Tesis

Profil Kadar Vitamin D dan Hubungannya dengan Derajat Keparahan Klinis serta Parameter Inflamasi pada Pasien Terkonfirmasi COVID-19 = Vitamin D Status and Its Association with Clinical Severity and Inflammatory Markers of COVID-19 Patients.

Latar belakang: Data yang ada saat ini belum terlalu adekuat untuk menunjukkan perbedaan kadar vitamin D pada berbagai derajat klinis COVID-19 di Indonesia. Oleh sebab itu, diperlukan bukti pendahuluan mengenai profil kadar vitamin D dan hubungannya terhadap berbagai derajat keparahan klinis dan parameter inflamasi pasien terkonfirmasi COVID-19. Tujuan: Mengetahui profil kadar vitamin D dan hubungannya dengan derajat keparahan klinis dan parameter inflamasi pada pasien terkonfirmasi COVID-19. Metode: Penelitian potong lintang ini dilakukan di RSUPN Cipto Mangunkusumo dan RS Darurat COVID-19 Wisma Atlet pada periode Januari – Desember 2021. Kriteria inklusi adalah usia 18 tahun ke atas dan terkonfirmasi COVID-19 melalui swab orofaring polymerase chain reaction (PCR) SARS-CoV-2. Kriteria eksklusi adalah pasien yang menolak berpartisipasi. Terdapat dua jenis pengambilan data pada penelitian, yaitu data primer (kami melakukan pengambilan data kadar vitamin D serum pasien saat pasien masuk pelayanan) dan data sekunder (rekam medis pasien). Hasil: Dari 96 subjek penelitian, 77,08% mengalami defisiensi vitamin D. Tidak ada hubungan signifikan antara status vitamin D dengan derajat keparahan klinis pasien terkonfirmasi COVID-19 (OR 1,16 (0,61 – 2,23); p = 0,641). Tidak terdapat hubungan signifikan antara kadar vitamin D dan parameter inflamasi, antara lain CRP kuantitatif (OR 1,51 (0,35 – 0,64); p = 0,691), D-dimer (OR 0,97 (0,35 – 2,69); p = 0,956), dan rasio neutrofil – limfosit (OR 1,08 (0,35 – 3,34); p = 0,883). Kesimpulan: Mayoritas pasien terkonfirmasi COVID-19 memiliki defisiensi vitamin D. Kadar vitamin D tidak memiliki hubungan signifikan dengan derajat keparahan klinis dan parameter inflamasi pada pasien terkonfirmasi COVID-19.
Kata kunci: derajat keparahan klinis, kadar vitamin D, parameter inflamasi, pasien terkonfirmasi COVID-19


Background: Previous studies were inadequate to determine association between vitamin D and COVID-19 clinical severity in Indonesia. Therefore, it is necessary to obtain preliminary evidence on vitamin D status and its association with clinical severity of COVID-19 patients, along with inflammatory markers. Objective: To determine vitamin D status profile and its association with clinical severity of COVID-19 patients, along with inflammatory markers. Method: This cross-sectional study was conducted at Cipto Mangunkusumo Hospital and Wisma Atlet COVID-19 Emergency Hospital in January – December 2021 . Inclusion criteria were 18-year-old subjects and confirmation of COVID-19 status with COVID-19 polymerase chain reaction (PCR) from oropharyngeal swab. Exclusion critera were subjects refusing to participate in the study. There were two types of data in this study, which were primary data (we obtained serum vitamin D from patients at the time of their admission) and secondary data (medical records of patients). Results: Out of 96 subjects, 77,08% had vitamin D deficiency. There was no significant association between vitamin D status and COVID-19 clinical severity (OR 1.16 (0.61 – 2.23); p = 0.641). There was no significant association between vitamin D status and inflammatory markers, which were quantitative CRP (OR 1.51 (0.35 – 0.64); p = 0.691), D-dimer (OR 0.97 (0.35 – 2.69); p = 0.956), and neutrophil-lymphocyte ratio (OR 1.08 (0.35 – 3.34); p = 0.883). Conclusion: Majority of COVID-19 patients had vitamin D deficiency. Vitamin D status was not significantly associated with COVID-19 clinical severity and inflammatory markers. Keywords: COVID-19 patients, clinical severity, inflammatory markers, vitamin D status