PERAN DISGLIKEMIA TERHADAP KADAR IL-6 DAN MORTALITAS PADA PASIEN COVID-19 DERAJAT SEDANG-BERAT

EVA NIAMUZISILAWATI, dr. M. Robikhul Ihsan, Sp.PD., KEMD, M.Kes ;dr. Vina Yanti Susanti, Sp.PD., KEMD, Ph.D

2022 | Tesis-Subspesialis | SUBSPESIALIS ILMU PENYAKIT DALAM

Latar Belakang: Coronavirus Disease 2019 (COVID-19) merupakan permasalahan kesehatan global yang disebabkan oleh infeksi Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2). Infeksi COVID-19 menyebabkan proses inflamasi ditandai tingginya kadar sitokin pro-inflamasi diantaranya IL-6. Disglikemia merupakan abnormalitas indeks glikemik yang meliputi diabetes melitus (DM), prediabetes dan hipoglikemia. Disglikemia dihubungkan dengan low grade inflammation yang ditandai tingginya kadar IL-6. Infeksi COVID-19 disertai adanya disglikemia memicu peningkatan kadar IL-6 yang dapat menimbulkan �badai sitokin� yang meningkatkan mortalitas. Metode: Penelitian adalah penelitian observasional analitik model cohort restrospektif. Sampel penelitian adalah pasien COVID-19 terkonfirmasi yang dirawat di RSUD Dr. Moewardi Surakarta. Sampel dibedakan menjadi dua kelompok besar yaitu kelompok non-disglikemia dan disglikemia. Analisis statistik awal dilakukan untuk mencari cut off IL-6 yang menjadi prediktor buruknya outcome. Analisis lanjutan dilakukan dengan uji binary logistic regression dan multivariate logistic regression. Hasil: Didapatkan pengaruh disglikemia terhadap IL-6 (p 0.003; OR 1.78;95%CI 1.21-2.62) dan disglikemia terhadap mortalitas Covid-19 (p 0.000; OR 2.15; 95%CI 1.46-3.17). penelitian ini didapatkan model prediktor mortalitas Covid-19 meliputi variabel IL-6, derajat covid-19, D-dimer, HsCRP, Komorbid dan lama perawatan. Kesimpulan: Terdapat pengaruh disglikemia terhadap tingginya kadar IL-6 dan mortalitas Covid-19 derajat sedang-berat Kata kunci: disglikemia, COVID-19, IL-6, outcome

Background: Coronavirus Disease 2019 (COVID-19) is global health problems that caused by Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2). Coronavirus Disease 2019 infection can cause inflammation and increase cytokine pro-inflammation especially IL-6. Disglycemia is an abnormality in glucose index such as diabetes melitus, prediabetes, and hypoglycemia. Disglycemia is associated with low grade inflammation that represent with high cytokine proinflammation such as IL-6. Coronavirus Disease 2019 infection with disglycemia as a comorbid can cause elevated in IL-6 concentration that leads to cytokine storm caused mortality. Metode: this study is an observational analytic with restrospective cohort model. Sample in this study was COVID-19 inpatient in RSUD Dr. Moewardi Surakarta hospital. Sample divided into two big groups, non-disglycemia and disglycemia. First statistic analysis was performed to find Cut Off IL-6 that represent as a bad predictor to outcome. Following analysis are done with binary logistic regression and multivariate logistic regression. Result: The effect of dysglycemia on IL-6 (p 0.003; OR 1.78; 95% CI 1.21-2.62) and dysglycemia on Covid-19 mortality (p 0.000; OR 2.15; 95%CI 1.46-3.17). In this study, it was found that the predictor models of Covid-19 mortality included IL-6 variables, the degree of covid-19, D-dimer, hsCRP, comorbidities and length of treatment. Conclusion: There is an effect of dysglycemia on high levels of IL-6 and moderate to severe Covid-19 mortality

Kata Kunci : disglikemia, COVID-19, IL-6, outcome