KORELASI CYCLE THRESHOLD (CT) VALUE TERHADAP GAMBARAN RADIOGRAFI TORAKS PNEUMONIA COVID-19

DODY SETIAWAN, DR.dr. Bagaswoto P., Sp.Rad(K)RI,Sp.KN,M.Kes,FICA .; DR.dr. Bambang Supriyadi, Sp.Rad (K),MM

2022 | Tesis-Spesialis | RADIOLOGI

Latar belakang: Kasus pneumonia COVID-19 terus meningkat. Baku emas diagnosis COVID-19 adalah RT-PCR, yang biasanya disertai dengan penjabaran Cycle Threshold (CT) value pada hasil pemeriksaan. Diketahui bahwa CT value merupakan salah satu faktor prediktor keparahan penyakit. Tujuan penelitian: Mengetahui korelasi CT value terhadap gambaran radiografi toraks pneumonia COVID-19. Bahan dan Cara: Penelitian ini adalah penelitian observasional analitik korelasi cross- sectional dengan data sekunder secara consecutive nonrandom sampling. Subjek penelitian adalah semua pasien COVID-19 dengan hasil PCR positif dengan gambaran pneumonia typical dengan hasil CT value Gen ORF1ab dan CT value Gen E menggunakan reagen biosensor dilakukan pada pengukuran CT value RT-PCR di RSUP Dr Sardjito periode Mei - Juli 2021. Dilakukan penilaian foto toraks dengan sistem Brixia Score dengan nilai Brixia Score 0-18. Hasil CT value dari pemeriksaan RT-PCR dikorelasikan dengan nilai Brixia Score dengan uji korelasi. Hasil: Didapatkan subjek 38 penelitian yang memenuhi kriteria inklusi dan eksklusi penelitian. Dari 38 subjek penelitian didapatkan jenis kelamin laki-laki lebih banyak yaitu 20 subjek (52,6%), perempuan 18 subjek (47,4%). Dengan sebaran usia <30 tahun sebanyak 2 subjek (5,7%), 31-40 tahun sebanyak 7 subjek (20%), 41-50 tahun sebanyak 4 subjek (11,4%) dan yang paling banyak adalah usia >50 tahun yaitu sebanyak 22 subjek (62,9%). Untuk hasil luaran didapatkan 31 subjek sembuh (81,6%), yang meninggal 4 subjek (10,5%) dan tidak didapatkan data sebanyak 3 subjek (7,9%). Untuk nilai mean Brixia score didapatkan 9,66 +-,53, dan nilai mean CT value Gen ORF1ab 23,72 +- 5,76 serta nilai mean CT Value Gen E 24,07+-5,58. Dari hasil perhitungan dapat diketahui bahwa besar koefisien korelasi (r) antara CT value ORF 1ab dengan Brixia score adalah sebesar -0,102 dengan signifikansi didapati nilai p=0,544 yang berarti bahwa tidak terdapat korelasi yang bermakna secara statistik antara CT value ORF 1ab dengan nilai Brixia score. Kemudian perhitungan diketahui bahwa besar koefisien korelasi (r) antara CT value Gen E dengan Brixia score adalah sebesar -0,053. Dari hasil uji signifikansi didapati nilai p=0,753 yang berarti bahwa juga tidak terdapat korelasi yang bermakna secara statistik antara CT value Gen E dengan nilai Brixia score. Kesimpulan : Tidak terdapat korelasi yang bermakna secara statistik antara CT value Gen ORF1ab dengan Brixia score (p= 0,544) serta tidak terdapat korelasi yang bermakna secara statistik antara CT value Gen E dengan Brixia score (p= 0,753).

Background: Cases of COVID-19 pneumonia continue to increase. The gold standard for the diagnosis of COVID-19 is RT-PCR, which is usually accompanied by a description of the Cycle Threshold (CT) value in the test results. It is known that CT value is one of the predictors of disease severity. Objective: To know the correlation between CT value and chest radiography of COVID-19 pneumonia. Materials and Methods: This study is a cross-sectional correlation analytic observational study with secondary data using consecutive nonrandom sampling. The research subjects were all COVID-19 patients with positive PCR results with a typical pneumonia picture with CT value results for Gene ORF1ab and CT value for Gene E using biosensor reagents carried out on CT value RT-PCR measurements at Dr Sardjito Hospital for the period May - July 2021. An assessment was carried out chest X-ray with the Brixia Score system with a Brixia Score 0-18. The results of the CT value from the RT-PCR examination were correlated with the value of the Brixia Score with the correlation test. Results: There were 38 research subjects who met the inclusion and exclusion criteria of the study. From 38 research subjects, there were more male sex, namely 20 subjects (52.6%), female 18 subjects (47.4%). With age distribution <30 years as many as 2 subjects (5.7%), 31-40 years as many as 7 subjects (20%), 41-50 years as many as 4 subjects (11.4%) and most of them were aged >50 years, as many as 22 subjects (62 ,9%). For the outcome, 31 subjects recovered (81.6%), 4 subjects died (10.5%) and 3 subjects (7.9%). The mean Brixia score was 9.66 3.53, and the mean CT value for the ORF1ab gene was 23.72 5.76 and the mean CT value for Gen E was 24.07 5.58. From the calculation results, it can be seen that the correlation coefficient (r) between the CT value of ORF 1ab and the Brixia score is -0.102 with a significance value of p = 0.544, which means that there is no statistically significant correlation between the CT value of ORF 1ab and the value of the Brixia score. . Then the calculation is known that the correlation coefficient (r) between the CT value of Gen E and the Brixia score is -0.053. From the results of the significance test, it was found that the p value = 0.753, which means that there is also no statistically significant correlation between the CT value of Gen E and the Brixia score. Conclusion: There is no statistically significant correlation between the CT value of Gene ORF1ab and the Brixia score (p= 0.544) and there is no statistically significant correlation between the CT value of Gene E and the Brixia score (p= 0.753).

Kata Kunci : Brixia Score, CT value, COVID-19, chest radiograph.