Background: Following the initial appearance of coronavirus disease 2019 (COVID-19) in December 2019, approximately 23 million cases have been documented worldwide, illustrating its devastation. Inflammation plays a role in both COVID-19 and burn pathophysiology. Despite the necessity of understanding this impact, few research studies explore the influence of COVID-19, a novel disease, on burns. The neutrophil-to-lymphocyte ratio (NLR) is a simple and inexpensive test that can be used to detect the overall status of inflammation. The NLR has not been thoroughly examined in people with COVID-19 and burns. In this study, the value of NLR less than 72 hours since a burn accident as a risk factor for mortality in burn patients with and without COVID-19 will be evaluated. Methods: A retrospective study was conducted between April 2020 and March 2022 at the Dr. Soetomo General Academic Hospital in East Java, Indonesia. We collected the following variable data: gender, age, cause of burn, co-morbidities, percentage of the total body surface area (%TBSA), length of stay (LoS), mortality outcome, and neutrophil and lymphocyte counts. The NLR is the ratio between the absolute neutrophil and lymphocyte counts. The data were analysed using Chi-Square and Mann-Whitney tests. The difference will be considered significant if the p value is < 0.05. Results: Based on data from 126 burn patients with and without COVID-19, the mean and standard deviation (SD) NLR for non-survivor patients were higher (12.05 and 9.7, respectively) than those for survivor patients (7.92 and 5.9, respectively). The receiver operating characteristic (ROC) curve analysis showed the area under ROC curve (AUC) for NLR value was 0.626 (95% confidence interval (CI): 0.535-0.71), which was statistically significant, namely the NLR cut-off value > 6.97 with a sensitivity value of 64.3%, a specificity of 59.5%, and a p value of 0.021. The risk of mortality with an NLR > 6.97 has an accuracy of 61.11%, a negative predictive value of 76.92%, and a positive predictive value of 44.26%. Conclusion: Our study showed that NLR is associated with the risk of mortality in burn patients, regardless of the presence or absence of COVID-19, and that it can be used as a low-cost, readily accessible approach to identify indications of intensive care monitoring for patients.

COVID-19

mortality

neutrophil-lymphocyte ratio

NLR

burn