Karakteristik Penanda Inflamasi dengan Kejadian ARDS pada Pasien Covid-19 Terkonfirmasi Derajat Berat dan Kritis di RSUP H Adam Malik Medan

Abstract

Background: COVID-19 can cause a serious condition known as acute respiratory distress syndrome (ARDS). The clinical features of COVID-19 patients with acute respiratory distress syndrome (ARDS) were described, and further described the inflammatory markers on ARDS in COVID-19. There is a scarcity of information on the clinical features and inflammation markers of people with severe COVID-19 and ARDS. Objectives : This study aimed to evaluate characteristics routines inflammatory markers with COVID-19-associated ARDS among patients hospitalized with COVID-19 cases in H Adam Malik Hospital Medan. Methods : This is a retrospective analysis of 204 medical record on patients hospitalized with confirmed case COVID-19 with severe and critical degree in RSUP H Adam Malik Medan between February and July 2021. The laboratory values were analyzed to compare ARDS group and non-ARDS group. Results : Among 204 patients, with mean age was 57 years, and 119 patients (58.3%) were male, and more than half, 116 patients (56.9%) developed ARDS. And in ARDS group, 58 patients (28.3%) were in elderly group (≥ 60 years old). Nearly half of the patients in ARDS group (42.6%) had at least one chronic medical illness. Compared to non-ARDS group, ARDS patients more likely to have coexisting hypertension conditions (34.8% vs 22.1%), more elevated neutrophil count (11.07 vs 7.57 x 103/μL), neutrophilia (43.6% vs 13.2%), lymphocytopenia (47.1% vs 9.8%), higher NLR count (13.87 vs 10.31), increased NLR (42.2% vs 14.7%), higher procalcitonin value ( 5.43 vs 2.81 ng/mL), and an increased procalcitonin (43.1% vs 13.7%). Conclusion : Older age was linked to a higher risk of ARDS and death, most likely due to a weakened immunological response. Measuring these parameters of inflammation can help physicians quickly identify severe COVID-19 patients and may facilitate an early start of effective treatment of ARDS in COVID-19 patients.