Analisis Komparatif Neutrophil-to-Lymphocyte, Platelet-to-Lymphocyte Ratio, Monocyte-to-Lymphocyte Ratio dan Derived Neutrophil-to-Lymphocyte Ratio Terkait Derajat Keparahan COVID-19 pada Pasien Anak di Rumah Sakit Umum Daerah Ulin Banjarmasin
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Latar belakang. Mayoritas COVID-19 pada anak memiliki luaran klinis yang baik, tetapi angka mortalitas COVID-19 di Indonesia tergolong tinggi. Identifikasi pasien dengan risiko mortalitas penting dilakukan sedini mungkin untuk mencegah luaran klinis yang buruk. Beberapa parameter pemeriksaan darah rutin terbukti pada dewasa, tetapi pada populasi anak masih belum diketahui.
Tujuan. Menilai hubungan antara parameter laboratoris dengan derajat keparahan COVID-19 (severe vs non-severe) pada anak usia 0-<18 tahun.
Metode. Studi cross-sectional dengan data sekunder retrospektif, diambil dari rekam medis pasien usia 0-<18 tahun yang terkonfirmasi transcription polymerase chain reaction dan dirawat inap di ruang isolasi RSUD Ulin Banjarmasin, Kalimantan Selatan, dari satu Januari 2020 – 31 Desember 2021.
Hasil. Total 77 orang subjek studi, terdiri dari 66 kasus non-severe dan 11 kasus severe. Median usia 10 tahun, perbandingan jenis kelamin laki-laki dan perempuan = (1,48 : 1). Angka mortalitas sebesar 7,79%. Perbedaan nilai neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, monocyte-to-lymphocyte ratio dan derived neutrophil-to-lymphocyte ratio yang bermakna tidak ditemukan antara kelompok anak dengan COVID-19 non-severe dan severe. Korelasi positif bermakna ditemukan antara neutrophil-to-lymphocyte ratio (p<0,001, r=0,453), monocyte-to-lymphocyte ratio (p<0,001, r=0,456) dan derived neutrophil-to-lymphocyte ratio (p=0,002, r=0,413) dengan kadar CRP; dan adanya korelasi negatif bermakna antara PLR (p=0,027, r= -0,274) dengan kadar LDH.
Kesimpulan. Tidak ditemukan perbedaan signifikan antara kelompok non-severe dan severe. Prognosis COVID-19 lebih baik pada populasi anak, jumlah kasus severe lebih jarang dan angka mortalitas lebih rendah dibandingkan populasi dewasa.
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Huang C, Wang Y, Li X, dkk. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497-506.
Liu YC, Kuo RL, Shih SR. COVID-19: The first documented coronavirus pandemic in history. Biomed J 2020;43:328-33.
COVID-19 Treatment Guidelines Panel. Coronavirus disease 2019 (COVID-19) treatment guidelines. national institutes of health. Diakses 18 November 2022.Didapat dari https://www.covid19treatmentguidelines.nih.gov/.
World Health Organization. WHO Coronavirus (COVID-19) Dashboard. Diakses 16 November 2022. Didapat dari: https://covid19.who.int/table.
Kementerian Kesehatan Republik Indonesia. Dashboard [internet]. 2022. Diakses: 7 Februari 2023. Didapat dari: https://infeksiemerging.kemkes.go.id/dashboard/covid-19
Mustafa NM, Selim LA. Characterization of COVID-19 pandemic in pediatric age group: a systematic review and meta-analysis. J Clin Virol 2020;128: 104395.
Soebandrio A, Kusumaningrum, Yudhaputri FA, dkk. Characteristics of children with confirmed SARS-CoV-2 infection in Indonesia. J Clin Virol Plus 1 (2021): 100027. doi.org/10.1016/j.jcvp.2021.100027.
Suhartono, Wijaya I. Dalimoenthe NZ. The correlation of neutrophil-to-lymphocyte ratio (NLR) and monocytes-to-lymphocytes ratio (MLR) with disease severity in hospitalized patients with Coronavirus disease 2019 (COVID-19). Bali Med J2021;10: 653 – 8..
Citu C, Gorun F, Motoc A, Sas I, Gorun OM, Burlea B, dkk. The predictive role of NLR, d-NLR, MLR, and SIRI in COVID-19 mortality. Diagnostics 2022;12:122.
Pasaribu FM, Setyaningtyas A, Andarsini MR. Neutrophil to lymphocyte ratio, monocyte to lymphocyte ratio, platelet to lymphocyte ratio, mean platelet volume as a predictor of sepsis mortality in children at Dr. Soetomo General Hospital. Crit Care Shock 2021;24: 65-71.
Yilmaz S, Uzunoglu I, Inandiklioglu N, Cag Y, Karaaslan A, Cetin C, dkk. The evaluation of complete blood count ratios in children with 2019 novel coronavirus (2019-ncov) infection. Med Sci 2022;11: 214-9.
Mathews S, Rajan A, Soans ST. Prognostic value of rise in neutrophil to lymphocyte ratio (NLR) dan platelet to lymphocyte ratio (PLR) in predicting the mortality in paediatric intensive care. Int J Contemp Pediatr. 2019;6:1052–8.
Yazaki LG, Faria JCP, Suano de Souza FI, Sarni ROS. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios of overweight children and adolescents. Rev Assoc Med Bras 2022;68:1006–10.
Yilmaz A, Taskin O, Demir U, Soylu VG. Predictive role of biomarkers in COVID-19 mortalirty. Cureus 2023;15:e34173.
Asghar MS, Akram M, Yasmin F, Najeeb H, Naeem U, Gaddam M, dkk. Comparative analysis of neutrophil to lymphocyte ratio and derived neutrophil to lymphocyte ratio with respect to outcomes of in-hospital coronavirus disease 2019 patients: a retrospective study. Front Med 2022;9:95156.
WHO. Clinical management of COVID-19: living guideline, 13 January 2023. Geneva: World Health Organization; 2022. h.30-2.
COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. National Institutes of Health. Diakses 6 Februari 2023. Diunduh dari: https://files.covid19treatmentguidelines.nih.gov/guidelines/covid19treatmentguidelines.pdf.
Choi SH, Choi JH, Yun KW. Therapeutics for the treatment of coronavirus disease 2019 in children and adolescents. Clin Exp Pediatr 2022;65(8):377-86.
Türkkan E, Dag ND, Arabaci C, Dikker O, Dag H. Evaluation of inflammatory hematological ratios (NLR, PLR, MLR and Monocyte/HDL-Cholesterol Ratio) in obese adolescents. Iberoamerican J Med 2022;1:11-7.
DOI: http://dx.doi.org/10.14238/sp24.6.2023.359-69
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