Nenci Siagian, - and Hermina Novida, - and Agung Pranoto, - and Usman Hadi, - and Cupuwatie Cahyani, - (2021) Dynamic Changes in Platelet-Lymphocyte Ratio in Diabetic Patients with COVID-19 within First Week of Hospitalization. Journal of Hunan University Natural Sciences, 48 (8). pp. 99-105. ISSN 1674-2974

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Abstract

The platelet-to-lymphocyte ratio (PLR) is an inexpensive, readily available marker of inflammation response that is widely investigated as a prognosis predictor in acute and chronic disease, such as viral pneumonia and diabetes mellitus (DM). Recently, dynamic changes in the PLR during hospitalization have become a concern in novel coronavirus pneumonia cases. The study objective is to determine the PLR trend of diabetic patients with COVID-19 on the basis of some clinical characteristics and outcomes. The records of 35 confirmed COVID-19 patients with DM who were hospitalized in a single center (Dr. Soetomo General Teaching Hospital, Surabaya, Indonesia) for seven days from May 2020 to August 2020 were retrospectively analyzed. We collected data about their clinical characteristics, clinical outcomes, and dynamic changes in the platelet and lymphocyte counts and the PLR. Of the 35 patients, 20 were female, 15 were male, and the median (interquartile range) age was 57. Cough was the most common symptom on admission (71.4%), and most patients were admitted with severe COVID-19 (48.6%). Fifteen patients had new-onset diabetes on admission, and 16 patients had had diabetes for less than five years. Hypertension was the other leading comorbidity (42.8%). There were 22 nonsurvival cases (62.9%). During admission, thrombocytopenia episodes were significantly observed among the elderly (p = 0.001), while lymphopenia episodes were significantly found in the nonsurvival cases (p = 0.037). The peak PLR commonly occurred on admission (40.0%), while the lowest was typically identified during the last evaluation (42.9%). A declining trend in the average PLR was evident in the severe and nonsurvival cases, and the average ∆PLR showed a statistically significant association with cardiac injury (p = 0.023), liver injury (p = 0.028), and respiratory failure (p = 0.045). The PLR may reflect the inflammatory response caused by COVID-19 infection and might be helpful in the monitoring of COVID-19 patients with DM.

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