HUBUNGAN JUMLAH SEL NATURAL KILLER DAN KADAR SITOKIN DI DARAH TEPI DENGAN DERAJAT KEPARAHAN PASIEN COVID-19

NINDA DEVITA, Dr. dr. Umi Solekhah Intansari, M.Kes Sp.PK(K); dr. Rina Susilowati, Ph.D

2022 | Tesis | MAGISTER ILMU BIOMEDIK

Latar Belakang: Infeksi virus SARS-CoV-2 pada COVID-19 dapat menyebabkan gejala berat hingga kematian. Limfopenia dan badai sitokin dianggap berperan dalam patofisiologi penyakit. Penelitian sebelumnya tentang sel NK dan sitokin yang mempengaruhi fungsi sel NK dengan derajat keparahan COVID-19 memberikan hasil yang berbeda. Penelitian ini akan mengklarifikasi hal tersebut. Tujuan Penelitian: Penelitian ini bertujuan untuk mengetahui hubungan jumlah sel NK dan kadar sitokin IFN-γ, IL-10, IL-12 dengan derajat keparahan pasien COVID 19. Metode Penelitian: Sebanyak 63 pasien COVID-19 yang menjalani rawat inap di RSUP dr. Sardjito Yogyakarta masuk sebagai subjek penelitian. Subjek dibagi menjadi kelompok derajat ringan-sedang dan berat-kritis. Kedua kelompok dilakukan pemeriksaan jumlah sel NK IFN-γ, IL-10, IL-12 dengan flowsitometri. Perbedaan jumlah sel NK dan kadar sitokin IFN-γ, IL-10, IL,12 antar kelompok dianalisis dengan uji Mann Whitney. Korelasi antara jumlah sel NK dengan kadar sitokin IFN-γ, IL-10, IL,12 dianalisis dengan uji korelasi Spearman Hasil: Sebanyak 53,4% subjek masuk derajat ringan-sedang. Jumlah sel NK pada kelompok derajat berat kritis lebih rendah dibandingkan kelompok ringan sedang (208,55 vs 251,85 sel/ μL, p=0,048). Median kadar IL-10 lebih tinggi pada kelompok berat-kritis (p=0,049). Namun median kadar IFN-γ dan IL-12 tidak berbeda antar kelompok. Jumlah sel NK tidak berkorelasi dengan kadar IFN-γ, IL-10, dan IL-12. Simpulan: Terdapat hubungan antara jumlah sel NK derajat keparahan pasien COVID-19.

Background: SARS-CoV-2 virus infection in COVID-19 can cause severe symptoms. Lymphopenia and cytokine storm to play a role in the pathophysiology. Previous studies on NK cells and cytokines that affect NK cell function with the severity of COVID-19 have different results. This study want to clarify. Objective: This study aims to determine relationship between the number of NK cells and levels of cytokines IFN-γ, IL-10, IL-12 with severity of COVID 19 patients. Methods: A total of 63 COVID-19 patients who were hospitalized at Sardjito Hospital were included. Subject were divided to mild-moderate symptom and severe-critical symptom. Both groups were examined for the number of NK cells IFN-γ, IL-10, IL-12 by flow cytometry. Differences in the number of NK cells and cytokine levels of IFN-γ, IL-10, IL,12 between groups were analyzed by Mann Whitney test. Correlation between the number of NK cells and levels of cytokines IFN-γ, IL-10, IL,12 was analyzed by Spearman correlation test. Results: A total of 53.4% of subjects have mild-moderate symptom. Number of NK cells in the critically severe group was lower than mild-moderate group (208.55 vs. 251.85 cells/μL, p=0.048). Median levels of IL-10 were higher in the severe-critical group (p=0.049). Median level of IFN-γ and IL-12 were not different between two groups. Number of NK cells was not correlated with the levels of IFN-γ, IL-10 and IL-12. Conclusions: There is a relationship between the number of NK cells and severity of COVID-19 patients.

Kata Kunci : COVID-19, derajat keparahan, sel NK, sitokin