Tesis

Hubungan Kadar C-Reactive Protein (CRP) dan Ferritin Serum Terhadap Luaran Pasien Coronavirus 2019 (COVID19) Terkonfirmasi di RSUP Persahabatan = Association between serum c-reactive protein (CRP) and ferritin and the clinical outcomes of COVID-19 confirmed patients treated at Persahabatan Hospital, Jakarta, Indonesia.

Latar belakang: Kondisi badai inflamasi pada patogenesis progresi penyakit COVID-19 dapat berakibat fatal. Pasien COVID-19 dengan kondisi kritis memiliki kadar sitokin plasma yang lebih tinggi. C-reactive protein (CRP) dan ferritin serum merupakan penanda inflamasi yang rutin diperiksa dan meningkat pada sebagian besar pasien COVID-19. Peran nilai CRP dan ferritin serum sebagai penanda inflamasi perlu ditelaah lebih lanjut. Tujuan penelitian: Mengetahui hubungan antara kadar CRP serum dan ferritin serum terhadap luaran pasien COVID-19 terkonfirmasi di RSUP Persahabatan Metode penelitian: Analisis observasional kohort retrospektif terhadap pasien COVID-19 terkonfirmasi yang di rawat di RSUP Persahabatan secara consecutive sampling dari bulan Oktober 2020 sampai dengan Maret 2021. Kami meninjau 232 rekam medis pasien terkonfirmasi yang memenuhi kriteria inklusi. Hasil penelitian: Rerata usia pasien pada penelitian ini adalah 52,51 tahun, didominasi oleh laki-laki sebanyak 50,9%. Derajat penyakit pasien paling banyak adalah berat-kritis sebesar 72,4%. Proporsi pasien dengan komorbid sebanyak 76,29%. Median lama rawat adalah 9 hari. Pasien meninggal sebanyak 66 orang (28,4%).Nilai median CRP dan ferritin awal pasien adalah 55, 5 mg/L (0.2-345,7 mg/L) dan 648,8 mg/L (0,38-11139,4 mg/L), secara berurutan. Terdapat hubungan antara nilai CRP (p=0,000) dan nilai ferritin serum (p=0,000) terhadap luaran pasien. Kesimpulan : Nilai CRP dan ferritin awal perawatan pasien COVID-19 terkonfirmasi di RSUP Persahabatan berhubungan dengan luaran dan tatalaksana pasien.
Kata Kunci : Coronavirus disease 2019, C-reactive protein, ferritin serum, mortalitas.


Backgrounds : Cytokine storm or hyperinflamation can occur in COVID-19 which could cause unfavourable outcome in patients. Critically-ill COVID-19 confirmed patient has higher plasma cytokine level. Serum c-reactive protein(CRP) and ferritin are known as inflammation markers in several diseases. The role of these biomarkers for hyperinflammation in COVID-19 is yet to be explored in this study. Aims : To identify the association between serum CRP and ferritin of COVID-19 confirmed patients and their clinical outcomes during their treatment in Persahabatan Hospital, Jakarta, Indonesia. Methods : We performed observational retrospective cohort analysis of COVID19 confirmed patients treated at the study site. Subject recruited from a consecutive sampling were COVID-19 confirmed patients between October 2020 until March 2021 . We reviewed the medical record of 232 patients whom met the inclusion criteria. Result : Mean age of patients in this study were 52.51 years old, predominantly males (50.9%). Most of the patients were presented with severe-to-critically ill (72.4%) and presented with comorbidities (76.29%). Hypertension was the most frequent comorbidity and followed by diabetic mellitus. Length of hospital stay was 9 days. The mortality was in 66 cases (28,4%). The median of serum CRP and ferritin levels were 55.5 mg/L (0.2-345.7 mg/L) and 648.8 mcg/L (0.38- 11139.4 mcg/L). There were an association between serum CRP (p=0.000) and ferritin levels (p=0.000) with patient outcomes. Conclusion : Serum CRP and ferritin levels were associated with the clinical outcomes of COVID-19 confirmed patients treated at the study site.
Keywords : Coronavirus disease 2019, C-reactive protein, ferritin serum, mortality.