GAMBARAN PENGGUNAAN ANTIKOAGULAN PADA PASIEN COVID-19 DI SALAH SATU RUMAH SAKIT RUJUKAN COVID-19 DI KOTA SEMARANG
DOI:
https://doi.org/10.46984/sebatik.v25i2.1619Keywords:
Terapi Antikoagulan, COVID-19, Nilai D-DimerAbstract
laboratorium serta terjadinya inflamasi akut pada pasien COVID-19. Penanda hasil laboratorium yang dapat digunakan sebagai parameter abnormalitas koagulasi pada pasien adalah D-Dimer. Beberapa studi telah menggambarkan manfaat dari penggunaan antikoagulan pada pasien COVID-19 untuk mencegah terjadinya risiko trombosis koagulopati. Studi ini masih terbatas dilakukan di Indonesia maka dari itu penelitian ini dilakukan sebagai langkah awal untuk meneliti pola dari penggunaan antikoagulan pada penderita SARS-CoV-2 yang menjalani perawatan di salah satu fasilitas kesehatan rumah sakit rujukan COVID-19 dengan melihat dampaknya terhadap parameter nilai D-Dimer. Tujuan penelitian ini adalah untuk mengidentifikasi penggunaan antikoagulan pada pasien COVID-19 dan melihat pengaruhnya terhadap nilai D-Dimer. Penelitian ini merupakan penelitian deskriptif retrospektif dengan model rancangan belah lintang (cross-sectional study). Pada studi ini menggambarkan bahwa pasien laki-laki cenderung lebih banyak terinfeksi SARS-CoV-2 (67%) dibandingkan perempuan (33%). Rentang usia 18-50 tahun merupakan usia yang paling tinggi dampak COVID-19 sebesar 47%. Enoxaparin merupakan antikoagulan yang paling banyak digunakan (44,7%) diikuti dengan Fondaparinux (42,1%) dan Heparin Na (7,90%). Evaluasi nilai D-Dimer menunjukkan terjadinya penurunan kadar dari awal pemeriksaan dan sebelum pasien keluar dari rumah sakit. Rata-rata kadar D-Dimer saat pemeriksaan awal 1839 ng/mL sedangkan pemeriksaan akhir sebelum keluar dari rumah sakit menjadi 799,37 ng/mL. Berdasarkan penemuan tersebut dapat dikatakan jika pemberian antikoagulan dapat bermanfaat menurunkan nilai D-Dimer sehingga diharapkan dapat menurunkan risiko mortalitas serta meningkatkan perbaikan kondisi pasien.
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Barnes, G. D., Burnett, A., Allen, A., Blumenstein, M., Clark, N. P., Cuker, A., Dager, W. E., Deitelzweig, S. B., Ellsworth, S., Garcia, D., Kaatz, S., & Minichiello, T. 2020. Thromboembolism and anticoagulant therapy during the Covid-19 pandemic: Interim clinical guidance from the anticoagulation forum. Journal of Thrombosis and Thrombolysis, 50(1), 72–81. https://doi.org/10.1007/s11239-020-02138-z
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Billett, H. H., Reyes-Gil, M., Szymanski, J., Ikemura, K., Stahl, L. R., Lo, Y., Rahman, S., Gonzalez-Lugo, J. D., Kushnir, M., Barouqa, M., Golestaneh, L., & Bellin, E. 2020. Anticoagulation in COVID-19: Effect of enoxaparin, heparin, and apixaban on mortality. Thrombosis and Haemostasis, 120(12), 1691–1699. https://doi.org/10.1055/s-0040-1720978
Carsana, L., Sonzogni, A., Nasr, A., Rossi, R. S., Pellegrinelli, A., Zerbi, P., Rech, R., Colombo, R., Antinori, S., Corbellino, M., Galli, M., Catena, E., Tosoni, A., Gianatti, A., & Nebuloni, M. 2020. Pulmonary post-mortem findings in a series of Covid-19 cases from northern Italy: A two-centre descriptive study. The Lancet Infectious Diseases, 20(10), 1135–1140. https://doi.org/10.1016/S1473-3099(20)30434-5
Cattaneo, M., Bertinato, E. M., Birocchi, S., Brizio, C., Malavolta, D., Manzoni, M., Muscarella, G., & Orlandi, M. 2020. Pulmonary embolism or pulmonary thrombosis in Covid-19? Is the recommendation to use high-dose heparin for thromboprophylaxis justified? Thrombosis and Haemostasis, 120(08), 1230–1232. https://doi.org/10.1055/s-0040-1712097
Chandra, A., Chakraborty, U., Ghosh, S., & Dasgupta, S. 2021. Anticoagulation in Covid-19: Current concepts and controversies. Postgraduate Medical Journal, 0, 1–8. https://doi.org/10.1136/postgradmedj-2021-139923
Chen, N., Zhou, M., Dong, X., Qu, J., Gong, F., Han, Y., Qiu, Y., Wang, J., Liu, Y., Wei, Y., Xia, J., Yu, T., Zhang, X., & Zhang, L. 2020. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: A descriptive study. The Lancet, 395(10223), 507–513. https://doi.org/10.1016/S0140-6736(20)30211-7
Cui, S., Chen, S., Li, X., Liu, S., & Wang, F. 2020. Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia. Journal of Thrombosis and Haemostasis, 18(6), 1421–1424. https://doi.org/10.1111/jth.14830
Farghaly, S., & Makboul, M. 2021. Correlation between age, sex, and severity of Coronavirus disease-19 based on chest computed tomography severity scoring system. Egyptian Journal of Radiology and Nuclear Medicine, 52(1), 23. https://doi.org/10.1186/s43055-021-00408-1
Han, H., Yang, L., Liu, R., Liu, F., Wu, K., Li, J., Liu, X., & Zhu, C. 2020. Prominent changes in blood coagulation of patients with SARS-CoV-2 infection. Clinical Chemistry and Laboratory Medicine (CCLM), 58(7), 1116–1120. https://doi.org/10.1515/cclm-2020-0188
Jose, R. J., & Manuel, A. 2020. Covid-19 cytokine storm: The interplay between inflammation and coagulation. The Lancet Respiratory Medicine, 8(6), e46–e47. https://doi.org/10.1016/S2213-2600(20)30216-2
Keputusan Menteri Kesehatan Republik Indonesia. 2020a. Keputusan Menteri Kesehatan Republik Indonesia Nomor : HK.01.07/MENKES/312/2020 Tentang Standar Profesi Perekan Medis dan Informasi Kesehatan.
Keputusan Menteri Kesehatan Republik Indonesia. 2020b. Keputusan Menteri Kesehatan Republik Indonesia Nomor HK.01.07/MenKes/413/2020 Tentang Pedoman Pencegahan dan Pengendalian Corona Virus Disease 2019 (Covid-19). In MenKes/413/2020 (Vol. 2019).
Khartabil, T. A., Russcher, H., van der Ven, A., & de Rijke, Y. B. 2020. A summary of the diagnostic and prognostic value of hemocytometry markers in Covid-19 patients. Critical Reviews in Clinical Laboratory Sciences, 57(6), 415–431. https://doi.org/10.1080/10408363.2020.1774736
Kollias, A., Kyriakoulis, K. G., Dimakakos, E., Poulakou, G., Stergiou, G. S., & Syrigos, K. 2020. Thromboembolic risk and anticoagulant therapy in Covid‐19 patients: emerging evidence and call for action. British Journal of Haematology, 189(5), 846–847. https://doi.org/10.1111/bjh.16727
Lodigiani, C., Iapichino, G., Carenzo, L., Cecconi, M., Ferrazzi, P., Sebastian, T., Kucher, N., Studt, J.-D., Sacco, C., Bertuzzi, A., Sandri, M. T., & Barco, S. 2020. Venous and arterial thromboembolic complications in Covid-19 patients admitted to an academic hospital in Milan, Italy. Thrombosis Research, 191, 9–14. https://doi.org/10.1016/j.thromres.2020.04.024
Miesbach, W., & Makris, M. 2020. Covid-19: Coagulopathy, risk of thrombosis, and the rationale for anticoagulation. Clinical and Applied Thrombosis/Hemostasis, 26, 107602962093814. https://doi.org/10.1177/1076029620938149
Peta Sebaran Covid-19. 2020. Infografis COVID-19 (31 Maret 2020) - Berita Terkini _ Covid19. https://covid19.go.id/
Poterucha, T. J., Libby, P., & Goldhaber, S. Z. 2017. More than an anticoagulant: Do heparins have direct anti-inflammatory effects? Thrombosis and Haemostasis, 117(03), 437–444. https://doi.org/10.1160/TH16-08-0620
Russo, V., Cardillo, G., Viggiano, G. V., Mangiacapra, S., Cavalli, A., Fontanella, A., Agrusta, F., Bellizzi, A., Amitrano, M., Iannuzzo, M., Sacco, C., Lodigiani, C., Castaldo, G., & Di Micco, P. 2020. Thromboprofilaxys with fondaparinux vs. enoxaparin in hospitalized Covid-19 patients: A multicenter Italian observational study. Frontiers in Medicine, 7, 1–5. https://doi.org/10.3389/fmed.2020.569567
Santoliquido, A., Porfidia, A., Nesci, A., De Matteis, G., Marrone, G., Porceddu, E., Cammà, G., Giarretta, I., Fantoni, M., Landi, F., Gasbarrini, A., Pola, R., D’Alfonso, M. E., & Lo Monaco, M. R. 2020. Incidence of deep vein thrombosis among non‐ICU patients hospitalized for Covid‐19 despite pharmacological thromboprophylaxis. Journal of Thrombosis and Haemostasis, 18(9), 2358–2363. https://doi.org/10.1111/jth.14992
Susilo, A., Rumende, C. M., Pitoyo, C. W., Santoso, W. D., Yulianti, M., Herikurniawan, H., Sinto, R., Singh, G., Nainggolan, L., Nelwan, E. J., Chen, L. K., Widhani, A., Wijaya, E., Wicaksana, B., Maksum, M., Annisa, F., Jasirwan, C. O. M., & Yunihastuti, E. 2020. Coronavirus disease 2019: Tinjauan literatur terkini. Jurnal Penyakit Dalam Indonesia, 7(1), 45. https://doi.org/10.7454/jpdi.v7i1.415
Tang, N., Li, D., Wang, X., & Sun, Z. 2020. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. Journal of Thrombosis and Haemostasis, 18(4), 844–847. https://doi.org/10.1111/jth.14768
Thachil, J., Tang, N., Gando, S., Falanga, A., Cattaneo, M., Levi, M., Clark, C., & Iba, T. 2020. ISTH interim guidance on recognition and management of coagulopathy in Covid‐19. Journal of Thrombosis and Haemostasis, 18(5), 1023–1026. https://doi.org/10.1111/jth.14810
Varga, Z., Flammer, A. J., Steiger, P., Haberecker, M., Andermatt, R., Zinkernagel, A. S., Mehra, M. R., Schuepbach, R. A., Ruschitzka, F., & Moch, H. 2020. Endothelial cell infection and endotheliitis in Covid-19. The Lancet, 395(10234), 1417–1418. https://doi.org/10.1016/S0140-6736(20)30937-5
WHO. 2020. Coronavirus disease (COVID-19) pandemic. WHO.Int. https://covid19.who.int/%0Ahttps://covid19.who.int/?gclid=CjwKCAjwnK36BRBVEiwAsMT8WJ3y00_BUzvrLsvbl3uthuoTH_Occ45gyEUbpYRyEqAzll3aZB6TYxoCcM0QAvD_BwE
Wichmann, D., Sperhake, J.-P., Lütgehetmann, M., Steurer, S., Edler, C., Heinemann, A., Heinrich, F., Mushumba, H., Kniep, I., Schröder, A. S., Burdelski, C., de Heer, G., Nierhaus, A., Frings, D., Pfefferle, S., Becker, H., Bredereke-Wiedling, H., de Weerth, A., Paschen, H.-R., … Kluge, S. 2020. Autopsy findings and venous thromboembolism in patients with Covid-19. Annals of Internal Medicine, 173(4), 268–277. https://doi.org/10.7326/M20-2003
Wulandari, A., Rahman, F., Pujianti, N., Sari, A. R., Laily, N., Anggraini, L., Muddin, F. I., Ridwan, A. M., Anhar, V. Y., Azmiyannoor, M., & Prasetio, D. B. 2020. Hubungan karakteristik individu dengan pengetahuan tentang pencegahan Coronavirus disease 2019 pada masyarakat di Kalimantan Selatan. Jurnal Kesehatan Masyarakat Indonesia, 15(1), 42. https://doi.org/10.26714/jkmi.15.1.2020.42-46
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2021-12-01
How to Cite
Pratiwi, A. D. E. and Adhityasmara, D. (2021) “GAMBARAN PENGGUNAAN ANTIKOAGULAN PADA PASIEN COVID-19 DI SALAH SATU RUMAH SAKIT RUJUKAN COVID-19 DI KOTA SEMARANG”, Sebatik, 25(2), pp. 442–448. doi: 10.46984/sebatik.v25i2.1619.
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