Neutrophil-Lymphocyte Ratio(NLR), Platelet-Lymphocyte Ratio (PLR) and D-Dimer to Length of Stay in ICU of Pregnancy with COVID-19 Complicating Severe Coagulopathy

Mona Galatia Marpaung,(1*) Rizky Syahriar Syoufana,(2) Radith Aulia,(3) Julian Dewantiningrum,(4)

(1) Department of Obstetrics and Gynecology, Faculty of Medicine Diponegoro University Kariadi General Hospital, Semarang, Central Java
(2) Department of Obstetrics and Gynecology, Faculty of Medicine Diponegoro University Kariadi General Hospital, Semarang, Central Java
(3) Department of Obstetrics and Gynecology, Faculty of Medicine Diponegoro University Kariadi General Hospital, Semarang, Central Java
(4) Department of Obstetrics and Gynecology, Faculty of Medicine Diponegoro University Kariadi General Hospital, Semarang, Central Java
(*) Corresponding Author

Abstract


Objective: The aim of this study was to obtain data that D-Dimer levels, Neutrophil-Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio (PLR) as a prognostic factors of length of stay in ICU. The longer length of stay in the Intensive Care Unit (ICU) as an indicator of severe coagulopathy.
Methods :This study uses an analytic observational study with a cross sectional approach to analyze NLR , PLR ,and the D-Dimer levels and their relationship to length of stay in ICU of pregnant women with COVID-19 infection who were treated at RSUP Dr. Kariadi during March 2020 to October 2021. Medical records of patients with pregnancy confirmed COVID-19 who were diagnosed by PCR (polymerase chain reaction) and treated at Dr Kariadi Hospital between March 2020 and October 2021 were reviewed,
p value <0.05 considered significant.
Results:  The mean value of D-Dimer was 3746.6 ± 4852.33 (460-20) ug/L, NLR was 8.14 ± 6.35 (2.20-29.60), PLR was 27.66 ± 20.60 (6.80-96.66). 15 were treated in ICU with Length of stay 0.3 ± 0.46 (0-1) with the significancy was NLR p 0.008, PLR p 0.073 and D-dimer p 0.225.
Conclusion : High NLR, PLR and D-dimer levels correlated with severe coagulopathy that effect the length of stay in ICU.

Neutrophyl-Lymphocyte Ratio (NLR) , Platelet-Lymphocyte Ratio (PLR) dan D-dimer Terhadap Lama Rawat Inap di ICU pada Kehamilan dengan COVID-19 yang Mengalami Koagulopati Berat

Abstrak
Tujuan: Tujuan dari studi ini untuk menilai jumlah D-Dimer , Neutrophyl-Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio (PLR) sebagai factor prognostic dari lama rawat inap di ICU.
Metode: Studi ini menggunakan desain analitik observasional dengan pendekatan cross sectional  untuk menganalisa NLR, PLR dan jumlah D Dimer dan hubungannya dengan lama rawat inap di ICU dari Wanita hamil dengan infeksi COVID 19 yang dirawat di RSUP Dr Kariadi selama bulan Maret 2020 hingga Oktober 2021, nilai p <0.05 dianggap signifikan.
Hasil: Rerata nilai D Dimer dari subjek ialah 3746,6 ± 4852.33 (460-20) ug/L, NLR  8.14 ± 6.35 (2.20-29.60), PLR  27.66 ± 20.60 (6.80-96.66). 15 pasien dirawat di  ICU dengan lama rawat inap 0.3 ± 0.46 (0-1) dengan nilai signifikansi dari NLR p 0.008, PLR p 0.073 dan D-dimer p 0.225.
Kesimpulan: NLR dan D dimer yang tinggi berhubungan dengan keparahan koagulopati yang menyebabkan lama rawat inap di ICU.

Kata kunci : Lama rawat inap ICU, koagulopati, kehamilan dengan COVID 19


Keywords


LOS in ICU, coagulopathy, pregnancy with Covid 19

Full Text:

PDF

References


Zhou J, Wang Y, Zhao J, Gu L, Yang C, Wang J et al. The metabolic and immunological characteristics of pregnant women with COVID-19 and their neonates. Eur J Clin Microbiol Infect Dis. 2021;40:565–74.

Zeng J, Li Y, Dong Y, Chen Y, Liu Y, Wang S, Zhu H, Liu J, Lu Y, Zhai Y CZ. Predictive values of D-dimer for adverse pregnancy outcomes: a retrospective study. Clin Chem Lab Med (CCLM). 2021;59(3):99–101.

Marpaung R, Chandra E, Suwanto D. Hypercoagulability in Pregnancy with COVID-19. Mirror of the World of Doctors. 2020;47(9):713–7.

CDC. Pregnant and recently pregnant people [Internet]. Centers for Disease Control and Prevention. 2021 [cited 2021 Aug 29]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnant-people.html

Ozen M, Yilmaz A, Cakmak V, Beyoglu R, Oskay A, Seyit M. D-Dimer as a potential biomarker for disease severity in COVID-19. American Journal of Emergency Medicine. 2021; 40:55–9

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID–19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395:1054–62.

Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020;18:844–7

Kulkarni A, Prabhu D, Likitesh AB, Kumar TA, Ra VV, Murthy SP. Utility of Neutrophil-Lymphocyte Ratio (NLR) as an Indicator of Disease Severity and Prognostic Marker among Patients with Covid-19 Infection in a Tertiary Care Center in Bangalore – A Retrospective Study. J Evid Based Medical Healthc. 2021;8(16):2349-70

Zeng F, Huang Y, Guo Y, et al. Association of inflammatory markers with the severity of Covid-19: a meta-analysis. Int J Infect Dis 2020;96:467-474.

Hu J, Zhou J, Dong F, et al. Neutrophil-to-lymphocyte ratio on admission predicts in-hospital mortality in patients with Covid-19. Research Square 2020.

Pimentel GD, Vega MCMD, Laviano A. High neutrophil to lymphocyte ratio as a prognostic marker in Covid-19 patients. Clin Nutr ESPEN 2020;40:101-102.

Chana AS, Routa A. Use of Neutrophil-to-Lymphocyte and Platelet-to Lymphocyte Ratios in COVID-19. J Clin Med Res. 2020;12(7):448-53

Henry BM, de Oliveira MHS, Benoit S, Plebani M, Lippi G. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis. Clin Chem Lab Med. 2020;58(7):1021-8.

Chen G, Wu D, Guo W, Cao Y, Huang D, Wang H, Wang T, et al. Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest. 2020;130(5):2620-9




DOI: http://dx.doi.org/10.24198/obgynia/v5n1.350

Refbacks

  • There are currently no refbacks.





     
       

Creative Commons License
Indonesian Journal of Obstetrics & Gynecology Science is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License
  Web Analytics
  View My Stat