Peranan Interleukin-6 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 | S2 Kedokteran 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. Peningkatan kadar IL-6 berkorelasi positif dengan peningkatan replikasi virus dan persistensi infeksi virus. Hasil penelitian IL-6 dan hubungannya dengan kematian pada COVID-19 bervariasi di berbagai negara. Peran IL-6 sebagai faktor prognosis kematian pasien COVID-19 khususnya di RSUP Dr. Sardjito, Yogyakarta belum banyak diteliti. Tujuan: untuk mengetahui kemampuan IL-6 dengan cut off > 80 pg/mL sebagai faktor prognosis dalam memprediksi kematian pasien COVID-19 di RSUP Dr. Sardjito Yogyakarta. Metode: Penelitian observasional kohort retrospektif ini dengan kriteria inklusi:pasien COVID-19 di RSUP Dr. Sardjito yang terkonfirmasi melalui RT-PCR, usia ? 18 tahun, dan memiliki data pemeriksaan IL-6 pada hari pertama kunjungan. Kriteria eksklusi: pasien HIV, kehamilan, penggunaan obat imunosupresan dan data yang tidak lengkap. Hasil data pemeriksaan IL-6 dengan cut off > 80 pg/mL ditetapkan sebagai faktor risiko. Luaran klinis pasien berdasarkan data rekam medis berupa meninggal atau bertahan hidup dicatat dengan maksimal pengamatan 30 hari pasca kunjungan hari pertama. Risiko kematian dianalisis dengan uji chi square dan perhitungan risiko relatif dengan menggunakan software SPSS versi 25 dengan kemaknaan p<0>

Background: Mortality from COVID-19 is 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. Increased IL-6 levels are positively correlated with increased viral replication and persistence of infection. Research results on IL-6 and its relationship to mortality in COVID-19 vary across countries. The role of IL-6 as a prognostic factor for the death of COVID-19 patients, especially at Dr. Sardjito, Yogyakarta, has not been studied much. Aims: This study aims to examine the ability of IL-6 with a cut-off of > 80 pg/mL as a prognostic factor in predicting the mortality of COVID-19 patients. Methods: This retrospective cohort observational study with inclusion criteria: COVID-19 patients at Dr Sardjito whom RT-PCR confirmed, aged ? 18 years, and had IL-6 examination data on the first day of the visit, with exclusion criteria are HIV patients, pregnancy, use of mmunosuppressant drugs, and incomplete data. The results of the IL-6 examination data with a cut-off of > 80 pg/mL are defined as risk factors. Clinical outcomes of patients based on medical record data in the form of non-survival or survival are recorded with a maximum of 30 days of observation after the first visit. The mortality risk was analyzed using relative risk with a significance p<0>

Kata Kunci : COVID-19, interleukin-6 (IL-6), faktor prognosis, kematian, interleukin-6, prognostic factors, mortality