Diagnostic Value of Neutrophil-to-Lymphocyte, Platelet-to-Lymphocyte and Monocyte-to-Lymphocyte Ratio for COVID-19 Screening

Authors

  • Johannes Dwight Risamasu Department of Clinical Pathology, Faculty of Medicine, Universitas Sebelas Maret/Dr. Moewardi General Hospital, Surakarta
  • JB. Suparyatmo Department of Clinical Pathology, Faculty of Medicine, Universitas Sebelas Maret/Dr. Moewardi General Hospital, Surakarta
  • Amiroh Kurniati Department of Clinical Pathology, Faculty of Medicine, Universitas Sebelas Maret/Dr. Moewardi General Hospital, Surakarta

DOI:

https://doi.org/10.24293/ijcpml.v30i1.2054

Keywords:

COVID-19, NLR, PLR, MLR

Abstract

COVID-19 is caused by SARS-CoV-2, which can affect all ages. The prevalence of COVID-19 reported by the World Health Organization (WHO) in March 2020 was 3 million cases worldwide. The number of confirmed cases of COVID-19 reported by WHO in June 2020 in Indonesia was 28,233 cases. This research was an observational analytic study with a cross-sectional approach to determine the performance and cut-off of NLR, PLR, and MLR as a screening for COVID-19 infection conducted at the RSDM Clinical Pathology Installation in Surakarta from March 2020 to April 2021. The total subjects of this study were 348 people. The characteristics of the research subjects were presented in descriptive form. The Receiver Operating Characteristic (ROC) curve and the Area Under Curve (AUC) were used to determine the cut-off of NLR, PLR, and MLR. The results were presented in a 2x2 table. A computer program was used for statistical analysis. There was a significant relationship between NLR, PLR, and MLR and the incidence of COVID-19. A cut-off > 3.010, sensitivity 66.5%, specificity 61.9%, PPV 0.773, NPV 0.487, LR (+) 1.744, and LR (-) 0.541 were obtained for NLR as a COVID-19 screening. A cut-off > 157.035, sensitivity 63%, specificity 60.2%, PPV 0.755, NPV 0.455, LR (+) 1.583, and LR (-) 0.614 were obtained for PLR as a COVID-19 screening. A cut-off > 0.296, sensitivity 60%, specificity 58.5%, PPV 0.738, NPV 0.429, LR (+) 1.445, and LR (-) 0.684 were obtained for MLR as a screening for COVID-19. NLR and PLR cannot be used as the main screening biomarkers for COVID-19. Regardless of the clinical manifestations of patients, other biomarkers such as antigen swabs should be considered.

Downloads

Download data is not yet available.

Author Biography

Johannes Dwight Risamasu, Department of Clinical Pathology, Faculty of Medicine, Universitas Sebelas Maret/Dr. Moewardi General Hospital, Surakarta

Dokter Spesialis Patologi Klini (Sp.PK). Kepala Unit Laboratorium RSUD Teluk Bintuni, Papua Barat, Indonesia, Kepala UTD RSUD Teluk Bintuni, Papua Barat.

References

Singhal T. A review of Coronavirus Disease-2019 (COVID-19). Indian J Pediatr, 2020; 87(4): 281-286.

Anonim. Coronavirus Disease 2019 (COVID-19) situation report-10. World Health Organization. 2020; 1-20.

Djalante R, Lassa J, Setiamarga D, Sudjatma A, Indrawan M, et al. Review and analysis of current responses to COVID-19 in Indonesia: Period of January to March 2020. Progress in Disaster Science, 2020; 6(2020): 1-9.

Borges L, Curi TC, Curi R, Hatanaka E. COVID-19 and neutrophils: The relationship between hyperinflammation and neutrophil extracellular traps. Mediators of Inflammation, 2020; 1-7.

Han H, Ma Q, Li C, Liu R, Zhao L, et al. Profiling serum cytokines in COVID-19 patients reveals IL-6 and IL-10 are disease severity predictors. Emerging Microbes & Infections, 2020; 9(2020): 1123-1130.

Sopiyudin Dahlan M. Besar sampel dan cara pengambilan sampel dalam penelitian kedokteran dan kesehatan/Sopiyudin Dahlan M. Jakarta, Epidemiologi Indonesia, 2016; 1-178.

Nalbant A, Kaya T, Varim C, Yaylaci S, Tamer A, Cinemre H. Can the Neutrophil/Lymphocyte Ratio (RNL) have a role in the diagnosis of Coronavirus Disease 2019 (COVID-19)?. Revista da Associação Médica Brasileira, 2020; 66(6): 746-751.

Bwire GM. Coronavirus: Why men are more vulnerable to COVID-19 than women?. SN Comprehensive Clinical Medicine, 2020; 2(7): 874-876.

Zhao Y, Zhao Z, Wang Y, Zhou Y, Ma Y, Zuo W. Single-cell RNA expression profiling of ACE2, the receptor of SARS-CoV-2. Am J Respir Crit Care Med, 2020; 202(5): 756-759. Erratum in: Am J Respir Crit Care Med, 2021; 203(6): 782. PMID: 32663409; PMCID: PMC7462411.

Shim E, Tariq A, Choi W, Lee Y, Chowell G. Transmission potential and severity of COVID-19 in South Korea. Int J Infect Dis, 2020; 93: 339–4.

Usul E, San I, Bekgoz B, Sahin A. The role of hematological parameters in COVID-19 patients in the emergency room. Future Medicine, 2020; 14(3): 1-9.

Zhao K, Li R, Wu X, Zhao Y, Wang T, et al. Clinical features in 52 patients with COVID-19 who have increased leukocyte count: A retrospective analysis. European Journal of Clinical Microbiology & Infectious Diseases, 2020; 39(12): 2279-2287.

Novianti AL, Dwi R. Correlation between platelet to lymphocyte ratio with C-reactive protein in COVID-19 patients. Indonesian Journal of Clinical Pathology and Medical Laboratory, 2021; 28(1): 17-21.

Sandquist I, Kolls J. Update on regulation and effector functions of Th17 cells. F1000Res, 2018; 7(205): 1-8.

Kadhem SJ, Raheem AH, Aljumaily HS, Shammari AA, Al-Humairi AK, Baay A. Platelets profile changes in patients with COVID 19. Systematic Reviews in Pharmacy, 2020; 11(9): 569-574.

Shofia WM, Delita P, Adhi KS. The combination of NLR and D-dimer as predictor instrument for the severity of COVID-19. Indonesian Journal of Clinical Pathology and Medical Laboratory, 2022; 28(3): 285-290.

Ish P, Malhotra N, Agrawal S, Gupta N. Relative lymphocytosis in COVID-19-a ray of hope. Advances in Respiratory Medicine, 2020; 88(3): 287-288.

Peng J, Qi D, Yuan G, Deng X, Mei Y, et al. Diagnostic value of peripheral hematologic markers for Coronavirus Disease 2019 (COVID 19): A multicenter, cross sectional study. Journal of Clinical Laboratory Analysis, 2020; 34(10): 1-10.

Eslamijouybari M, Heydari K, Maleki I, Moosazadeh M, Hedayatizadeh A, Vahedi L, Alizadeh R. Neutrophil to lymphocyte and platelet-to-lymphocyte ratios in COVID-19 patients and control group and relationship with disease prognosis. Caspian Journal of Internal Medicine, 2020; 11(suppl 1): 531.

Qu R, Ling Y, Zhang YH, Wei LY, Chen X, et al. Platelet to lymphocyte ratio is associated with prognosis in patients with Coronavirus disease 19. Journal of Medical Virology, 2020; 92(9): 1533-1541.

Zarychanski R, Houston DS. Assessing thrombocytopenia in the intensive care unit: The past, present, and future. The American Society of Hematology Education Program Book, 2017; 1: 660-666.

Downloads

Submitted

2022-11-09

Accepted

2023-08-14

Published

2023-11-03

How to Cite

[1]
Risamasu, J.D., Suparyatmo, J. and Kurniati, A. 2023. Diagnostic Value of Neutrophil-to-Lymphocyte, Platelet-to-Lymphocyte and Monocyte-to-Lymphocyte Ratio for COVID-19 Screening. INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY. 30, 1 (Nov. 2023), 33–38. DOI:https://doi.org/10.24293/ijcpml.v30i1.2054.

Issue

Section

Articles