Hubungan komorbiditas dengan tingkat keparahan COVID-19 berdasarkan computerized tomography severity score

A Retrospective Cross-Sectional Study

Authors

  • Sri Asriyani Radiology Department, Medical Faculty of Hasanuddin University
  • Silvia Suminto Program Studi Pendidikan Dokter Spesialis 1 Radiologi, Fakultas Kedokteran, Universitas Hasanuddin
  • Nikmatia Latief Departemen Radiologi, Fakultas Kedokteran Universitas Hasanuddin
  • Andi Alfian Departemen Ilmu Kesehatan Masyarakat, Fakultas Kedokteran Universitas Hasanuddin
  • Irawaty Djaharuddin Departemen Pulmonologi dan Kedokeran Respirasi, Fakultas Kedokteran Universitas Hasanuddin
  • Bachtiar Murtala Departemen Radiologi, Fakultas Kedokteran Universitas Hasanuddin

DOI:

https://doi.org/10.25170/djm.v22i1.3702

Keywords:

COVID-19, CT scan toraks, CT severity score, komorbiditas

Abstract

Pendahuluan: CT scan toraks berperan penting dalam COVID-19, baik dalam penentuan diagnosis, menentukan tingkat keparahan, dan memandu tatalaksana. Penelitian ini bertujuan untuk mengetahui hubungan komorbiditas dengan tingkat keparahan COVID-19 berdasarkan CT Severity Score (CT SS).

Metode: Desain penelitian retrospektif cross-sectional dilakukan pada 192 pasien terkonfirmasi COVID-19 yang memenuhi syarat  dan menjalani CT scan toraks. Analisis karakteristik gambaran CT scan toraks pasien dilakukan pada window paru dan mediastinal. CT SS dilakukan untuk penilaian derajat keparahan COVID-19. Perbedaan proporsi gambaran CT scan berdasarkan komorbiditas diuji dengan chi-square.

Hasil: Penyakit komorbid yang paling banyak ditemukan yaitu hipertensi (51 pasien), diabetes mellitus (37 pasien), gagal ginjal kronik (29 pasien), penyakit jantung koroner (14 pasien), keganasan (14 pasien), dan tuberkulosis (5 pasien). Temuan CT scan yang paling sering adalah ground-glass opacities, konsolidasi, crazy paving, dan fibrosis dengan distribusi periferal. Terdapat hubungan yang signifikan antara pasien berusia > 50 tahun, memiliki riwayat komorbiditas, komorbiditas >1, memiliki riwayat diabetes mellitus, hipertensi, dan penyakit jantung koroner dengan CT SS ≥19,5 menunjukkan tingkat penyakit yang lebih berat (p<0,05).

Simpulan: Pasien dengan riwayat komorbiditas, komorbiditas >1, berusia >50 tahun, memiliki riwayat diabetes mellitus, hipertensi, dan PJK menunjukkan tingkat penyakit yang lebih berat berdasarkan CT SS. 

Kata Kunci: COVID-19, CT scan toraks, CT severity score, komorbiditas.

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Author Biographies

Silvia Suminto, Program Studi Pendidikan Dokter Spesialis 1 Radiologi, Fakultas Kedokteran, Universitas Hasanuddin

Student at Radiology Study Program

Nikmatia Latief, Departemen Radiologi, Fakultas Kedokteran Universitas Hasanuddin

Lektor pada Departemen Radiologi

Andi Alfian, Departemen Ilmu Kesehatan Masyarakat, Fakultas Kedokteran Universitas Hasanuddin

Lektor Kepala di Departemen Ilmu Kesehatan Masyarakat

Irawaty Djaharuddin, Departemen Pulmonologi dan Kedokeran Respirasi, Fakultas Kedokteran Universitas Hasanuddin

Lektor Kepala di Departemen Pulmonologi dan Kedokteran Respirasi

Bachtiar Murtala, Departemen Radiologi, Fakultas Kedokteran Universitas Hasanuddin

Guru Besar di Departemen Radiologi

References

Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. New England journal of medicine. 2020 Jan 24.

World Health Organization. Coronavirus disease 2019 (COVID-19): situation report, 17. [internet]. [cited 26 July 2020] Available from https://www.who.int/docs/default-source/searo/ indonesia/covid19/external-situation-report-17-21july2020.pdf?sfvrsn=e15ee803_2

Situasi COVID-19 di Indonesia. [internet]. Jakarta; 2023. [cited 6 March 2023] Available at: https://covid19.go.id/id/artikel/2023/03/05/situasi-covid-19-di-indonesia-update-5-maret-2023

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. 2020 Feb 15;395(10223):497-506.

Odegaard JI, Chawla A. Connecting type 1 and type 2 diabetes through innate immunity. Cold Spring Harbor perspectives in medicine. 2012 Mar 1;2(3):a007724.

Rodrigues JC, Hare SS, Edey A, Devaraj A, Jacob J, Johnstone A, et al. An update on COVID-19 for the radiologist-A British Society of Thoracic Imaging statement. Clinical radiology. 2020 May 1;75(5):323-5.

British Society Thoracic Imaging. Thoracic Imaging in COVID-19 Infection. Guidance for the Reporting Radiologist. [Internet]. 2020. [cited 16 March 2020] Available at: https://www.bsti.org.uk/media/ resources/files/BSTI_COVID-19_Radiology_ Guidance_version_2_16.03.20.pdf

Yu M, Xu D, Lan L, Tu M, Liao R, Cai S, et al. Thin-section chest CT imaging of COVID-19 pneumonia: a comparison between patients with mild and severe disease. Radiology: Cardiothoracic Imaging. 2020 Apr 23;2(2):e200126.

Yang R, Li X, Liu H, Zhen Y, Zhang X, Xiong Q, et al. Chest CT severity score: an imaging tool for assessing severe COVID-19. Radiology: Cardiothoracic Imaging. 2020 Mar 30;2(2):e200047.

World Health Organization. Global tuberculosis report 2022. [internet]. Geneva; 2022. [cited 8 March 2023] Available at: https://www.who.int/ teams/global-tuberculosis-programme/tb-reports

Chen Y, Wang Y, Fleming J, Yu Y, Gu Y, Liu C, et al. Active or latent tuberculosis increases susceptibility to COVID-19 and disease severity. MedRxiv. 2020 Mar 16:2020-03.

Zhao L, Wang X, Xiong Y, Fan Y, Zhou Y, Zhu W. Correlation of autopsy pathological findings and imaging features from 9 fatal cases of COVID-19 pneumonia. Medicine. 2021 Mar 26;100(12): e25232.

Gross S, Jahn C, Cushman S, Baer C, Thum T. SARS-CoV-2 receptor ACE2-dependent implica-tions on the cardiovascular system: From basic science to clinical implications. Journal of Molecular and Cellular Cardiology. 2020 Jul 1;144:47-53.

Ejaz H, Alsrhani A, Zafar A, Javed H, Junaid K, Abdalla AE, et al. COVID-19 and comorbidities: Deleterious impact on infected patients. Journal of Infection and Public Health. 2020 Dec 1;13(12):1833-9.

Pinto BG, Oliveira AE, Singh Y, Jimenez L, Gonçalves AN, Ogava RL, et al. ACE2 expression is increased in the lungs of patients with comorbidities associated with severe COVID-19. The Journal of Infectious Diseases. 2020 Jul 23;222(4):556-63.

Biswas M, Rahaman S, Biswas TK, Haque Z, Ibrahim B. Association of sex, age, and comor-bidities with mortality in COVID-19 patients: a systematic review and meta-analysis. Intervirology. 2021;64(1):36-47.

Kanwal A, Agarwala A, Martin LW, Handberg EM, Yang E. COVID-19 and hypertension: What we know and don't know. American College of Cardiology. 2020 Jul;6.

South AM, Brady TM, Flynn JT. ACE2 (angiotensin-converting enzyme 2), COVID-19, and ACE inhibitor and Ang II (angiotensin II) receptor blocker use during the pandemic: the pediatric perspective. Hypertension. 2020 Jul;76(1):16-22.

Hussain A, Bhowmik B, do Vale Moreira NC. COVID-19 and diabetes: Knowledge in progress. Diabetes research and clinical practice. 2020 Apr 1;162:108142.

Muniyappa R, Gubbi S. COVID-19 pandemic, coronaviruses, and diabetes mellitus. American Journal of Physiology-Endocrinology and Metabolism. 2020 Apr 26.

Lu S, Xing Z, Zhao S, Meng X, Yang J, Ding W, et al. Different appearance of chest CT images of T2DM and NDM patients with COVID-19 pneu-monia based on an artificial intelligent quantitative method. International Journal of Endocrinology. 2021 Mar 14;2021.

Guzik TJ, Mohiddin SA, Dimarco A, Patel V, Savvatis K, Marelli-Berg FM, et al. COVID-19 and the cardiovascular system: implications for risk assessment, diagnosis, and treatment options. Cardiovascular research. 2020 Aug 1;116(10):1666-87.

Feng Z, Yu Q, Yao S, Luo L, Zhou W, Mao X, et al. Early prediction of disease progression in COVID-19 pneumonia patients with chest CT and clinical characteristics. Nature communications. 2020 Oct 2;11(1):4968.

Borakati A, Perera A, Johnson J, Sood T. Diagnostic accuracy of X-ray versus CT in COVID-19: a propensity-matched database study. BMJ open. 2020 Nov 1;10(11):e042946.

Sverzellati N, Ryerson CJ, Milanese G, Renzoni EA, Volpi A, Spagnolo P, et al. Chest radiography or computed tomography for COVID-19 pneumonia? Comparative study in a simulated triage setting. European Respiratory Journal. 2021 Sep 1;58(3).

Published

2023-07-04

How to Cite

1.
Asriyani S, Suminto S, Latief N, Alfian A, Djaharuddin I, Murtala B. Hubungan komorbiditas dengan tingkat keparahan COVID-19 berdasarkan computerized tomography severity score: A Retrospective Cross-Sectional Study. DJM [Internet]. 2023 Jul. 4 [cited 2024 Oct. 12];22(1):10-2. Available from: https://ejournal.atmajaya.ac.id/index.php/damianus/article/view/3702
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