Hubungan Nilai Neutrophil-to-Monocyte Ratio terhadap Angka Kematian Pasien COVID-19 di RSUP H Adam Malik Medan

Abstract

Background: Inflammation plays an important role in the development of disease from COVID-19 infection, a severe inflammatory response can cause an imbalance in the immune response which can worsened the development of a disease. The aim of the study was to assess whether there is a relationship between the value of the NMR to the mortality rate of COVID-19 patients. Methods : Clinical and laboratory data of adult COVID-19 patients at H. Adam Malik General Hospital Medan, were collected and analysed, then bivariate analysis was carried out to determine whether there was a relationship between NMR and the COVID-19 disease mortality rate using the Mann-Whitney test, and analysed using the ROC curve to be able to determine the best cut-off point, specificity and sensitivity from the NMR value. Result: A significant relationship was found between the NMR values of patients and the mortality rate of COVID-19 patients at H. Adam Malik General Hospital Medan (p<0.05). From the results of the ROC Curve analysis, the value of the area under the curve (AUC) is 82% (95% CI, 73.1% - 91%) with a significance value of p <0.001. The best cut-off value obtained from NMR was ≥ 14.72 with a sensitivity value of 77.4% and a specificity value of 80.6%. Conclusion: It can be concluded that patients with high NMR values can be more at risk of developing the disease in a worse direction until mortality.