Hubungan Ketidakseimbangan Elektrolit dengan Kematian pada Pasien Covid-19 di RSUP Dr. Sardjito Yogyakarta

Afik Maulana Rachman, dr. Raden Heru Prasanto, SpPD-KGH .; dr. Rizka Humardewayanti Asdie, SpPD-KPTI

2023 | Tesis-Spesialis | S2 Ilmu Penyakit Dalam

Latar Belakang: Coronavirus Disease 2019 (COVID-19) mengalami peningkatan kasus yang berlangsung cepat dan menyebar ke berbagai negara dengan angka kematian sebanyak 4.500.667 (2,1%) di dunia dan sebesar 3.3% di Indonesia. Infeksi SARS-CoV-2 ke dalam tubuh terjadi melalui pengikatan antara reseptor angiotensin converting enzyme 2 (ACE2) dengan protein permukaan virus. Reseptor ACE2 ditemukan pada saluran pernapasan, ginjal, dan gastrointestinal, kedua organ tersebut memiliki peran esensial dalam keseimbangan elektrolit, sehingga gangguan pada dua sistem tersebut dapat menyebabkan abnormalitas kadar elektrolit. Dari penelitian yang telah dilakukan sebelumnya diketahui bahwa ketidakseimbangan elektrolit dapat berdampak pada perjalanan penyakit COVID-19 dan keluaran penyakit, sehingga diperlukan penelitian lebih lanjut khususnya di Yogyakarta. Tujuan: Mengetahui hubungan ketidakseimbangan elektrolit dengan kematian pada pasien COVID-19 di RSUP dr. Sardjito Yogyakarta. Metode: Penelitian observasional cohort retrospektif pada Juli-Desember 2021 dari rekam medis elektronik pasien didiagnosis COVID-19 yang memenuhi kriteria inklusi dan eksklusi. Analisa statistik bivariat menggunakan uji Chi-Square dengan variabel kategorik 2 kelompok tidak berpasangan, dan menghitung OR (Odds ratio) untuk mengetahui hubungan ketidakseimbangan elektrolit terhadap kematian pada pasien COVID-19. Apabila hasil analisis bivariat didapatkan nilai p <0 OR=11,5, CI=5,38-24,53. OR=4,61), OR=17,47), OR=12,61), OR=9,92), OR=7,03), OR=4,71).Kesimpulan:>

Background: Corona virus Disease 2019 (COVID-19) has rapid increase in cases and spread to various countries with a mortality rate of 4.500,667 (21%) in the world and 3.3% in Indonesia. SARS-CoV-2 infection into the body occurs through binding between angiotensin converting enzyme 2 (ACE) receptors and viral surface proteins ACE2 receptors are found in the respiratory, renal and gastrointestinal tracts, both organs have an essential role in electrolyte balance, so disturbances in these two systems can cause abnormalities in electrolyte levels. From previous studies, the electrolyte imbalance would be to poor prognosis in hospitalized coronavirus disease, so further research is needed, especially in Yogyakarta. Objective: To determine the relationship between electrolyte imbalance and COVID-19 mortality at Sardjito Hospital Yogyakarta. Methods: Retrospective cohort observational study in July until December 2021 from electronic medical records of patients diagnosed with COVID-19 who met the inclusion and exclusion criteria. Bivariate statistical analysis using the Chi-Square test with categorical variables of 2 unpaired groups, and calculating the OR (Odds ratio) to determine the relationship between electrolyte imbalance and COVID-19 mortality followed by multivariate analysis test with Logistic Regression to assess which variable was the most statistically significant. Results: Total of 180 COVID-19 patients with median age of 53 years. There were 86 patients with normal electrolytes (47.8%) and 94 patients with electrolyte imbalance (52.2%). In bivariate analysis that electrolyte abnormalities (hyponatremia, hyperkalemia, hypochloremia), are significantly related to COVID-19 mortality with p<0 OR=11.5, CI=5.38-24.53. OR=4.61), OR=17.47), OR=12.61), OR=9.92), OR=7.03), OR=4,71).>

Kata Kunci : COVID-19, ketidakseimbangan elektrolit, kematian pada rawat ina, electrolyte imbalance, In-hospital mortality