Hubungan antara Kadar LDH dengan Derajat Keparahan Pasien Covid-19 di RSUP Haji Adam Malik Medan

Abstract

Background : LDH is one of the significant predictors of prognosis and follow-up in Covid-19 patients. Several studies reported elevated LDH in hospitalized COVID-19 patients to be associated with a higher risk of death. Increased LDH levels can result from any tissue damage due to SARS-CoV-2 infection. Aim of Study : To describe the relationship between LDH value on the severity of Covid-19. Methods : This study is a cross sectional study of 55 patients who confirmed positive by RTPCR SARS-CoV-2 at H. Adam Malik General Hospital Medan (November 2021 – Maret 2022). Examination of the LDH value was carried out by the Chemiluminescent Immunoassays method (Abbott Architect). COVID-19 severity degree was assessed based on the operational criteria for COVID-19 cases in Indonesia. Results : Among the 55 COVID-19 patients in this study, the average age found was 45,73. with men counted for 54,5%. Moderate, severe, and critical patients were found 63,6%; 29,1%; and 7,3% respectively. The mean LDH value at admission was 278 U/L, was higher in the severe (333,19 U/L) and critical (465,75 U/L) group than in the moderate (231,31 U/L) degree group. Elevated LDH ≥ 256 U/L have significant relations with the severity degree of COVID- 19 upon hospital admission (CI 95%; p = 0,001). Conclusions LDH values that increased ≥ 256 U/L were significantly related with the severity degree of COVID-19 at admission into the hospital.

Latar Belakang : LDH merupakan salah satu prediktor yang signifikan untuk prognosis dan tindak lanjut pada pasien Covid-19. Selain itu, beberapa penelitian melaporkan peningkatan LDH pada pasien COVID-19 yang dirawat di rumah sakit berkorelasi dengan risiko kematian yang lebih tinggi. Peningkatan kadar LDH dapat diakibatkan oleh kerusakan jaringan akibat infeksi SARS- CoV-2. Tujuan : Mengetahui hubungan nilai LDH terhadap derajat keparahan Covid-19. Metode : Penelitian ini merupakan penelitian cross sectional terhadap 55 orang pasien terkonfimasi positif RT-PCR SARS-CoV-2 di RSUP H. Adam Malik Medan (November 2021 – Maret 2022). Pemeriksaan nilai LDH dilakukan dengan metode Chemiluminescent Immunoassay (Abbott Architect). Derajat keparahan dinilai berdasarkan kriteria operasional kasus COVID-19 di Indonesia. Hasil : Dari 55 orang pasien COVID-19 pada penelitian ini didapati usia rerata 45,73 dengan mayoritas pria sebesar 54,5%. Pasien derajat sedang, berat, dan kritis didapati sebesar 63,6%; 29,1%; dan 7,3%. Rerata LDH saat masuk RS sebesar 278 U/L, dan lebih tinggi pada pasien derajat berat (333,19 U/L) dan kritis (465,75 U/L) dibandingkan dengan derajat sedang (231,31 U/L). Peningkatan LDH ≥ 256 U/L berhubungan secara signifikan dengan derajat keparahan COVID-19 saat masuk RS (CI 95%; p = 0,001). Simpulan : Nilai LDH ≥ 256 U/L berhubungan signifikan dengan derajat keparahan COVID- 19 saat masuk RS.