KORELASI NETROPHIL TO LYMPHOCYTE RATIO (NLR) DAN KADAR C-REACTIVE PROTEIN (CRP) PADA PASIEN COVID-19 DI RSUP DR. SARDJITO

Muhammad Bayu Maulidian, Umi S Intansari

2023 | Tesis | S2 Kedokteran Klinik

Latar belakang: Coronavirus Disease 2019 atau COVID-19 adalah penyakit menular yang disebabkan oleh SARS-CoV2. Beberapa penelitian yang menunjukkan bahwa pada pasien COVID-19 dengan gejala berat dapat mengalami respon imun yang terganggu, hal ini dapat menyebabkan perkembangan kondisi hiperinflamasi. Peningkatan NLR mencerminkan ketidakseimbangan respon inflamasi. Terdapat indikator inflamasi yang lain yaitu adalah C-reactive protein (CRP). Peningkatan kadar CRP merupakan penanda inflamasi yang sudah lazim dipakai. C-Reactive protein merupakan golongan protein yang diproduksi dalam hepatosit saat terjadi inflamasi dengan sensitivitas yang baik. Biaya pemeriksaan CRP masih relatif lebih tinggi dan ketersediaan di pelayanan kesehatan primer belum ada. Sampai saat ini belum ada penelitian korelasi NLR dan CRP pada pasien COVID-19 khususnya yang dirawat di RSUP Dr. Sardjito, Yogyakarta.

Tujuan: Penelitian ini bertujuan untuk mengevaluasi bagaimana korelasi NLR dengan kadar CRP pada pasien COVID-19 yang dirawat inap RSUP Dr. Sardjito.

Metode: Penelitian dilakukan dengan desain observasional analitik menggunakan data sekunder pada pasien COVID-19yang dirawat di RSUP Dr. Sardjito. Data diambil berdasarkan hasil PCR di laboratorium biomolekular di Instalasi Laboratorium Terpadu, kemudian subjek penelitian dipilih berdasarkan kriteria inklusi yaitu pasien rawat inap ³ 18 tahun yang menjalani perawatan dengan protokol COVID-19 di RSUP Dr. Sardjito dan memiliki hasil pemeriksaan NLR dan CRP dalam 24 jam saat terdiagnosis Covid-19. Analisis data dasar secara deskriptif, ditampilkan dalam median (minimal–maksimal). Data kategorikal disajikan dalam proporsi. Data yang dianalisis secara statistik adalah pemeriksaan NLR dan CRP dengan uji korelasi Spearman nilai p <0>

Hasil: Didapatkan 277 subjek penelitian, terdiri dari pasien COVID-19 dengan usia 57 (18-90) tahun, 56% pria dan 44% wanita. Didapatkan median NLR 6,24 (0,78 – 81,1) dan kadar CRP 77 (4-151) mg/L. Pada penelitian ini didapatkan koefisien korelasi antara NLR dan kadar CRP sebesar r=0,487; p<0>

Backgrounds: Coronavirus Disease 2019 or COVID-19 is an infectious disease caused by SARS-CoV2. Several studies have shown that  COVID-19 patients with severe symptoms may have impaired immune responses, which can lead to the development of hyperinflammatory conditions. An increase in NLR reflects an imbalance of the inflammatory response. There is another indicator of inflammation, namely C-reactive protein (CRP). Elevated CRP levels are a commonly used marker of inflammation. C-reactive protein is a class of proteins produced in hepatocytes during inflammation with high sensitivity. The cost of CRP examination is still relatively pricey and availability in primary health services is not yet available. Until now there has been no research on the correlation of NLR and CRP in COVID-19 patients, especially those treated at Dr. Sardjito, Yogyakarta

Objective: This study aims to evaluate how NLR correlates with CRP levels in COVID-19 patients hospitalized at RSUP Dr. Sardjito.

Method: The research was an analytical observational design using secondary data on COVID-19 patients treated at RSUP Dr. Sardjito. Data was taken based on PCR results in the biomolecular laboratory at the Integrated Laboratory Installation, then research subjects were selected based on inclusion criteria, namely inpatients aged ?18 years who were undergoing treatment with the COVID-19 protocol at RSUP Dr. Sardjito and had NLR and CRP examination results within 24 hours when diagnosed with Covid-19. Basic data analysis is descriptive, displayed in median (minimum–maximum). Categorical data are presented in proportions. Data that were analyzed statistically were NLR and CRP examinations with the Spearman correlation test, a p-value <0>

Results: There were 277 research subjects, consisting of COVID-19 patients aged 57 (18-90) years, 56% men and 44% women. There was a median NLR of 6.24 (0.78 – 81.1) and a CRP level of 77 (4-151) mg/L. In this study, the correlation coefficient between NLR and CRP levels was r=0.487; p<0>

Kata Kunci : Kata kunci: COVID-19, hiperinflamasi, neutrophil to lymphocyte ratio (NLR), CRP (C-reactive protein) ?