High Neutrophil to Lymphocyte Ratio, C-Reactive Protein, Procalcitonin and D-dimer as Risk Factors for Severe COVID-19

Abstract

Background: COVID-19 is caused by the SARS-CoV2 virus which is a new type of virus that causes global morbidity and mortality. Several studies are needed to determine biomarkers to identify the severity of COVID-19. Objective: to analyze the correlation between Neutrophil to lymphocyte rate (NLR), C-Reactive Protein (CRP), D-dimer, dan Procalcitonin (PCT) on the severity of COVID-19. Method: A retrospective case-control study was done in our institution using data from June 2020 to March 2021. Data collected were serum NLR, CRP, d-dimer and PCT. Data were analysed using SPSS. Participants were divided into 2 groups, severe COVID-19 as case and mild to moderate as control group. The data collection was carried out in June 2020 – March 2021, included NLR, CRP, D-dimer, and PCT in patient serum. Data analysis using Chi-Square test and logistic regression with p < 0.05. Result: The NLR value of participants in case group is 11.4 ± 9.7 and in control group is 8.2 ± 8.5 (95% CI 1.081 – 4.641;p = 0.023). The PCT value of participants in case group was 10.3 ± 75.4 and in control group was 6.9 ± 41.4 (95% CI 1.495 – 6.908;p < 0.001). CRP values ​in case group (123.7 ± 108.9) were higher than control group (61.3 ± 60.8;95% CI 1.181 – 5.063;p < 0.001). Meanwhile, the value of D-dimer participants in case group was 3.5 ± 3.7 and control group was 2.7 ± 4.6 (95% CI 0.604 – 2.958;p = 0.473). Conclusion: increased values ​of NLR, CRP, and D-dimer are risk factors for severe COVID-19.