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Observational Study
. 2023 Jun 16:29:e940130.
doi: 10.12659/MSM.940130.

Relationship Between D-Dimer Levels and Neutrophil-to-Lymphocyte Ratio (NLR) in Preeclamptic Pregnant Women with COVID-19: A Cohort Study

Dian Tjahyadi  1 , Bayu Indrayana Irsyad  1 , Akhmad Yogi Pramatirta  1 , Siti Salima  1 , Anita Deborah Anwar  1 , Jusuf Sulaeman Effendi  1 , Aisyah Shofiatun Nisa  1 , Wiryawan Permadi  1
Affiliations
Observational Study

Relationship Between D-Dimer Levels and Neutrophil-to-Lymphocyte Ratio (NLR) in Preeclamptic Pregnant Women with COVID-19: A Cohort Study

Dian Tjahyadi et al. Med Sci Monit. .

Abstract

BACKGROUND Preeclampsia involves an inflammatory response and vascular endothelial dysfunction. In COVID-19, there is also tissue damage and an inflammatory response that stimulates the formation of D-dimers and an increase in the neutrophil-to-lymphocyte ratio (NLR). These 2 parameters have become laboratory tests carried out both in preeclampsia and COVID-19. This study aimed to determine the relationship between D-dimer levels and NLR in patients with both COVID-19 and preeclampsia. MATERIAL AND METHODS This was an observational analytic study with a retrospective approach. The subjects were pregnant women with gestational age >20 weeks diagnosed with severe preeclampsia and had D-dimer and neutrophil-to-lymphocyte ratio (NLR) laboratory results at Hasan Sadikin Hospital Bandung during the period April 2020 to July 2021. We enrolled 31 COVID-19 patients with preeclampsia and 113 COVID-19 patients without preeclampsia. RESULTS The mean level of D-dimer in COVID-19 patients with preeclampsia was 3.66±3.15 and in those with COVID-19 without preeclampsia it was 3.03±3.15 (P<0.05). The mean NLR value in COVID-19 patients with preeclampsia was 7.22±4.30 and in COVID-19 patients without preeclampsia it was 5.47±2.20 (p<0.05). In the Spearman correlation test, the correlation coefficient was 0.159. Area under curve (AUC) D-dimer level was 64.9% (p<0.05) and NLR was 61.7% (p<0.05). CONCLUSIONS There was a significant difference (P<0.05) in D-dimer and NLR between COVID-19 patients with preeclampsia and those without preeclampsia. There was also a weak positive relationship between D-dimer and NLR levels in COVID-19 patients with preeclampsia, which means that the higher the D-dimer level, the higher the NLR value in COVID-19 patients with preeclampsia.

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Conflict of interest statement

Conflict of interest: None declared

Figures

Figure 1
Figure 1
ROC curve of D-dimer levels and NLR values in COVID-19 patients with preeclampsia.
Figure 2
Figure 2
Cut-off point for D-dimer levels in COVID-19 patients with and without preeclampsia.
Figure 3
Figure 3
Cut-off point of neutrophil-to-lymphocyte ratio (NLR) in COVID-19 patients with preeclampsia.
See this image and copyright information in PMC

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