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Risky Vitria Prasetyo
Departemen Ilmu Kesehatan Anak, Fakultas Kedokteran, Universitas Airlangga
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High neutrophil-to-lymphocyte ratio is not a risk factor of severe dengue infection in children Desita, Saskia Ratna; Prasetyo, Risky Vitria; Irwanto, Irwanto
Universa Medicina Vol. 45 No. 1 (2026): Aheaf Of Print
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2026.v45.39-45

Abstract

BackgroundDengue infection in children globally shows a significant increasing trend in incidence and remains a heavy public health burden. Dengue infection can progress rapidly to death, especially in children. The neutrophil-to-lymphocyte ratio (NLR) is an inflammatory biomarker that represents an immune response to the disease. This study investigated NLR as a risk factor of dengue infection severity in children. MethodsA cross-sectional study was conducted involving 237 children, (110 girls and 127 boys) aged 1-18 years with dengue infection. Patients were categorized into dengue fever (DF) and dengue hemorrhagic fever (DHF) according to WHO 2011 criteria. Demographic characteristics, clinical manifestations, and hematological parameters, including hemoglobin (Hb), leukocyte count, thrombocyte count, hematocrit (HCT), and NLR, were extracted. Bivariate and multivariate logistic regression analysis were used to analyze the data. ResultsThe study demonstrated that 59.9% of cases were classified as DF and 40.1% as DHF, with a mean age of 9.99 ± 4.84 years. The mean NLR was 0.99 ± 0.98 in DHF and 1.51 ± 1.38 in DF. Univariate regression analysis stated that NLR≥2 was associated with dengue severity. However, multivariate regression analysis stated that NLR was not a risk factor of dengue severity, adjusted from demographic characteristics and hematologic parameters. Hemoglobin and platelets are the independent factors of dengue severity. ConclusionNeutrophil-to-lymphocyte ratio is a simple biomarker but not a risk factor of dengue fever severity in children. There is evidence suggesting that the relationship between NLR and dengue fever severity is complex, with varying trends in different phases of the disease.
Co-Authors Abdul Latief Azis Adhima, Fauziah AGUNG PRANOTO Agus Budiarto Aras, Jusli Aras, Jusli Aras Arief Rakhman Hakim Ayling Sanjaya Bambang Permono Chairunnisa Desita, Saskia Ratna Dewi, Maharani Sita Dwiyanti Puspitasari, Dwiyanti Egi Azhar Rafsanjani Fandaruzzahra Putri Firyal Nadiah Rahmah Hanna Dyahferi Anomsari Heru Setiawan I Dewa Gede Ugrasena Ida Fitriawati Irwanto Irwanto Irwanto Irwanto Irwanto, Irwanto Ismoedijanto Joshua Teofilus Sutadji Kardani, Astrid Kristina Lilis Sulastri Lukman Oktadianto Magdalena Sidhartani ManikRetno Wahyunitisari Mia Ratwita Andarsini Mohammad Sjaifullah Noer Muhammad Riza Kurniawan Nanan Sekarwana Ni Wayan Tirthaningsih Ninik Asmaningsih Soemyarso Noershanti Ramadhani Oktri Mohammad Firdaus Prastiya Indra Gunawan Putu Dian Saraswati Rebekah Setiabudi, Rebekah Rozalina Loebis, Rozalina Shanty, Maria Christina Sherly Yuniarchan Sherly Yuniarchan, Sherly Soegeng Soegijanto Sri Andreani Utomo, Sri Andreani Susianto, Steven Christian Tirthaningsih, Ni Wajan Tuksin Jearanaiwitayakul Wahyunitisari, Manik Retno Yuni Hisbiiyah