Pengaruh Pemberian Tiamin Intravena Terhadap Kadar Tumor Necrosis Factor Alpha (Tnf- Α) pada Pasien Covid-19 di Ruang Isolasi Rsup H. Adam Malik Medan

Abstract

Background : Many cytokines and inflammatory mediators play a role in the progression of COVID-19 disease, including interleukins, interferons, and tumor necrosis factor. Thiamine can affect proinflammatory cytokines, especially TNF-α so that thiamine administration can reduce the production of IL-6 and TNF- α. Objective: To determine the effect of intravenous thiamine administration on Tumor Necrosis Factor (TNF-α) levels in COVID-19 patients in the isolation room of H. Adam Malik Hospital. Methods : This study used analytical design of one group pre test - post test in the isolation room of Haji Adam Malik Hospital Medan with 16 samples. Samples were given thiamine IV 200 mg/12 hours and then the levels of TNF-α were measured using the ELISA method. Results : Characteristics of the sample, males and females were 8 (50%), the mean of age was 43 ± 14.78, the Javanese were dominated by 9 (56.3%), the mean of BMI was 23.31 ± 6.55, the mean of systolic 122.50 ± 5.77 and diastolic 88.88 ± 6.55 with the p value > 0.05 (normally distributed). Before administration of thiamine, the median TNF-α was 186.5 with a minimum and maximum value (171- 420) and after administration of thiamine, the median TNF-α was 180.50 with a minimum and maximum value (122-200), the P value was 0.001 < 0.05 (there was significant effect) Conclusion : There is a decreasing effect between TNF-α levels before and after thiamine administration, although it is not significant.

Pendahuluan : Banyak sitokin dan mediator inflamasi yang berperan dalam progresivitas penyakit COVID-19, diantaranya golongan interleukin, interferon, dan tumor necrosis faktor. Tiamin dapat mempengaruhi sitokin proinflamasi terutama TNF α sehingga pemberian tiamin dapat menurunkan produksi IL-6 dan TNF-α. Tujuan : Untuk mengetahui pengaruh pemberian tiamin intravena terhadap kadar Tumor Necrosis Factor (TNF- α) pada pasien COVID-19 diruang isolasi RSUP H Adam Malik. Metode : Penelitian ini menggunakan desain analitik one group pre test - post test di ruangan isolasi RSUP Haji Adam Malik Medan dengan 16 sampel. Sampel diberi tiamin IV 200 mg/12 jam lalu diukur kadar TNF-α dengan metode ELISA.Hasil : Karakteristik sampel didapatkan laki – laki dan perempuan sebanyak 8 (50%), usia rerata sebesar 43 ±14,78, di dominasi suku jawa sebesar 9 ( 56,3%), rerata IMT sebesar 23,31 ± 6,55, rerata sistolik 122,50 ± 5,77 dan diastolik 88,88 ±6,55 dimana nilai p > 0,05 (berdistribusi normal). Sebelum pemberian tiamin median TNF sebesar 186,5 dengan nilai minimal dan maksimal (171-420) dan setelah pemberian tiamin Median TNF α sebesar 180,50 dengan nilai minimal dan maksimal (122- 200) didapatkan nilai P sebesar 0,001 < 0,05 (adanya pengaruh yang signifikan) Kesimpulan : Terdapat pengaruh penurunan antara kadar TNF α sebelum dan sesudah pemberian tiamin walaupun tidak signifikan.