Korelasi Parameter Tromboelastografi dengan C-Reactive Protein (CRP) Pada Pasien COVID-19

Ika Hariyani, Dr. dr. Usi Sukorini, M.Kes., Sp.PK(K).; dr. Ira Puspitawati, M.Kes., Sp.PK(K),

2023 | Tesis | S2 Kedokteran Klinik

Latar belakang: Salah satu manifestasi klinis yang berat dari COVID-19 adalah COVID-19 associated coagulopathy (CAC) yang ditandai dengan hiperkoagulasi, dan keadaan protrombosis dengan peningkatan risiko terjadinya trombosis. Pemeriksaan tromboelastografi (TEG) dapat mengetahui kejadian hiperkoagulasi pada pasien COVID-19. C-reactive protein (CRP) merupakan biomarker yang baik untuk mendeteksi keparahan penyakit pada pasien COVID-19. Saat ini belum ada penelitian terkait korelasi antara parameter tromboelastografi (R, K, ?-angle, MA, Ly30, dan CI) dengan kadar CRP pada pasien COVID-19 di Yogyakarta, khususnya RSUP Dr. Sardjito. Tujuan: Mengetahui korelasi antara parameter tromboelastografi (R, K, ?-angle, MA, Ly30, dan CI) dan kadar CRP pada pasien COVID-19 di RSUP Dr. Sardjito. Metode: Penelitian ini menggunakan desain observasional potong lintang dengan subjek penelitian yaitu pasien terdiagnosis COVID-19 derajat berat yang dirawat inap intensif. Kriteria inklusi adalah pasien terkonfirmasi COVID-19 melalui RT- PCR, berusia ?18 tahun, dan memiliki hasil pemeriksaan TEG dan CRP pada saat rawat inap intensif dengan perbedaan waktu pemeriksaan TEG dan CRP kurang dari 24 jam. Kriteria eksklusi adalah pasien yang sebelumnya menggunakan antikoagulan, leukemia, kehamilan, deep vein thrombosis (DVT), dan acute limb ischemia (ALI). Data dasar ditampilkan secara deskriptif. Untuk mengetahui korelasi antara parameter TEG dan kadar CRP dilakukan uji korelasi Pearson untuk data yang terdistribusi normal dan Spearman untuk data yang tidak terdistribusi normal dengan p<0 xss=removed xss=removed xss=removed xss=removed xss=removed xss=removed xss=removed xss=removed xss=removed>

Background: One of the severe clinical manifestations of COVID-19 is COVID-19 associated coagulopathy (CAC) which is characterized by hypercoagulation and a prothrombotic state with an increased risk of thrombosis. Thromboelastography (TEG) examination can determine the incidence of hypercoagulability in COVID-19 patients. C-reactive protein (CRP) is a good biomarker for detecting disease severity in COVID-19 patients. Currently there is no study that correlates between thromboelastographic parameters (R, K, ?-angle, MA, Ly30, and CI) and CRP levels in COVID-19 patients in Yogyakarta, especially at Dr. Sardjito Hospital. Objective: To determine the correlation between thromboelastographic parameters (R, K, ?-angle, MA, Ly30, and CI) and CRP levels in COVID-19 patients at Dr. Sardjito Hospital. Methods: This study used a cross-sectional observational design with subjects patients diagnosed with severe COVID-19 who were in intensive care unit. Inclusion criterias were patients with confirmed COVID-19 through RT-PCR, aged ?18 years, and had TEG and CRP examination results during intensive care with a difference in TEG and CRP examination times of less than 24 hours. Exclusion criteria were patients who had previously used anticoagulants, leukemia, pregnancy, deep vein thrombosis, and acute limb ischemia. Baseline data were displayed descriptively. To determine the correlation between TEG parameters and CRP level, Pearsons correlation was performed for normally distributed data and Spearmans correlation for non-normally distributed data with p<0 xss=removed xss=removed xss=removed xss=removed xss=removed xss=removed xss=removed xss=removed xss=removed>

Kata Kunci : COVID-19, hiperkoagulasi, tromboelastografi, C-reactive protein, hypercoagulable, tromboelastography