Utilization of Neutrophil to Lymphocyte Ratio to Assess Recovery in Patients with Dengue

Abstract

Objectives: This study aims to assess recovery in patients with dengue by utilizing Neutrophil-to-Lymphocyte ratio (NLR) reversal i.e increase in atypical lymphocytes in peripheral blood, for early detection of transformation to DHF.

Methodology: A cross-sectional study was conducted from 26th October, 2021 to 26th November, 2021 by consecutive sampling of patients from Outdoor and Indoor of National Hospital, Lahore. Ethical approval was taken from Chughtai Institute of Pathology, Lahore before initiation of research involving 141 patients diagnosed with dengue fever. Quantitative variables like mean age, Hb, TLC, haematocrit, platelet count and degree of platelet fall were summarized as the appropriate means and standard deviations. The association NLR reversal with DHF was determined using Chi-square and Fisher´s Exact test.

Results: There was no significant difference in mean Haemoglobin, Haematocrit and Total Leukocyte Count of Early-Reversal Group (14.2 ± 1.7), (43.1 ± 5.2), (3.8 ± 1.2) and of Late-Reversal group (14.7 ± 2.1), (45.1 ± 6.1), (4.5 ± 1.4). Mean of minimum platelet count observed in Early-Reversal Group was higher (49.2 ± 28.3) than Late-Reversal Group (19.3 ± 22.1) (p-value <0.05). Significant number of patients developed DHF in Late-Reversal Group (80.9%) than Early-Reversal Group (8.3%) (p-value < 0.05).

Conclusion: There is no significant difference in age, haemoglobin, haematocrit and total leukocyte count of DF and DHF patients. Serial NLR can predict the haemorrhagic complications in dengue fever patients. Severe thrombocytopenia occurs in patients with late reversal of NLR.