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The Effect of Neutrophil Lymphocyte Ratio and Bacterial Co-Infection on Mortality and Length of Hospital Stay of COVID-19 Patients
(1) Faculty of Medicine, Sebelas Maret University, Surakarta, Central Java, Indonesia
(2) Department of Pulmonology, Faculty of Medicine, Sebelas Maret University, Surakarta, Central Java, Indonesia
(3) Department of Histology, Faculty of Medicine, Sebelas Maret University, Surakarta, Central Java, Indonesia
(*) Corresponding Author
Abstract
Background: The new coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly contagious disease. The disease has spread rapidly and widely around the world, and was declared as pandemic in March 2020 by WHO. The neutrophil lymphocyte ratio (NLR) is a biomarker that provides important information about the status of systemic inflammation, including in COVID-19. Bacterial co-infection is commonly identified in viral respiratory tract infections such as SARS-CoV-2 and is an important cause of morbidity and mortality.
Objective: This study aims to retrospectively analyze clinical data of COVID-19 patients who were treated at Dr. Moewardi General Hospital in Surakarta, to determine the effect of NLR and bacterial co-infection with mortality and length of hospital stay of COVID-19 patients.
Methods: This study is an analytical observational study with a cross-sectional design using secondary data from 87 adult COVID-19 patients at Dr. Moewardi Hospital in August 2021. The sampling method used was purposive sampling of all adult patients aged 18 years or above who had been diagnosed with COVID-19 and hospitalized.
Results: It was found that there was a strong effect of bacterial co-infection on NLR (r= 0.528). It was also found that NLR and bacterial co-infection simultaneously affected the length of hospital stay (Sig.= 0.02) and mortality (Sig.= 0.027). Partially, the effect of NLR on length of hospital stay was found (Sig.= 0.045).
Conclusion: NLR and bacterial co-infection have an effect on mortality and length of hospital stay of COVID-19 patients.Keywords
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World Health Organization (WHO). 14.9 million excess deaths associated with the COVID-19 pandemic in 2020 and 2021. Geneva: WHO; 2022.
Singhal T. A Review of Coronavirus Disease-2019 (COVID-19). Indian J Pediatric. 2020;87(4):281-286.
Yan X, Li F, Wang X, et al. Neutrophil to lymphocyte ratio as prognostic and predictive factor in patients with coronavirus disease 2019: A retrospective cross-sectional study. J Med Virol. 2020;92(11):2573-2581.
Liu J, Liu Y, Xiang P, et al. Neutrophil-to-lymphocyte ratio predicts critical illness patients with 2019 coronavirus disease in the early stage. J Transl Med. 2020;18(1):206.
Lavillegrand JR, Garnier M, Spaeth A, et al. Elevated plasma IL-6 and CRP levels are asso-ciated with adverse clinical outcomes and death in critically ill SARS-CoV-2 patients: in-flammatory response of SARS-CoV-2 patients [published correction appears in Ann Inten-sive Care. 2021(6)9;11(1):93.
Vuillaume LA, Le Borgne P, Alamé K, et al. Neutrophil-to-Lymphocyte Ratio and Early Variation of NLR to Predict In-Hospital Mortality and Severity in ED Patients with SARS-CoV-2 Infection. J Clin Med. 2021;10(12):2563.
Forget P, Khalifa C, Defour JP, et al. What is the normal value of the neutrophil-to-lymphocyte ratio?. BMC Res Notes. 2017;10(1):12.
Feng X, Li S, Sun Q, et al. Immune-inflammatory parameters in COVID-19 cases: A systematic review and meta-analysis. Front Med. 2020;7(6):301
Feldman, C., Anderson, R. The role of co-infections and secondary infections in patients with COVID-19. Pneumonia. 2021;13(1):5.
Langford BJ, So M, Raybardhan S, et al. Bacterial Co-Infection and Secondary Infection in Patients with COVID-19: a living rapid review and meta-analysis. Clin Microbiol Infect. 2020;26(12):1622-1629.
Soltani S, Faramarzi S, Zandi M, et al. Bacterial coinfection among coronavirus disease 2019 patient groups: an updated systematic review and meta-analysis. New Microbes New Infect. 2021;43(9):100910.
Pramana IG, Masyuni PU, Surawan ID. Nilai Rasio Neutrofil-Limfosit Sebagai Prediktor Kasus COVID-19 Serangan Berat pada Pasien Dewasa. Intisari Sains Medis. 2021;12(2):530-533.
Eslamijouybari M, Heydari K, Maleki I, et al. Neutrophil-to-Lymphocyte and Platelet-to- Lymphocyte Ratios in COVID-19 Patients and Control Group and Relationship with Dis-ease Prognosis. Caspian J Intern Med. 2020;11(1):531-535.
Toori KU, Qureshi MA, Chaudhry A, et al. Neutrophil to lymphocyte ratio (NLR) in COVID-19: A cheap prognostic marker in a resource constraint setting. Pak J Med Sci. 2021;37(5):1435-1439.
Vekaria, B., Overton, C., Wiśniowski, A. Hospital length of stay for COVID-19 patients: Data-driven methods for forward planning. BMC Infect Dis. 2021;21(1):700.
Perazzo H, Cardoso S, Ribeiro M, et al. In-hospital mortality and severe outcomes after hospital discharge due to COVID-19: A prospective multicenter study from Brazil. Lancet Reg Health Am. 2022;11(7):100244.
Jayaswal SK, Singh S, Malik PS, et al. Detrimental effect of diabetes and hypertension on the severity and mortality of COVID-19 infection: A multi-center case-control study from India. Diabetes Metabolic Syndrome. 2021;15(5):102248.
Vélez-Páez JL, Tercero-Martínez W, Jiménez-Alulima G. Neutrophil-to- lymphocyte ratio and mean platelet volume in the diagnosis of bacterial infections in COVID-19 patients. A preliminary analysis from Ecuador. Infez Med. 2021;29(4):530-537.
Yang AP, Liu JP, Tao WQ, et al. The diagnostic and predictive role of NLR, d- NLR and PLR in COVID-19 patients. Int Immunopharmacology. 2020;84(7):106504.
Silva DL, Lima CM, Magalhães VCR, et al. Fungal and bacterial coinfections increase mor-tality of severely ill COVID-19 patients. J Hosp Infect. 2021;113(7):145-154.
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DOI: https://doi.org/10.26714/magnamed.11.2.2024.122-129
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