DOI: https://doi.org/10.14710/jai.v13i2.37050

Hubungan Penanda Infeksi, Penanda Oksigenasi, dan Faktor Risiko Lainnya terhadap Mortalitas Pasien COVID-19 dengan Pneumonia Saat Admisi di Unit Perawatan Intensif RSUP Dr. Wahidin Sudirohusodo

Departemen Anestesiologi dan Terapi Intensif, Fakultas Kedokteran, Universitas Hasanuddin, Makassar, Indonesia

Received: 4 Mar 2021; Published: 1 Jul 2021.
Open Access Copyright 2021 JAI (Jurnal Anestesiologi Indonesia)

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Abstract

Latar Belakang: Organisasi Kesehatan Dunia (WHO) mendeklarasikan penyebaran dari coronavirus disease 2019 (COVID-19). Faktor risiko terhadap mortalitas pasien COVID-19 rawat intensive care unit (ICU) belum banyak diteliti.

Tujuan: Mengetahui hubungan penanda infeksi, penanda oksigenasi dan faktor risiko lainnya terhadap mortalitas pasien COVID-19 dengan pneumonia.

Metode: Penelitian retrospektif dilakukan di ICU Infection Centre RSUP Dr. Wahidin Sudirohusodo, Makassar pada April – Agustus 2020. Sampel penelitian adalah data pasien COVID-19 dengan pneumonia yang dirawat di ICU. Pasien dibagi ke dalam dua kelompok survivor grup (SG) dan non-survivor (NSG). Variabel penelitian berupa penanda infeksi, penanda oksigenasi dan faktor risiko yang didapatkan dari rekam medis pasien. Analisis bivariat dan multivariat dilakukan terhadap semua variabel penelitian.

Hasil: Dari 92 pasien didapatkan 46 NSG dan 46 SG. Perbandingan jenis kelamin dan indeks massa tubuh antara kedua kelompok tidak signifikan bermakna secara statistik. Tidak didapatkan perbedaan signifikan secara statistik pada level c-reactive protein (CRP) antara kelompok NSG dengan median 91,1 (IQR 32,3-200,45) dan SG 88,95 (IQR 33,50-177,80), p= 0,899. Faktor risiko usia tua, diabetes mellitus (DM), dan peningkatan rasio neutrofil-limfosit (RNL) berdasarkan klasifikasi cut-off signifikan secara statistik pada mortalitas antar kedua kelompok.  Pada NSG didapatkan median usia 60,5 (IQR 53-67,25) vs SG 56 (IQR 35-61,25), p= 0.02. Komorbid DM SG 8 dari 46 pasien (17,4%) dan NSG 17 dari 46 pasien (37%), p = 0,035. Pemeriksaan kadar RNL berdasarkan klasifikasi cut-off > 3,4 NSG 42 dari 46 pasien (91,3%) dan NS 11 dari 46 (23,9%), p= 0,048.  Analisis multivariat regresi logistik didapatkan rasio P/F merupakan faktor risiko independen. Mortalitas pasien COVID-19 dengan pneumonia (OR 0,99 95% CI 0,988-1,00, p = 0,043).  

Kesimpulan: Umur di atas 60 tahun, DM, RNL, dan indeks oksigenasi bermakna secara signifikan terhadap kejadian mortalitas pasien COVID-19 dengan pneumonia, dimana pada indeks oksigenasi yang rendah didapatkan kejadian mortalitas yang tinggi.

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Keywords: COVID-19; faktor risiko; mortalitas; parameter oksigenasi; penanda inflamasi; pneumonia

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  1. Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, et al. Dysregulation of immune response in patients with coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020; 20(20):4-10
  2. Kementerian Kesehatan RI. Pedoman pencegahan dan pengendalian coronavirus disesase Indonesia. 2020
  3. Haimovich A, Ravindra NG, et al. Development and validation of the COVID-19 severity index (CSI): a prognostic tool for early respiratory decompensation. medRxiv [Internet]. 2020;2020.05.07.20094573. Available from: http://medrxiv.org/content/early/2020/05/14/2020.05.07.20094573.abstract
  4. Li H, Wang S, Zhong F, Bao W, Li Y, Liu L, et al. Age-dependent risks of incidence and mortality of COVID-19 in Hubei province and other parts in China. Front Med. 2020;7(190):1-6
  5. Islam N, Khunti K, Dambha-Miller H, Kawachi I, Marmot M. COVID-19 mortality: a complex interplay of sex, gender, and ethnicity. Europe J Pub Health. 2020;30(5):847-8
  6. Iaccaroni G, Grassi G, Borghi C, Ferri C, Salvetti M, et al. Age and multimorbidity predict death among COVID-19 patients; results of the SARS-RAS study of the Italian society of hypertension. Hypertension. 2020;1-
  7. Tartof SY, Qian L, Hong V, Wei R, Nadjafi RF, Fischer H, et al. Obesity and mortality among patients diagnosed with COVID-19: results from an integrated health care organization. Annals Intern Med. 2020;1-10
  8. Lippi G, Wong J, Henry BM. Hypertension and its severity or mortality in coronavirus disease 2019 (COVID-19): a pooled analysis. Polish Arch Intern Med. 2020;1-22
  9. Mehra MR, Desai SS, Kuy SR, Henry TD, Patel AN. Cardiovascular disease, drug therapy, and mortality in Covid-19. New Eng J Med. 2020;1-8
  10. Cheng Y, Luo R, Wang K, Yao Y, Ge S, Xu G. kidney disease is associated with in-hospital death of patients with COVID-19. Kidney Inter. 2020;97(5):P829-38
  11. Reddy RK, Charles WN, Sklavounos A, Dutt A, Seed PT, Khajuria A. The effect of smoking on COVID-19 severity: a systematic review and meta-analysis. J Med Virol. 2020;1-12
  12. Roncon L, Zuin M, Rigatelli G, Zuliani G. Diabetic patients with COVID-19 infection are at higher risk of ICU admission and poor short-term outcome. J Clin Virol. 2020;127:1-5
  13. Singh AK, Gupta R, Ghosh A, Misra A. Diabetes in COVID-19: prevalence, pathophysiology, prognosis and practical considerations. Diabet Metab Synd: Clin Res Rev. 2020;14:303-10
  14. Li N, Kong H, Zheng XZ, Li XY, Ma J, Zhang H, et al. Early predictive factors of progression from severe type to critical ill type in patients with coronavirus disease 2019: a retrospective cohort study. Plos One. 2020;1-13
  15. Seyit M, Avci E, Nar R, Senol H, Yilmaz A, Ozen M, Oskay A, Aybek H. Neutrophil to lymphocyte ratio, lymphocyte to monocyte ratio and platelet to lymphocyte ratio to predict the severity of COVID-19. Am J Emerg Med. 2021
  16. Huang I, Pranata R. Lymphopenia in severe coronavirus disease-2019 (COVID-19): systematic review and meta-analysis. J Intens Care. 2020;8(36):1-10
  17. Lin S, Mao W, Zou Q, Lu S, Zheng S. Associations between hematological parameters and disease severity in patients with SARS-CoV-2 infection. J Clin Lab Anal. 2021 Jan;35(1):e23604. doi: 10.1002/jcla.23604.Epub2020Nov13.PMID:33184946;PMCID:PMC7843261
  18. Li N, Kong H, Zheng XZ, Li XY, Ma J, Zhang H, et al. Early predictive factors of progression from severe type to critical ill type in patients with Coronavirus Disease 2019: a retrospective cohort study. Plos One. 2020;1-13
  19. Shang W, Dong J, Ren Y, Tian M, Li W, Hu J. the value of clinical parameters in predicting the severity of COVID-19. J Med Virol. 2020;92(10):2188-92
  20. Ma A, Cheng J, et al. Neutrophil-to-lymphocyte ratio as a predictive biomarker for moderate-severe ARDS in severe COVID-19 patients. Crit Care. 2020;24(1):288
  21. Xiaomin L, Wei Z, et al. Prognostic value of C-reactive protein in patients with COVID-19, Clinical Infectious Diseases, , ciaa641, Oxford University Press for the Infectious Diseases Society of America; 2020. p. 1–21
  22. Luzy L, Radaelli MG. Influenza and obesity: its odd relationship and the lessons for COVID 19 pandemic. Acta Diabetologica.2020(57);759–64
  23. Yamada T, Wakabayashi M, Yamaji T, Chopra N, Mikami T, Miyashita H, et al. Value of leukocytosis and elevated C-Reactive protein in predicting severe coronavirus
  24. Hernandez-Romieu AC, Adelman MW, Hockstein MA, Robichaux CJ, Edwards JA, Fazio JC, et al. timing of intubation and mortality among critically ill coronavirus disease 2019 patients: a single-center cohort study. 2020;48(11):e1045-53
  25. COVID-UPO Clinical Team, Sainaghi PP. Fatality rate and predictors of mortality in a large Italian cohort of hospitalized COVID-19 patients. Res Squar. 2020;1-19

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