Putri, Ayu Sekarani Damana and Dr. dr. Cesarius Singgih Wahono,, SpPD, K-R, FINASIM and dr. Herwindo Pudjo Bramantya,, SpPD, K-HOM (2024) Pengaruh Komorbid Hipertensi Terhadap Efektivitas Vaksin dan Kadar Antibodi Anti Spike-Receptor Binding Domain (S-RBD) pada Tenaga Kesehatan yang Diberikan Vaksinasi Coronavac. Tesis Program Pendidikan Dokter Spesialis I Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Brawijaya, RSUD Dr Saiful Anwar Malang. Magister thesis, Universitas Brawijaya.
Abstract
Pendahuluan : Hipertensi merupakan komorbiditas yang paling banyak pada pasien yang terinfeksi COVID-19 dan berkaitan dengan peningkatan derajat keparahan, resiko rawat inap dan mortalitas. Tujuan: Untuk menganalisis pengaruh hipertensi terhadap kadar antibodi S-RBD SARS-CoV-2 dan efektivitas vaksinasi CoronaVac pada tenaga kesehatan. Metode: Penelitian ini merupakan penelitian kohort prospektif yang dilakukan pada 155 petugas kesehatan Rumah Sakit Umum Saiful Anwar,Malang,Indonesia yang berusia 18-59 tahun dan telah menerima dua kali suntikan vaksin CoronaVac dengan interval 14 hari. Hipertensi didiagnosis menurut kriteria International Society of Hypertension tahun 2020. Subjek dipantau selama 24 minggu. Perbedaan kadar antibodi S-RBD antara kelompok hipertensi dan normotensi dianalisa dengan uji mann-whitney. Hubungan antara status komorbid hipertensi dengan kadar antibodi S-RBD, kejadian infeksi Covid-19 pasca vaksinasi, dan derajat keparahan infeksi Covid-19 pasca vaksinasi dianalisis dengan uji regresi logistic. Hasil: Penelitian ini menunjukkan 18,7% subjek (29 orang) didiagnosis dengan hipertensi. Pada minggu ke-6 paska vaksinasi, kadar anti-SRBD kelompok hipertensi secara signifikan lebih rendah dari kelompok normotensi (24.82+13.06 vs 44.31+27.06, p=0.004). Sebaliknya, kadar anti-SRBD tidak berbeda signifikan pada follow-up minggu ke-24. Kelompok hipertensi memiliki risiko 2.57 kali lipat terinfeksi COVID-19 dengan rerata waktu 4.9 bulan (uji log-rank,p=0,03;95%CI (1.06-4.39),p=0.009). Kelompok hipertensi juga beresiko 5.5 kali lipat (95%CI(1.19-25.68),p=0.029) menderita infeksi Covid-19 simptomatik dan 6.1 kali lipat (95%CI(1.12-33.19),p=0.036) memerlukan rawat inap di rumah sakit saat terinfeksi Covid-19. Kesimpulan: Komorbid hipertensi berhubungan dengan efektivitas vaksin yang lebih rendah pada petugas kesehatan.
English Abstract
BACKGROUND: CoronaVac, Indonesia's first authorized COVID-19 vaccine, remains the most widely used inactivated coronavirus vaccine in developing countries. Hypertension increases the risk of severe infection and death due to Covid-19 by 2-3 times. OBJECTIVE: This study assesses anti-S-RBD antibody levels and the vaccine's effectiveness among health care workers with hypertensive patients. METHODS: A prospective cohort study was conducted at Saiful Anwar General Hospital in Malang, Indonesia, involving 155 healthcare workers who received two doses of CoronaVac with a 14-day interval. Subjects were monitored for 24 weeks. Mann-Whitney and Wilcoxon signed-rank test analyzed differences in S-RBD antibody levels between hypertensive and normotensive groups. Logistic regression analyzed the relationship between hypertension status, S-RBD antibody levels, and post-vaccination COVID-19 infection incidence and severity. RESULTS: 29 of 155 (18.7%) participants were diagnosed with hypertension. At week 6 post-vaccination, the anti-S-RBD level in the hypertensive group was significantly lower than that in the normotensive group (24.82±13.06 vs. 44.31±27.06,p=0.004). However, anti-S-RBD levels were not significantly different at week 24 post-vaccination. The hypertensive group had a 2.57 times higher risk of getting infected with COVID-19, and the mean time to infection was 4.9 months (log rank test p=0.031, HR 2.57, 95%CI 1.06-4.39, p= 0.009). Additionally, the hypertensive group had a 5.5-fold increased risk of symptomatic infection (95%CI 1.19-25.68, p=0.029) and a 6.1-fold increased risk of requiring hospitalization when infected with COVID-19 (95%CI 1.12-33.19,p= 0.036). CONCLUSION: Hypertension was associated with lower vaccine effectiveness in healthcare workers.
| Item Type: | Thesis (Magister) |
|---|---|
| Identification Number: | 0424060136 |
| Uncontrolled Keywords: | Hipertensi, antibodi anti S-RBD, covid-19, vaksinasi CoronaVac |
| Divisions: | Profesi Kedokteran > Spesialis Ilmu Penyakit Dalam, Fakultas Kedokteran |
| Depositing User: | Unnamed user with username nova |
| Date Deposited: | 28 Nov 2024 06:35 |
| Last Modified: | 28 Nov 2024 06:35 |
| URI: | http://repository.ub.ac.id/id/eprint/233070 |
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