Skripsi

Association Between Pre-existing Cardiovascular Disease and In-Hospital Mortality of COVID-19 Patients at National Cardiovascular Center Harapan Kita = Hubungan antara Riwayat Penyakit Jantung dan Angka Kematian pada Pasien COVID-19 di Rumah Sakit Harapan Kita.

Latar belakang: Beberapa faktor risiko terkait dengan angka kematian COVID-19 telah diidentifikasi, antara lain usia tua, laki-laki, perokok, dan memiliki komorbiditas. Di antara banyak penyakit penyerta, penyakit kardiovaskular dikenal sebagai penyebab utama kematian di dunia. Penelitian ini bertujuan untuk mengetahui hubungan antara riwayat penyakit jantung dan angka kematian pada pasien COVID-19.
Metode: Studi potong lintang ini dilakukan di Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita, Kota Bambu Utara, Jakarta Barat. Data penelitian ini diambil dari registri COVID-19 periode Juni hingga Agustus 2021.
Hasil: Dari 439 pasien yang dilibatkan dalam penelitian, 238 pasien (54,2%) memiliki setidaknya satu riwayat penyakit jantung dan 201 pasien lainnya (45,8%) tidak memiliki riwayat penyakit jantung. Riwayat penyakit jantung yang termasuk dalam penelitian ini adalah gagal jantung, penyakit jantung koroner, penyakit katup jantung, dan aritmia. Sedangkan faktor risiko lain yang diteliti dalam penelitian ini antara lain hipertensi, diabetes, dislipidemia, riwayat merokok, asma, dan PPOK. Profil klinis pasien yang akan dianalisis adalah IMT, tekanan darah, denyut nadi, saturasi oksigen, CT value, NLR, infiltrat pada rontgen toraks, dan D-dimer. Sebanyak 134 pasien (30,5%) dilaporkan meninggal dan 305 pasien (69,5%) dilaporkan masih hidup. Analisis bivariat menunjukkan bahwa usia tua (p = 0,000; OR = 2,27), denyut nadi cepat (p = 0,017; OR = 1,69), saturasi oksigen rendah (p = 0,000; OR = 4,62), NLR tinggi (p = 0,000; OR = 3,10), D-dimer tinggi (p = 0,001; OR = 2,07), PJK (p = 0,018; OR = 1,64), hipertensi (p = 0,008; OR = 1,76), dan diabetes (p = 0,001; OR = 2,00) memiliki hubungan yang signifikan secara statistik dengan kematian pada pasien COVID-19. Selain itu, peluang kematian pada pasien COVID-19 meningkat ketika terdapat dua atau lebih faktor risiko (p = 0,001; OR = 2,42). Setelah faktor-faktor lain dikendalikan, saturasi oksigen (AOR = 5,06), NLR (AOR = 3,12), gagal jantung (AOR = 2,90), dan diabetes (AOR = 2,63) ditemukan lebih signifikan secara independen.
Kesimpulan: Beberapa riwayat penyakit jantung berhubungan dengan kematian pada pasien COVID-19. Di samping itu, faktor risiko dan profil klinis pasien juga berperan dalam tingkat kematian yang lebih tinggi.

Kata kunci: Riwayat penyakit jantung, angka kematian, COVID-19




Introduction: Several risk factors related to the COVID-19 mortality rate have been identified, including old age, male, smoking, and having comorbidities. Among many comorbidities, cardiovascular disease is known as the leading cause of death in the world. This study aims to determine the relationship between a history of heart disease and mortality in COVID-19 patients.
Method: This cross-sectional study was conducted at The National Cardiovascular Center Harapan Kita, North Bambu City, West Jakarta. The data for this study were taken from the COVID-19 registry from the period June to August 2021.
Result: Of the 439 patients included in the study, 238 patients (54.2%) had at least one history of heart disease and 201 patients (45.8%) had no history of heart disease. Pre-existing cardiovascular diseases included in this study were heart failure, coronary heart disease, heart valve disease, and arrhythmias. Meanwhile, other risk factors studied in this study include hypertension, diabetes, dyslipidemia, smoking history, asthma, and COPD. The clinical profiles of the patients to be analyzed are BMI, blood pressure, pulse, oxygen saturation, CT value, NLR, infiltrates on chest X-ray, and D-dimer. A total of 134 patients (30.5%) were reported to have died and 305 patients (69.5%) were reported to be alive. Bivariate analysis showed that old age (p = 0.000; OR = 2.27), rapid heart rate (p = 0.017; OR = 1.69), low oxygen saturation (p = 0.000; OR = 4.62), high NLR (p = 0.000; OR = 3.10), high D-dimer (p = 0.001; OR = 2.07), CAD (p = 0.018; OR = 1.64), hypertension (p = 0.008; OR = 1.76), and diabetes (p = 0.001; OR = 2.00) had statistically significant associations with mortality in COVID-19 patients. In addition, the odds of death in COVID-19 patients increased when two or more risk factors were present (p = 0.001; OR = 2.42). After other factors were controlled, oxygen saturation (AOR = 5.06), NLR (AOR = 3.12), heart failure (AOR = 2.90), and diabetes (AOR = 2.63) were found to be more significant independently.
Conclusion: Some pre-existing cardiovascular diseases were associated with death in COVID-19 patients. In addition, risk factors and patients’ clinical profiles also play a role in higher mortality rate.

Keywords: Pre-existing cardiovascular disease, in-hospital mortality, COVID-19