<![CDATA[Dengue Hemorrhagic Fever (DHF) remains a major public health problem in Indonesia, with high morbidity and mortality rates. The Neutrophil-to-Lymphocyte Ratio (NLR) is a simple hematological parameter that reflects systemic inflammation and has potential as a biomarker of DHF severity. However, previous studies have reported inconsistent findings regarding this association. This study aimed to analyze the correlation between NLR and DHF severity in hospitalized patients at Purwokerto Islamic Hospital. An analytical observational study with a retrospective cohort design was conducted using medical records of DHF patients hospitalized from January 2024 to December 2025. Of 326 medical records screened using total sampling, 103 patients met the inclusion and exclusion criteria. NLR values were analyzed serially on the fourth, fifth, and sixth days of hospitalization. The correlation between NLR and DHF severity was analyzed using Spearman's rank correlation test with a significance level of p < 0.05. Among the 103 patients, 53 (51.5%) had Grade I DHF and 50 (48.5%) had Grade II DHF. The median NLR decreased from 2.44 on day 4 to 1.51 on day 5 and 1.15 on day 6. No significant correlation was found between NLR and DHF severity on day 4 (r = -0.077; p = 0.439), day 5 (r = -0.030; p = 0.763), or day 6 (r = 0.022; p = 0.829). Therefore, NLR cannot yet be used as a standalone biomarker for assessing DHF severity.]]>
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