Relationship of Depression, Anxiety, and Stress (DASS-21), Saliva Cortisol Levels, Platelet-Lymphocyte Ratio with Severity in COVID-19

Background: COVID-19 causes physical and psychological stressors. The aim of this study is to analyze the relationship depression, anxiety, stress levels (DASS-21), salivary cortisol, platelet-lymphocyte ratio (PLR) with severity in patients. Methods: This a cohort prospective study. Inclusion criteria were new patient at isolation room Dr. Soetomo Hospital Surabaya confirmed COVID-19, 21-60 years, could answer questionnaire. Measurements DASS-21, cortisol (at 7-9 a.m), PLR, carried out on day-0, 3, 6 during hospitalization. Bivariate multivariate (logistic regression) analyses conducted assess between variables. Results: 46 subjects included On there 34.8% very severe anxiety. DASS-21 score PLR decreased significantly day-3 6. anxiety (p=0.002), lymphocyte (p=0.000), (p=0.032) different mild-moderate group day-0. In group, lower than group. day-3, depression (p=0.021), (p=0.001), (p=0.025), (p=0.005) analysis, days 0 3 (respectively OR=1.015, p=0.012 OR=1.010, p=0.013) level (OR=1.225, p=0.019) had significant effect COVID-19. Conclusion: Salivary was day 0. day-0 independent factors related case. Improvements all variables followed by decreasing severity.