The Correlation of D- Dimer and Neutrophil Lymphocyte Ratio (NLR) Levels on COVID-19 Mortality

Authors

  • Evi Nurhayatun Department of Internal Medicine, Faculty of Medicine, Sebelas Maret University, Surakarta, Central Java, Indonesia
  • Meilani Ayu Safira Faculty of Medicine, Sebelas Maret University, Surakarta, Central Java, Indonesia
  • Arief Nurudhin Department of Internal Medicine, Dr Moewardi Hospital, Surakarta, Central Java, Indonesia

DOI:

https://doi.org/10.31965/infokes.Vol21.Iss3.1207

Keywords:

COVID-19, D-dimer, Neutrophil Lymphocyte Ratio, Mortality

Abstract

Coronavirus disease 2019 (COVID-19) is a disease caused by a novel coronavirus or a new type of corona virus, namely severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). D-dimer and Neutrophil Lymphocyte Ratio are parameters that can be used as a predictor of mortality in COVID-19, so this study aims to determine the relationship between D-dimer levels and NLR with mortality in COVID-19 patients. The study used an analytic observational method with a cross sectional approach from medical record data at UNS Hospital. The population in this study were COVID-19 patients at UNS Hospital who had their D-dimer and NLR levels checked in the period November 2020-January 2021. The sample was taken using a simple random sampling technique. Bivariate data analysis with Spearman Rank Correlation Test. Obtained 72 samples. 46 male patients and 26 female patients with the highest age range of 40-59 years as many as 34 patients. Patients who experienced mortality as many as 24 people while the rest survived. Spearman's Rank test obtained p-values of D-dimer and neutrophil lymphocyte ratio (NLR) with mortality of COVID-19 patients 0.009 and <0.001, respectively. While the correlation coefficients for D-dimer and NLR on mortality were 0.308 and 0.515, respectively. There is a relationship between D-dimer and NLR levels with mortality in COVID-19 patients with a positive correlation.

Downloads

Download data is not yet available.

References

Baloch, S., Baloch, M. A., Zheng, T., & Pei, X. (2020). The coronavirus disease 2019 (COVID-19) pandemic. The Tohoku Journal of Experimental Medicine, 250(4), 271–278. https://doi.org/10.1620/tjem.250.271

Bastug, A., Bodur, H., Erdogan, S., Gokcinar, D., Kazancioglu, S., Kosovali, B. D., Ozbay, B. O., Gok, G., Turan, I. O., & Yilmaz, G. (2020). Clinical and laboratory features of COVID-19: Predictors of severe prognosis. International Immunopharmacology, 88, 106950. https://doi.org/10.1016/j.intimp.2020.106950

Becker, R. C. (2020). COVID-19 update: Covid-19-associated coagulopathy. Journal of Thrombosis and Thrombolysis, 50(1), 54–67. https://doi.org/10.1007/s11239-020-02134-3

Breakey, N., & Escher, R. (2020). D-dimer and mortality in COVID-19: a self-fulfilling prophecy or a pathophysiological clue? Swiss Medical Weekly, 150(2122), w20293–w20293. https://doi.org/10.4414/smw.2020.20293

Çalıca Utku, A., Budak, G., Karabay, O., Güçlü, E., Okan, H. D., & Vatan, A. (2020). Main symptoms in patients presenting in the COVID-19 period. Scottish Medical Journal, 65(4), 127–132. https://doi.org/10.1177/0036933020949253

Cevik, M., Kuppalli, K., Kindrachuk, J., & Peiris, M. (2020). Virology, transmission, and pathogenesis of SARS-CoV-2. BMJ, 371. https://doi.org/10.1136/bmj.m3862

CDC. (2020). Coronavirus disease 2019 (COVID-19).CDC

Channappanavar, R., & Perlman, S. (2017). Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathology. Seminars in Immunopathology, 39, 529–539. https://doi.org/10.1007/s00281-017-0629-x

Demelo-rodríguez, P., Cervilla-muñoz, E., Ordieres-ortega, L., & Parra-virto, A. (2020). Incidence of asymptomatic deep vein thrombosis in patients with COVID-19 pneumonia and elevated D-dimer levels ☆. 192(May), 23–26. https://doi.org/10.1016/j.thromres.2020.05.018

Dhama, K., Khan, S., Tiwari, R., Sircar, S., Bhat, S., Malik, Y. S., Singh, K. P., Chaicumpa, W., Bonilla-Aldana, D. K., & Rodriguez-Morales, A. J. (2020). Coronavirus disease 2019–COVID-19. Clinical Microbiology Reviews, 33(4), e00028-20. https://doi.org/10.1128/cmr.00028-20

El-Anwar, M. W., Elzayat, S., & Fouad, Y. A. (2020). ENT manifestation in COVID-19 patients. Auris Nasus Larynx, 47(4), 559–564. https://doi.org/10.1016/j.anl.2020.06.003

Farasani, A. (2021). Biochemical role of serum ferratin and d-dimer parameters in COVID 19 diagnosis. Saudi Journal of Biological Sciences, 28(12), 7486–7490. https://doi.org/10.1016/j.sjbs.2021.08.040

Giannis, D., Ziogas, I. A., & Gianni, P. (2020). Coagulation disorders in coronavirus infected patients: COVID-19, SARS-CoV-1, MERS-CoV and lessons from the past. Journal of Clinical Virology, 127, 104362. https://doi.org/10.1016/j.jcv.2020.104362

Gomez-Mesa, J. E., Galindo-Coral, S., Montes, M. C., & Martin, A. J. M. (2021). Thrombosis and Coagulopathy in COVID-19. Current Problems in Cardiology, 46(3), 100742. https://doi.org/10.1016/j.cpcardiol.2020.100742

Guo, J., Radloff, C. L., Wawrzynski, S. E., & Cloyes, K. G. (2020). Mining twitter to explore the emergence of COVID‐19 symptoms. Public Health Nursing, 37(6), 934–940. https://doi.org/10.1111/phn.12809

Harrison, A. G., Lin, T., & Wang, P. (2020). Mechanisms of SARS-CoV-2 transmission and pathogenesis. Trends in Immunology, 41(12), 1100–1115. https://doi.org/10.1016/j.it.2020.10.004

He, X., Yao, F., Chen, J., Wang, Y., Fang, X., Lin, X., Long, H., Wang, Q., & Wu, Q. (2021). The poor prognosis and influencing factors of high D-dimer levels for COVID-19 patients. Scientific Reports, 11(1), 1830. https://doi.org/10.1038/s41598-021-81300-w

Hornuss, D., Lange, B., Schroeter, N., Rieg, S., Kern, W. V, & Wagner, D. (2020). Anosmia in COVID-19 patients. Clinical Microbiology and Infection, 26(10), 1426–1427. https://doi.org/10.1016/j.cmi.2020.05.017

Hu, J., & Wang, Y. (2021). The clinical characteristics and risk factors of severe COVID-19. Gerontology, 67(3), 255–266. https://doi.org/10.1159/000513400

Iba, T., Levy, J. H., Levi, M., & Thachil, J. (2020). Coagulopathy in COVID‐19. Journal of Thrombosis and Haemostasis, 18(9), 2103–2109. https://doi.org/10.1111/jth.14975

Imran, M. M., Ahmad, U., Usman, U., Ali, M., Shaukat, A., & Gul, N. (2021). Retracted: Neutrophil/lymphocyte ratio—A marker of COVID‐19 pneumonia severity. International Journal of Clinical Practice, 75(4), e13698. https://doi.org/10.1111/ijcp.13698

Lamers, M. M., & Haagmans, B. L. (2022). SARS-CoV-2 pathogenesis. Nature Reviews Microbiology, 20(5), 270–284. https://doi.org/10.1038/s41579-022-00713-0

Lan, F.-Y., Filler, R., Mathew, S., Buley, J., Iliaki, E., Bruno-Murtha, L. A., Osgood, R., Christophi, C. A., Fernandez-Montero, A., & Kales, S. N. (2020). COVID-19 symptoms predictive of healthcare workers’ SARS-CoV-2 PCR results. PloS One, 15(6), e0235460. https://doi.org/10.1371/journal.pone.0235460

Li, Y., Zhao, K., Wei, H., Chen, W., Wang, W., Jia, L., Liu, Q., Zhang, J., Shan, T., & Peng, Z. (2020). Dynamic relationship between D‐dimer and COVID‐19 severity. British Journal of Haematology, 190(1), e24-e27. https://doi.org/10.1111/bjh.16811

Liu, Y.-C., Liao, C.-H., Chang, C.-F., Chou, C.-C., & Lin, Y.-R. (2020). A locally transmitted case of SARS-CoV-2 infection in Taiwan. New England Journal of Medicine, 382(11), 1070–1072. https://doi.org/10.1056/NEJMc2001573

Liu, Y., Du, X., Chen, J., Jin, Y., Peng, L., Wang, H. H. X., Luo, M., Chen, L., & Zhao, Y. (2020). Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19. Journal of Infection, 81(1), e6–e12. https://doi.org/10.1016/j.jinf.2020.04.002

Mellett, L., & Khader, S. A. (2022). S100A8/A9 in COVID-19 pathogenesis: Impact on clinical outcomes. Cytokine & Growth Factor Reviews, 63, 90–97. https://doi.org/10.1016/j.cytogfr.2021.10.004

Menni, C., Valdes, A. M., Freidin, M. B., Ganesh, S., El-Sayed Moustafa, J. S., Visconti, A., Hysi, P., Bowyer, R. C. E., Mangino, M., & Falchi, M. (2020). Loss of smell and taste in combination with other symptoms is a strong predictor of COVID-19 infection. MedRxiv, 2004–2020. https://doi.org/10.1101/2020.04.05.20048421

Ozen, M., Yilmaz, A., Cakmak, V., Beyoglu, R., Oskay, A., Seyit, M., & Senol, H. (2021). D-Dimer as a potential biomarker for disease severity in COVID-19. The American Journal of Emergency Medicine, 40, 55–59. https://doi.org/10.1016/j.ajem.2020.12.023

Prather, K. A., Wang, C. C., & Schooley, R. T. (2020). Reducing transmission of SARS-CoV-2. Science, 368(6498), 1422–1424. https://doi.org/10.1126/science.abc6197

Sarohan, A. R., Kızıl, M., İnkaya, A. Ç., Mahmud, S., Akram, M., & Cen, O. (2021). A novel hypothesis for COVID-19 pathogenesis: Retinol depletion and retinoid signaling disorder. Cellular Signalling, 87, 110121. https://doi.org/10.1016/j.cellsig.2021.110121

Simadibrata, D. M., Calvin, J., Wijaya, A. D., & Ibrahim, N. A. A. (2021). Neutrophil-to-lymphocyte ratio on admission to predict the severity and mortality of COVID-19 patients: A meta-analysis. The American Journal of Emergency Medicine, 42, 60–69. https://doi.org/10.1016/j.ajem.2021.01.006

Singh, K., Mittal, S., Gollapudi, S., Butzmann, A., Kumar, J., & Ohgami, R. S. (2021). A meta‐analysis of SARS‐CoV‐2 patients identifies the combinatorial significance of D‐dimer, C‐reactive protein, lymphocyte, and neutrophil values as a predictor of disease severity. International Journal of Laboratory Hematology, 43(2), 324–328. https://doi.org/10.1111/ijlh.13354

Soni, M., Gopalakrishnan, R., Vaishya, R., & Prabu, P. (2020). D-dimer level is a useful predictor for mortality in patients with COVID-19: Analysis of 483 cases. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 14(6), 2245–2249. https://doi.org/10.1016/j.dsx.2020.11.007

Sun, S.-H., Chen, Q., Gu, H.-J., Yang, G., Wang, Y.-X., Huang, X.-Y., Liu, S.-S., Zhang, N.-N., Li, X.-F., & Xiong, R. (2020). A mouse model of SARS-CoV-2 infection and pathogenesis. Cell Host & Microbe, 28(1), 124–133. https://doi.org/10.1016/j.chom.2020.05.020

Tsai, P.-H., Lai, W.-Y., Lin, Y.-Y., Luo, Y.-H., Lin, Y.-T., Chen, H.-K., Chen, Y.-M., Lai, Y.-C., Kuo, L.-C., & Chen, S.-D. (2021). Clinical manifestation and disease progression in COVID-19 infection. Journal of the Chinese Medical Association, 84(1), 3–8. https://doi.org/10.1097/JCMA.0000000000000463

Vidali, S., Morosetti, D., Cossu, E., Luisi, M. L. E., Pancani, S., Semeraro, V., & Consales, G. (2020). D-dimer as an indicator of prognosis in SARS-CoV-2 infection: a systematic review. ERJ Open Research, 6(2). https://doi.org/10.1183/23120541.00260-2020

Yu, H.-H., Qin, C., Chen, M., Wang, W., & Tian, D.-S. (2020). D-dimer level is associated with the severity of COVID-19. Thrombosis Research, 195, 219–225. https://doi.org/10.1016/j.thromres.2020.07.047

Yu, T., Cai, S., Zheng, Z., Cai, X., Liu, Y., Yin, S., Peng, J., & Xu, X. (2020). Association between clinical manifestations and prognosis in patients with COVID-19. Clinical Therapeutics, 42(6), 964–972. https://doi.org/10.1016/j.clinthera.2020.04.009

Downloads

Published

2023-09-30

How to Cite

Nurhayatun, E., Ayu Safira, M., & Nurudhin, A. (2023). The Correlation of D- Dimer and Neutrophil Lymphocyte Ratio (NLR) Levels on COVID-19 Mortality. JURNAL INFO KESEHATAN, 21(3), 600–609. https://doi.org/10.31965/infokes.Vol21.Iss3.1207

Issue

Section

Original Articles

Most read articles by the same author(s)

Similar Articles

<< < 1 2 3 4 

You may also start an advanced similarity search for this article.