PENGARUH KADAR D-DIMER, KREATININ SERUM, DAN JUMLAH LIMFOSIT ABSOLUT TERHADAP DERAJAT KEPARAHAN PASIEN COVID-19 KOMORBID CHRONIC KIDNEY DISEASE

Abstract

ABSTRACT

COVID-19 is an infectious respiratory disease caused by infection SARS-CoV-2. Abnormal kidney function is associated with increased morbidity and mortality in COVID-19 patients. D-dimer levels, serum creatinine, and ALC can be used as markers of inflammation to determine the severity of COVID-19 comorbid chronic kidney disease (CKD). However, there are not many studies on this subject. This study aims to determine the impact of D-dimer, serum creatinine, and Absolute Lymphocyte Count (ALC) on the severity of COVID-19 comorbid CKD. This study uses an analytic observational method with a cross sectional approach from medical record data. The study population included COVID-19 patients with comorbid CKD at RS X Surakarta, who was examined for D-dimer levels, serum creatinine, and absolute lymphocyte counts, using purposive sampling and sample consisted of 53 patients. Bivariate analysis using Spearman’s Rank test obtained p value of D-dimer, serum creatinine, absolute lymphocyte counts 0,002; 0,042; 0,455. Multivariate analysis using multiple logistics regression showed that D-dimer OR=28,521 and serum creatinine OR=5,650, with a Nagelkerke R Square value of 0,338. There is an impact of D-dimer and serum creatinine levels on the severity of COVID-19 patients with CKD.

ABSTRAK

COVID-19 adalah penyakit pernapasan menular akibat infeksi virus SARS-CoV-2. Penyakit ginjal merupakan salah satu komorbid terbanyak pasien COVID-19, fungsi ginjal yang tidak normal berhubungan dengan peningkatan angka morbiditas dan mortalitas pasien COVID-19. Penelitian ini bertujuan untuk mengetahui pengaruh antara D-dimer, kreatinin serum, dan jumlah limfosit absolut terhadap derajat keparahan COVID-19 dengan komorbid chronic kidney disease (CKD). Penelitian ini menggunakan metode observasional analitik dengan pendekatan cross sectional dari data rekam medis. Populasi penelitian meliputi pasien COVID-19 dengan komorbid CKD di RS X Surakarta yang dilakukan pemeriksaan kadar D-dimer, kreatinin serum, dan jumlah limfosit absolut dengan teknik sampling purposive sampling didapatkan sebanyak 53 sampel. Analisis bivariat menggunakan uji korelasi Rank Spearman dan didapatkan nilai p D-dimer, kreatinin serum, jumlah limfosit absolut dengan keparahan COVID-19 masing-masing 0,002; 0,042; 0,455. Analisis multivariat menggunakan uji regresi logistik berganda dan didapatkan nilai OR D-dimer dan kreatinin serum masing-masing 28,521 dan 5,650 dengan nilai Nagelkerke R Square 0,338. Kesimpulan penelitian ini bahwa Kadar D-dimer dan kreatinin serum berpengaruh terhadap derajat keparahan pasien COVID-19 dengan komorbid CKD.