Tesis

Hubungan galaktomanan serum pasien COVID-19 dengan diagnosis COVID-19 Associated Pulmonary Aspergillosis (CAPA) = Correlation between serum galactomannan of COVID-19 patients and diagnosis of COVID-19 associated pulmonary aspergillosis (CAPA).

Latar belakang: Aspergillus adalah jamur saprofit di alam dan mudah terhirup ke dalam saluran napas. Pada pasien dengan gangguan sistem imun, Aspergillus dapat menimbulkan gangguan kesehatan, termasuk penyakit aspergilosis paru invasif (API). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) adalah penyebab COVID-19 yang dapat mengganggu imunitas lokal saluran napas. Kondisi tersebut memudahkan Aspergillus melakukan invasi ke jaringan paru dan menyebabkan COVID- 19-associated pulmonary aspergillosis (CAPA). Deteksi galaktomanan (GM) serum dapat membantu diagnosis CAPA. Penelitian ini bertujuan untuk mengetahui hubungan GM serum pasien COVID-19 dengan kejadian CAPA. Metode: Penelitian potong lintang ini dilaksanakan pada Agustus 2022-Juni 2023. Data GM serum diperoleh dari Laboratorium Parasitologi Klinik FKUI, sedangkan data klinis dan radiologis pasien COVID-19 diperoleh dari salah satu rumah sakit swasta di Jakarta. Analisis statistik dilakukan untuk mencari hubungan GM serum dengan diagnosis CAPA. Hasil: Proporsi hasil GM serum positif didapatkan pada 24 (43,6%) dari 55 pasien COVID-19 yang diteliti. Dari 22 pasien probable CAPA, penyakit penyerta terbanyak adalah hipertensi (51,7%), diikuti IMT overweight (77,27%). Gejala klinis terbanyak adalah batuk (95,45%), demam (86,36%) dan sesak napas (68,18%). Faktor risiko CAPA belum dapat ditentukan dalam penelitian ini. Hasil GM serum tidak menunjukkan hubungan secara statistik dengan kejadian CAPA. Kesimpulan: Deteksi GM serum pada 55 pasien COVID-19 menunjukkan hasil positif 43,6%. Pada penelitian ini tidak ditemukan hubungan antara GM serum dengan kejadian CAPA.
Kata kunci: aspergilosis invasif, COVID-19, galaktomanan


Background: Aspergillus, a ubiquitous saprophytic fungus, is easily inhaled into the respiratory tract. In patients with impaired immune systems, Aspergillus can cause health disorders, including invasive pulmonary aspergillosis (IPA). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of COVID-19, which can disrupt local airway immunity. These conditions make Aspergillus easier to invade lung tissue and cause COVID-19-associated pulmonary aspergillosis (CAPA). Serum galactomannan (GM) detection can support the diagnosis of CAPA. This study aimed to determine the relationship between the serum GM of COVID-19 patients and the diagnosis of CAPA. Methods: This cross-sectional study was conducted in August 2022-June 2023. Serum GM data were obtained from the Clinical Parasitology Laboratory FMUI, while clinical and radiological data of COVID-19 patients were obtained from a private hospital in Jakarta. Statistical analysis was conducted to determine the relationship between serum GM and CAPA diagnosis. Results: The proportion of positive serum GM results was found in 24 (43.6%) of the 55 COVID-19 patients studied. Furthermore, of the 22 probable CAPA patients, the most comorbid disease were hypertension (51.7%), followed by overweight BMI (77.27%). The most clinical symptoms were cough (95.45%), fever (86.36%) and shortness of breath (68.18%). The risk factors of CAPA could not be determined in this study. Serum GM results showed no statistical association with the incidence of CAPA. Conclusion: Detection of serum GM in 55 COVID-19 patients showed a positive result of 43.6%. There was no association between serum GM and CAPA events in this study.
Keywords: COVID-19, galactomannan, invasive aspergillosis