564 Available Online at www.ijscia.com | Volume 2 | Issue 4 | Jul-Sep 2021 The Trend of Platelet-To-Lymphocyte Ratio (PLR) and Absolute-Lymphocyte-Count (ALC) in the Severity of Covid-19 Patients Markus Gatot Sura Wijaya 1 , Arie Utariani 2* , Hamzah 3 , Bambang Pujo Semedi 4 and Prananda Surya Airlangga 4 1 Anesthesiologist; Anesthesiology and Intensive Therapy Department, Faculty of Medicine Universitas Airlangga Surabaya Indonesia. 2 Doctorate & Consultant of Pediatric Anesthesia; Anesthesiology and Intensive Therapy Department, Faculty of Medicine Universitas Airlangga Surabaya. 3 Doctorate & Consultant of Neuro Anesthesia; Anesthesiology and Intensive Therapy Department, Faculty of Medicine Universitas Airlangga Surabaya. 4 Consultant of Intensive Care; Anesthesiology and Intensive Therapy Department, Faculty of Medicine Universitas Airlangga Surabaya. E-mail: xuz1997@126.com; 17853465307@163.com; 15969671713@163.com; 1141614547@qq.com; 13295351580@163.com; 1149094331@qq.com *Corresponding author details: Arie Utariani; arieutariani1955@gmail.com ABSTRACT Background: Cytokine storms and severe immune injury are suspected as the cause of the occurrence of Acute Respiratory Distress Syndrome (ARDS), sepsis and various another organ failure. The trend of Platelet-to- Lymphocyte Ratio (PLR) and Absolute Lymphocyte Count (ALC) were expected to show the inflammatory process and the cytokine storm in the severity of Covid-19 patients. This research’s purpose is to analyze the time course and dynamic changes of PLR and ALC in each severity. Method: The research method used was an observational analytic study with a prospective cohort design. The research sample taken was Covid-19 patients admitted from July to October 2020 who met the inclusion and exclusion criteria. PLR, ALC was counted from the CBC (Complete Blood Count) examination checked every three days. The PLR and ALC trend of 14-days were then analyzed. Result: A total of 119 research subjects were involved in this study. PLR is significantly different at day-0 and the day-3 with p-value <0.001 and 0.003. On the 3rd day of treatment, PLR of moderate severity rose rapidly. Mild, severe, and critical cases’ PLR rose until day-6. After the day-6, PLR of all severity class tend to decrease. ALC was significantly different on day-0, day-3, day-6 and day-9 with p-value <0.001, 0.006, 0.024 and 0.001. ALC day-0 in critical patients is the lowest, and tend to be the lowest throughout the 14 days. ALC in mild, moderate and severe declined until day 6, then began to rise until day 14. Conclusion: In Conclusion, PLR tend to increase from day-0 of treatment and peak in day-3 or day-6 of treatment and then decreased gradually until day-14 of the treatment. Meanwhile, ALC tend to decrease from day-0 of treatment and reach the lowest point at day-6 of treatment and then increased gradually until day-14 of the treatment. PLR was significantly different among the severity in day-0 and day-3 with p-value <0.001 and 0.003. ALC was significantly different among the severity in day-0, day-3, day-6 and day-9 with p-value <0.001, 0.006, 0.024 and 0.001. Keywords: Platelet to Lymphocyte Ratio (PLR); Absolute Lymphocyte Count (ALC); Covid-19; Dynamic changes; Complete Blood Count (CBC) INTRODUCTION The first case of Covid-19 was reported in Wuhan in early December 2019 [1] Covid-19 spread rapidly from one city to the rest of the country in just 30 days. Case Fatality Rate (CFR) total of 2.3%, in patients over 80 years old 14.8%, in patients aged 70-79 years 8.0%, and 49.0% in patients who arrive at the critical stage [2]. Cytokine storms and severe immune injury are suspected as the cause of the occurrence of ARDS, sepsis and various other organ failure [3]. Platelet serves as a target and also as an effector that strengthens inflammatory signals [4]. Lymphocytes are the effectors of the immune system. After activating, naïve T lymphocytes will proliferate in accordance with the antigen presented by APC, activated B lymphocytes will undergo proliferation and differentiation to produce appropriate antibodies [5]. International Journal of Scientific Advances ISSN: 2708-7972 Volume: 2 | Issue: 4 | Jul - Sep 2021 Available Online: www.ijscia.com DOI: 10.51542/ijscia.v2i4.18