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- Title
The role of CD4<sup>+</sup>, CD8<sup>+</sup>, CD4<sup>+</sup>/CD8<sup>+</sup> and neutrophile to lymphocyte ratio in predicting and determining COVID-19 severity in Indonesian patients.
- Authors
Masyeni, Sri; Budhitresna, Anak Agung Gede; Adiwinata, Randy; Wibawa, Surya; Nugraha, Putu Arya; Antara, Jarwa; Asmara, Dewa Putu Gede Wedha; Widyaningsih, Putu Dyah; Yenny, Luh Gede Sri; Widiastika, Made; Kahari, Siska; Wardhana, Clareza Arief; Pasek, Arya Widiyana; Putrawan, Oka; Santosa, Agus; Herawati, Sianny; Arisanti, Nih Luh Putu Eka; Astini, Wining; Fatawy, Rois Muqsith; Kameoka, Masanori
- Abstract
Background Biomarkers that are cost-effective and accurate for predicting severe coronavirus disease 2019 (COVID-19) are urgently needed. We would like to assess the role of various inflammatory biomarkers on admission as disease severity predictors and determine the optimal cut-off of the neutrophile-to-lymphocyte ratio (NLR) for predicting severe COVID-19. Methods We conducted a cross-sectional study in six hospitals in Bali and recruited real-time PCR-confirmed COVID-19 patients aged >18 y from June to August 2020. Data collection included each patient's demographic, clinical, disease severity and hematological data. Multivariate and receiver operating characteristic curve analyses were performed. Results A total of 95 Indonesian COVID-19 patients were included. The highest NLR among severe patients was 11.5±6.2, followed by the non-severe group at 3.3±2.8. The lowest NLR was found in the asymptomatic group (1.9±1.1). The CD4+ and CD8+ values were lowest in the critical and severe disease groups. The area under the curve of NLR was 0.959. Therefore, the optimal NLR cut-off value for predicting severe COVID-19 was ≥3.55, with sensitivity at 90.9% and a specificity of 16.7%. Conclusions Lower CD4+ and CD8+ and higher NLR values on admission are reliable predictors of severe COVID-19 among Indonesian people. NLR cut-off ≥3.55 is the optimal value for predicting severe COVID-19.
- Subjects
INDONESIANS; RECEIVER operating characteristic curves; COVID-19
- Publication
Transactions of the Royal Society of Tropical Medicine & Hygiene, 2023, Vol 117, Issue 8, p591
- ISSN
0035-9203
- Publication type
Article
- DOI
10.1093/trstmh/trad012