Peranan Subset Limfosit T sebagai Faktor Prognosis dalam Memprediksi Kematian Pasien COVID-19

Komang Agus Trisna Amijaya, Dr. dr. Umi Solekhah Intansari, M.Kes., Sp.PK(K.; dr. E. Henny Herningtyas., MSi., Ph.D., Sp.PK(K)

2023 | Tesis-Spesialis | S2 Ilmu Patologi Klinik

Latar belakang: Kematian akibat COVID-19 masih cukup tinggi di berbagai wilayah menjadi fokus perawatan saat pandemi COVID-19. Identifikasi faktor risiko kematian sangat penting dalam upaya pencegahan kematian pasien COVID-19. Peningkatan respon inflamasi berhubungan dengan risiko kematian pada pasien COVID-19. Kejadian limfopenia memiliki angka prevalensi yang paling tinggi di antara penurunan penanda hematologi lainnya dan dapat menjadi faktor  risiko kematian. Hasil penelitian subset limfosit T belum banyak dan hubungannya dengan kematian pada COVID-19 masih kontradiktif. Peran pengukuran subset limfosit T yang dihubungkan dengan kematian pasien COVID-19 khususnya di RSUP Dr. Sardjito, Yogyakarta belum pernah diteliti. Tujuan: Untuk mengkaji kemampuan subset limfosit T sebagai faktor prognosis dalam memprediksi kematian pasien COVID-19 di RSUP Dr. Sardjito Yogyakarta. Metode: Penelitian observasional kohort prospektif ini dengan kriteria inklusi: pasien COVID-19 di RSUP Dr. Sardjito yang terkonfirmasi melalui RT-PCR, usia ? 18 tahun, dan memiliki sampel dan hasil pemeriksaan darah lengkap pada hari pertama kunjungan. Kriteria eksklusi: pasien HIV, kehamilan dan penggunaan obat imunosupresan. Pemeriksaan subset limfosit T  dengan metode flow cytometry menggunakan alat BD FACSCanto™ II yang dilakukan pada hari pertama perawatan. Hasil subset limfosit T dibagi berdasarkan cut-off sel T CD3+ <500 xss=removed xss=removed xss=removed>

Background: Mortality from COVID-19 are still relatively high in various regions and is the focus of treatment during the COVID-19 pandemic. Identification of risk factors for death is crucial in efforts to prevent the death of COVID-19 patients. The increased inflammatory response is associated with the risk of mortality in COVID-19 patients. Lymphopenia has the highest prevalence rate among other hematological markers and can be a risk factor for mortality. The results of research on T lymphocyte subsets are few, and their relationship with death in COVID-19 is still contradictory. The role of measuring the T lymphocyte subset in being associated with the mortality of COVID-19 patients, especially at Dr Sardjito, Yogyakarta, has never been studied. Aims: This study aims to determine the ability of the T lymphocyte subset as a prognostic factor in predicting the mortality of COVID-19 patients at Dr Sardjito Yogyakarta. Methods:  This prospective cohort observational  study with inclusion criteria: COVID-19 patients at Dr Sardjito whom RT-PCR confirmed, aged ? 18 years, and had a sample and complete blood test results on the first day of the visit —the Exclusion criteria: HIV patients, pregnancy and use of immunosuppressant drugs. Examination of the T lymphocyte subset using the flow cytometry method using the BD FACSCanto™ II tool was carried out on the first day of treatment. The results of the T lymphocyte subset were divided based on the cut-off of CD3+ T cells <500 RR=  RR=16,04; xss=removed>

Kata Kunci : COVID-19, subset limfositT, faktor prognosis, kematian, T lymphocyte subset, prognostic factors, mortality