Skripsi

Studi retrospektif pengaruh pemberian heparin terhadap perbaikan klinis, jumlah trombosit dan d-dimer pada pasien covid-19 kondisi sedang-berat = Retrospective study of the efficacy of heparin towards clinical improvements, thrombocytes, and d-dimer level in moderate-severe covid-19 patients.

Latar Belakang Heparin dapat digunakan sebagai terapi bagi pasien COVID-19. Namun, indikasi dan efeknya masih berbeda di berbagai penelitian. Oleh karena itu, penelitian ini bertujuan untuk menilai efektivitas pemberian heparin dalam menurunkan keparahan gejala klinis Metode Studi retrospektif dilakukan dari rekam medis pasien COVID-19 kondisi sedang-berat yang dirawat di Rumah Sakit Universitas Indonesia (RSUI). Parameter yang diperiksa adalah kondisi klinis pasien (tingkat mortalitas dan total lama perawatan), kadar Ddimer, dan trombosit pada dua kelompok, kelompok yang diberikan heparin dan yang tidak. Hasil Penelitian ini menyertakan 110 subjek penelitian yang mayoritas terdiri atas laki-laki (59,1%) dengan proporsi lebih besar dijumpai pada kelompok heparin (67,2% vs 21 32,8%). Selain itu, rerata usia subjek penelitian pada kelompok heparin juga lebih tua dibandingkan kontrol (57,02 ± 11,725 vs 54,39 ± 11,405 tahun). Kelompok heparin juga memiliki proporsi komorbiditas yang lebih tinggi dibandingkan kontrol (90,6% vs 70,9%). Proporsi tiga komorbiditas terbesar adalah kardiovaskular (64,5%), diabetes mellitus (33.6%) dan respirasi kronis (12,7%). Lalu, dalam segi pengobatan, semua pasien dalam penelitian ini diberikan obat-obatan anti-viral dan kelompok heparin menerima lebih banyak pengobatan kortikosteroid dibandingkan kelompok kontrol (89,5% vs 30,4%). Dari hasil secara klinis, terdapat tingkat mortalitas yang lebih tinggi pada kelompok heparin dibandingkan kontrol (45,3% vs 5 10,9%); (p < 0,01)). Namun, heparin tidak memberikan efek yang signifikan terhadap lama rawat pasien. Pada pengecekan laboratorium, heparin menurunkan kadar D-dimer dan trombosit secara signifikan (p < 0,01). Kesimpulan Kelompok pasien COVID-19 yang diberikan heparin memiliki tingkat mortalitas yang tinggi, tetapi kadar D-dimer dan trombosit menurun dibandingkan kelompok kontrol.
Kata Kunci: Heparin, mortalitas, lama rawat, D-Dimer, trombosit


Introduction Heparin can be used as therapy for COVID-19 patients. However, the indications and effects still differ in various studies. Therefore, this study aims to assess the effectiveness of heparin administration in reducing the severity of clinical symptoms Method A retrospective study was conducted from medical records of moderate-severe COVID- 19 patients treated at the University of Indonesia Hospital (RSUI). The parameters examined were the patient's clinical condition (mortality rate and total length of treatment), D-dimer levels, and platelets in two groups, those given heparin and those not. Results This study was followed by 110 research subjects, the majority of which consisted of male (59.1%) with a greater proportion found in the heparin group (67.2% vs. 32.8%). In addition, the mean age of the study subjects in the heparin group was also older than the controls (57.02 ± 11.725 vs 54.39 ± 11.405 years). The heparin group also had a higher proportion of comorbidities than the control group (90.6% vs 70.9%). The three largest proportions of comorbidities were cardiovascular (64.5%), diabetes mellitus (33.6%) and chronic respiration (12.7%). Then, in terms of treatment, all patients in this study were given anti-viral drugs and the heparin group received more corticosteroid treatment than the control group (89.5% vs 30.4%). From the clinical results, there was a higher mortality rate in the heparin group than the control (45.3% vs. 10.9%); (p < 0.01)). However, heparin did not have a significant effect on patient length of stay. In terms of laboratory checks, heparin significantly reduced D-dimer and platelet levels (p < 0.01). Conclusion The group of COVID-19 patients given heparin had a high mortality rate, but D-dimer and platelet levels decreased compared to the control group.
Keywords: Heparine, mortality, length of stay, d-dimer, thrombocycte