Korelasi Tingkat Kecemasan pada Pasien Covid-19 dengan Systemic Immune-Inflammation Index (SII) dan Platelet Lymphocyte Ratio (PLR) di RSUP H. Adam Malik Medan

Abstract

Objective: To determine the correlation and association of systemic immune inflammation index (SII) and platelet lymphocyte ratio (PLR) with anxiety levels in COVID-19 patients Methods: This research is analytical-retrospective research with a cross-sectional design. The subjects of this study were 50 COVID-19 patients who were treated at HAM Hospital. The study used medical records as an instrument, where basic characteristic data of the patient along with laboratory data such as platelet counts, neutrophils, leukocytes, lymphocytes, and degrees of anxiety that was measured by the Beck anxiety inventory (BAI) questionnaire, were collected. The SII index was calculated by the equation: neutrophils × platelets/lymphocytes, while the PLR ratio is calculated employing a comparison of absolute platelet values and absolute values of lymphocytes. The correlation between the SII index, PLR ratio, and BAI score was analyzed using the Spearman Rho test to determine the relationship coefficient. Logistic regression tests were also conducted to find out the factors that had the biggest impact in causing severe anxiety in the study subjects. Results: Of the 50 study subjects, 28 (56%) were in the severe anxiety category, 15(30%) were in the moderate anxiety category, and 7(14%) were in the mild anxiety category. The average SII index of the overall subject was 29995.11 ± 4531.37 while the average overall PLR ratio was 309.75 ±253.85. Spearman correlation test showed the result of the correlation coefficient R = 0.518 with the value P = 0.0001 for the correlation of SII index and anxiety level, while for PLR ratio, the result of the correlation coefficient was R = 0.436 with the value P = 0.002. Logistic regression analysis showed the combination of SII index > 410 and PLR > 140 in COVID-19 sufferers increase the risk of severe anxiety by 9,754 times (P = 0.37; 95% CI 1,152 – 82,620) compared to patients without COVID-19. Conclusion: There is a linear relationship between the Systemic Inflammatory Index (SII) and platelet lymphocyte ratio (PLR) with a BAI score that indicates anxiety levels. The higher the SII index and PLR ratio, the higher the BAI score. The combination of SII> 410 and PLR >140 in COVID-19 patients increases the risk of severe anxiety by 9,754 times greater than patients who do not suffer from COVID-19.