Correlation between Neutrophil Lymphocyte Ratio (NLR) and the Severity of Dengue Hemorrhagic Fever at Candi Umbul Hospital, Magelang

Dengue hemorrhagic fever (DHF) remains a significant public health concern, especially in tropical and subtropical regions, where early identification of severe cases is crucial to prevent fatal complications. This study investigated the relationship between hematological parameters, namely neutrophil-to-lymphocyte ratio (NLR) and platelet count, and the severity of DHF among adult patients. A retrospective observational study was conducted at Candi Umbul Hospital, Magelang, from June 2024 to April 2025, involving 184 confirmed DHF patients classified into severity Grades I to III. NLR and platelet counts were calculated from complete blood counts taken upon admission. Spearman’s rank correlation test assessed associations between these parameters and disease severity. Results showed a significant negative correlation between NLR and DHF severity (? = -0.356, p < 0.001), indicating lower NLR values in more severe cases. Similarly, platelet count negatively correlated with DHF severity (? = -0.400, p < 0.001), reflecting progressive thrombocytopenia with increased severity. Notably, no significant correlation was found between NLR and platelet count (? = 0.004, p = 0.959), suggesting that these parameters independently reflect different aspects of DHF pathophysiology. The findings highlight that combined NLR and platelet count can improve early detection of high-risk DHF patients by providing complementary insights into the disease’s immunopathology. This underscores the importance of incorporating routine hematological markers in dengue severity assessments to guide timely clinical decisions.