducted in Dr. Soetomo General Academic Hospital (referral hospital for COVID-19, 1500 beds) and Universitas Airlangga Hospital (Referal Hospital for COVID-19, 600 beds). The study used data on patients with confirmed COVID-19 who were hospitalized at these two referral hospitals. Predictors of mortality were analyzed using logistic regressions.Result: There were 247 COVID-19 patients enrolled in this study, all patients were tested positive PCR SARS-CoV-2. The main complaints were cough, nasal congestion, dyspnea, and fever. Significant predictor mortality in this study were age >60 years old (OR: 3.24, 95% CI, 1.36 - 7.70), chronic kidney disease (OR: 5.71, 95% CI, 2.05 - 15.89), obesity (OR: 8.22, 95% CI,1.5 - 54.17), malignancy (OR: 6.025, 95% CI, 1.1- 33.00), coronary heart disease (OR: 5.31, 95% CI, 1.28 - 21.98) , and C-reactive protein >10 mg/L (OR 4.603, 95% CI, 2.03 - 10.44).Conclusions: Obesity and the presence of malignancy, chronic kidney disease, heart disease and age >60 yearsold are the strongest predictors of mortality in people with COVID-19, despite high CRP results.