Lestar, Sakina and dr. Badrul Munir, Sp. S (K) and Dr. dr. Masruroh Rahayu,, M.Kes and Dr. dr. Agustin Iskandar, M.Kes, Sp.PK (K) (2023) Perbandingan antara Kadar TNF- dan IL-6 dengan Luaran Mortalitas pada Pasien CVA Trombosis Terkonfirmasi COVID-19 dan CVA Trombosis tanpa COVID-19 Di RSUD Dr. Saiful Anwar Malang. Magister thesis, Universitas Brawijaya.
Abstract
COVID-19 merupakan suatu kasus infeksi yang disebabkan oleh virus SARS�COV-2 yang muncul sejak akhir tahun 2019. COVID-19 sendiri selain menyebabkan gejala pernapasan, juga dapat menyebabkan gejala pada organ lain seperti pada sistem saraf. Kondisi stroke akut merupakan suatu kegawatan medis. Pada pasien COVID-19, Stroke iskemik, stroke perdarahan dan cerebral venous trombosis dilaporkan banyak terjadi dengan frekwensi yang berbeda. Proporsi pasien dengan COVID-19 yang juga memiliki stroke iskemik sebanyak 4.9%. Dalam sebuah studi melaporkan kejadian Acute Cerebrovascular Disease pada pasien COVID-19 berkisar 8,1%. Beberapa sitokin (IL-6 dan TNF-) dapat digunakan secara tersendiri untuk penanda penyakit yang berat. TNF- dan IL-6 merupakan salah satu prediktor severity dari COVID-19 dan terkait keluaran klinis pada pasien stroke dengan maupun tanpa COVID-19 dan dikarenakan dalam beberapa literatur didapatkan adanya korelasi yang kuat antara TNF- dan IL-6 dengan COVID-19 dan stroke trombosis. Namun, perlu diteliti kembali peran IL-6 dan TNF- pada pasien COVID�19 untuk dibandingkan luaran klinisnya dengan pasien non COVID-19. Penelitian ini dilakukan untuk mengetahui perbedaan kadar TNF- dan IL-6 dengan luaran mortalitas pada pasien CVA trombosis terkonfirmasi COVID-19 dan CVA trombosis tanpa COVID-19 di RSUD Dr. Saiful Anwar Malang sehingga diharapkan kedua biomarker tersebut dapat digunakan dalam stratifikasi pasien COVID-19 dengan CVA trombosis. Penelitian ini adalah observasional analitik dengan metode cohort prospektif yang menilai perbandingan kadar IL-6 dan TNF- pada pasien CVA trombosis terkonfirmasi COVID-19 dan pasien CVA trombosis tanpa COVID-19. Penegakan diagnosis COVID-19 dengan menggunakan RT-PCR SARS-COV-2 dengan menggunakan metode swab pada nasofaring dan orofaring. Pengambilan sampel dilakukan dengan rentang waktu perawatan 1 sampai 7 hari. Teknik sampling yang digunakan adalah nonprobability total sampling pada pasien di Rumah Sakit Saiful Anwar Malang sejak April 2020 hingga April 2023 dengan melibatkan 15 pasien CVA vii trombosis, 8 pasien CVA trombosis dengan COVID-19 dan 15 pasien COVID-19 yang telah dipilih melalui kriteria inklusi dalam kurun waktu tertentu yang telah ditetapkan.
English Abstract
COVID-19 is a case of infection caused by the SARS-COV-2 virus which appeared at the end of 2019. Apart from causing respiratory symptoms, COVID-19 itself can also cause symptoms in other organs such as the nervous system. Acute stroke is a medical emergency. In COVID-19 patients, ischemic stroke, hemorrhagic stroke and cerebral venous thrombosis have been reported to occur with different frequencies. The proportion of patients with COVID-19 who also had an ischemic stroke was 4.9%. In a study, the incidence of Acute Cerebrovascular Disease in COVID-19 patients was around 8.1%. Some cytokines (IL-6 and TNF-) can be used alone as markers of severe disease. TNF- and IL-6 are predictors of the severity of COVID-19 and are related to clinical outcomes in stroke patients with and without COVID-19 and because in several literatures it has been found that there is a strong correlation between TNF- and IL-6 with COVID-19 and thrombotic stroke. However, it is necessary to re-examine the role of IL-6 and TNF- in COVID-19 patients to compare clinical outcomes with non-COVID-19 patients. This research was conducted to determine the difference in levels of TNF- and IL-6 with mortality outcomes in patients with CVA thrombosis confirmed with COVID-19 and CVA thrombosis without COVID-19 at RSUD Dr. Saiful Anwar Malang so it is hoped that these two biomarkers can be used in stratifying COVID-19 patients with CVA thrombosis. The method used in this study was observational analytic with a prospective cohort method that assessed the relationship between IL-6 and TNF- levels in thrombosis CVA patients confirmed with COVID-19 and CVA thrombosis patients without COVID-19. Establishing the diagnosis of COVID-19 using RT-PCR SARS�COV-2 using the swab method on the nasopharynx and oropharynx. Sampling was carried out over a treatment period of 1 to 7 days. The sampling technique used was nonprobability total sampling on patients at Saiful Anwar Hospital Malang from April 2020 to April 2023 involving 15 CVA thrombosis patients, 8 CVA thrombosis patients ix with COVID-19 and 15 COVID-19 patients who had been selected based on the inclusion criteria in a certain period of time that has been determined.
| Item Type: | Thesis (Magister) |
|---|---|
| Identification Number: | 042306 |
| Divisions: | Profesi Kedokteran > Spesialis Neurologi, Fakultas Kedokteran |
| Depositing User: | Endang Susworini |
| Date Deposited: | 23 Feb 2024 03:59 |
| Last Modified: | 23 Feb 2024 03:59 |
| URI: | http://repository.ub.ac.id/id/eprint/216193 |
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