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Profil Koagulasi Pasien COVID-19 yang Mendapat Terapi Antikoagulan di ICU

*Muhammad Yunus  -  , Indonesia

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Abstract

Latar belakang: Penyakit coronavirus 2019 (COVID-19) melibatkan banyak sistem termasuk kardiovaskular, pernapasan, gastrointestinal, neurologis, hematopoietik dan imun. Gangguan koagulasi pada pasien COVID-19 telah dilaporkan pada beberapa penelitian. Di Indonesia, penelitian mengenai profil koagulasi pada pasien sakit kitis dengan COVID-19 yang bertahan hidup dan tidak bertahan hidup dan mendapat terapi antikoagulan masih belum diteliti secara luas, sementara jumlah penderita dan mortalitas terus bertambah. Tujuan: Mengetahui perbandingan profil koagulasi pasien COVID-19 yang bertahan hidup dan yang tidak bertahan hidup yang mendapatkan terapi antikoagulan di Intensive Care Unit (ICU) Infection Centre RS Wahidin Sudirohusodo, Makassar. Metode: Desain penelitian retrospektif menggunakan data rekam medis pasien COVID-19 yang mendapatkan terapi antikoagulan di ICU Infection Centre RSUP Dr. Wahidin Sudirohusodo Makassar mulai tanggal Maret hingga November 2020. Data yang diambil mencakup identitas, usia, jenis kelamin, dan indeks massa tubuh. Hasil pemeriksaan penunjang mencakup trombosit, PT, APTT, INR dan D-Dimer. Hasil pemeriksaan didapatkan dari data saat pasien dirawat di ICU sebelum diberikan antikoagulan dan 5-7 hari sesudah pemberian antikoagulan. Hasil: Dari 106 subyek, 58 subyek bertahan hidup dan 48 subyek tidak bertahan hidup. Pada kelompok tidak bertahan hidup, rerata kadar D-Dimer di hari ketujuh perawatan ICU meningkat secara signifikan dan lebih tinggi dibandingkan kelompok bertahan hidup. Perbandingan rerata PT, aPTT, INR, dan trombosit saat masuk ICU dan pada hari ketujuh tidak menunjukkan perbedaan yang signifikan secara statistik. Kesimpulan: Profil koagulasi pasien COVID-19 yang mendapat terapi antikoagulan sebanding antara kelompok yang bertahan hidup dan yang tidak bertahan hidup kecuali kadar D-dimer yang lebih baik pada kelompok yang bertahan hidup.

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Keywords: antikoagulan; COVID-19; hematologi; koagulasi; unit perawatan intensif

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