Title : The association of platelet-lymphocyte and neutrophil-lymphocyte ratios to in hospital outcome among admitted diabetic patients with COVID -19 infection.
Abstract:
Background:
In COVID-19 a dysregulated immune response and cytokine storm is the underlying mechanism that determines the adverse outcome. The Neutrophil/Lymphocyte Ratio(NLR) and Platelet/Lymphocyte Ratio(PLR) have been considered as systemic inflammatory response markers.
Objectives:
This research aims to determine the correlation of PLR and NLR as inflammatory markers to the In-Hospital outcome of diabetic patients admitted for COVID19.
Methods:
This is a Descriptive (Retrospective) Analytical - Cross-Sectional study of adult diabetic patients with confirmed COVID infection that determines the association of inflammatory markers specifically PLR and NLR to the in-hospital outcomes.
Results:
A total of 75 patients with diabetes mellitus and confirmed Covid-19 were included. No significant difference in gender distribution: Female (66%,) Male (49.33%), Average age: 57.97 +/- 15.047 years old. Majority have uncontrolled diabetes (73.33%). There was a higher proportion of uncontrolled diabetes who develop disease progression (HBa1C > 7: p-0.019). The mean HBA1C values of those with disease progression (9.04 ± 2.4) was significantly higher (p = 0.0275) compared to those without disease progression (7.66 ± 2.34).The frequency of patients with disease progression with a PLR value of <369 is 37.92% versus 19.57%. There was an increase of sensitivity and specificity upon computing the optimal cut off of NLR from 4.5 to 3.73 (from 50% and 36.36 % to 65% and 62%) and PLR from 369 to 469 (from 55% and 67.27% to 70% and 55%).
Conclusion:
This study revealed elderly patients with uncontrolled diabetes and confirmed COVID infection have a higher chance of disease progression. The use of PLR and NLR in detecting disease progression is still low compared to another inflammatory marker, but in areas where no available inflammatory marker tests, this can aid in detecting the early progression of disease with the assistance of clinical manifestation of patients.
Audience take away:
1. The audience may be able to use PLR and NLR in supporting evidence of detecting the early progression of COVID-19.
2. The audience may be able to use this as another variable in expanding their COVID-19 related research.
3. This can be used as an alternative inflammatory marker in the settings where only PLR and NLR are available.
