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The relationship between the cycle threshold value of SARS CoV-2 with neutrophil lymphocyte ratio (NLR), absolute lymphocyte count (ALC), severity degrees, long of treatment, and outcomes COVID-19 patients

  • Aina Nurlaila ,
  • Mohamad Isa ,
  • Rahmiati Lao ,
  • Ira Nurrasyidah ,
  • Isa Ansori ,
  • Erna Kusumawardhani ,


Link of Video Abstract:


Background: Coronavirus disease 2019 (COVID-19) has caused serious public health problems since the end of 2019. Viral load is known in COVID-19 infection, which indicates the number of causative agents and is indirectly assessed by the Cycle threshold value (Ct value). Ct value assessment has not been declared an essential parameter in COVID-19 infection. Due to the high number of COVID-19 cases, an additional strategy is needed to help identify patients at high risk of experiencing severe clinical conditions by knowing the relationship between the Ct value of SARS CoV-2 and neutrophil lymphocyte ratio (NLR), absolute lymphocyte count (ALC), severity, length of stay, and outcomes.

Methods: This was an analytic observational study with cross-sectional approach in confirmed COVID-19 patients to investigate the relationship between the Ct value of SARS CoV-2 and NLR, ALC, severity, length of stay, and outcome of COVID-19 patients. There were 337 patients analyzed with chi square test.

Results: The results of this study indicate that the majority of subjects were male (51%), aged <60 years (27%), Ct value ≤29 (70%), had a critical severity (36.5%), length of stay >10 days (64.1%) and survived (74.7%). Inflammatory markers examination shows NLR<3,13 (57.9%) and ALC<1500 (66.2%). The chi-square test shows a significant relationship between Ct value and ALC, degree of severity, and outcome in COVID-19 patients (p <0.05). No association was found between Ct value, NLR, and length of stay (p>0.05).

Conclusion: There is a relationship between Ct value and ALC, degree of severity, and outcome in COVID-19 patients.


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How to Cite

Aina Nurlaila, Mohamad Isa, Rahmiati Lao, Ira Nurrasyidah, Isa Ansori, & Erna Kusumawardhani. (2023). The relationship between the cycle threshold value of SARS CoV-2 with neutrophil lymphocyte ratio (NLR), absolute lymphocyte count (ALC), severity degrees, long of treatment, and outcomes COVID-19 patients. Bali Medical Journal, 12(3), 2484–2487.