R. Prawira Bayu Putra Dewa
Program Studi Pendidikan Dokter Spesialis Penyakit Dalam, Fakultas Kedokteran Universitas Udayana, RSUP Sanglah, Bali, Indonesia

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Hubungan nilai Neutrophil Lymphocyte Ratio (NLR) terhadap parameter laboratorium pada pasien DM tipe 2 yang terkonfirmasi COVID-19 di Rumah Sakit Umum Pusat (RSUP) Sanglah, Bali, Indonesia R. Prawira Bayu Putra Dewa; Made Ratna Saraswati; Anak Agung Gde Budhiarta; Ketut Suastika; I Made Pande Dwipayana; I Made Siswadi Semadi; Ida Bagus Aditya Nugraha
Intisari Sains Medis Vol. 13 No. 2 (2022): (In Press : 1 August 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/ism.v13i2.1345

Abstract

Background: The pathogenesis of COVID-19 infection is the occurrence of excessive inflammatory reactions in which one of the markers of inflammation that is easy to work with is the value of the Neutrophil Lymphocyte Ratio (NLR). The NLR value increases in uncontrolled type 2 DM patients and is a prognostic factor for the occurrence of severe symptomatic COVID-19 infection. This study aims to examine the correlation between NLR values ​​and various laboratory parameters of type 2 DM patients with COVID-19 infection at Sanglah Hospital. Methods: This study used a cross-sectional analytical design and involved 70 research samples from the medical records of type 2 DM patients with COVID-19 who were treated at Sanglah Hospital from April 2020 to October 2020. Analysis with Pearson and Spearman tests to see the correlation between NLR values ​​and 12 laboratory parameters such as GDS, GDP, HbA1c, Leukocytes, Hemoglobin, BUN, D-Dimer, CRP, serum creatinine, SGOT, SGPT and Ferritin using SPSS software version 21 for Windows. Results: From the results of the correlation test, laboratory parameters that were found to be significantly positively correlated with NLR values ​​were GDS levels (r=0.451; p=0.000), GDP (r=0.037; p=0.001), leukocytes (r=0.479; p=0.000), BUN (r=0.368; p=0002), D-dimer (r=0.348; p=0.011), CRP (r=0.557; p=0.000), serum creatinine (r=0.313; p=0.009) and ferritin (r=0.337; p=0.011). Conclusion: The NLR value in type 2 DM patients with COVID-19 is positively correlated with glycemic markers, namely GDS and GDP. In addition, it is also positively correlated with leukocytes, BUN, D-dimer, CRP, serum creatinine and ferritin.   Latar belakang: Patogenesis infeksi COVID-19 adalah terjadinya reaksi inflamasi berlebihan dimana salah satu penanda inflamasi yang mudah dikerjakan adalah nilai Neutrophil Lymphocyte Ratio (NLR). Nilai NLR meningkat pada pasien DM tipe 2 yang tidak terkontrol dan menjadi faktor prognostik untuk terjadinya infeksi COVID-19 gejala berat. Penelitian ini bertujuan untuk meneliti korelasi antara nilai NLR dengan berbagai parameter laboratorium pasien DM tipe 2 dengan infeksi COVID-19 di RSUP Sanglah. Metode: Studi ini menggunakan desain analitik potong lintang dan melibatkan 70 sampel penelitian dari rekam medik pasien DM tipe 2 dengan COVID-19 yang dirawat di RSUP Sanglah bulan April 2020 hingga Oktober 2020. Analisis dengan Uji Pearson dan Spearman untuk melihat korelasi antara nilai NLR dengan 12 parameter laboratorium berupa GDS, GDP, HbA1c, Leukosit, Hemoglobin, BUN, D-Dimer, CRP, serum kreatinin, SGOT, SGPT dan Ferritin menggunakan piranti lunak  SPSS versi 21 untuk Windows. Hasil: Dari hasil uji korelasi, parameter laboratorium yang ditemukan signifikan berkorelasi positif dengan nilai NLR adalah kadar GDS (r=0,451; p=0,000), GDP (r=0,037; p=0,001), leukosit (r=0,479; p=0,000), BUN (r=0,368; p=0002), D-dimer (r=0,348; p=0,011), CRP (r=0,557; p=0,000), serum kreatinin (r=0,313; p=0,009) dan ferritin (r=0,337; p=0,011). Kesimpulan: Nilai NLR pada pasien DM tipe 2 dengan COVID-19 berkorelasi positif dengan penanda glikemik yaitu GDS dan GDP. Selain itu berkorelasi positif juga dengan leukosit, BUN, D-dimer, CRP, serum kreatinin dan ferritin.