BAB V KESIMPULAN DAN SARAN
5.1. Kesimpulan
1. Terdapat korelasi antara nilai Absolute Lymphocyte Count (ALC) dengan mortalitas pasien COVID-19 yang dirawat inap di Rumah Sakit Islam Sultan Agung Semarang (p < 0,001).
2. Sebanyak 25,56% pasien COVID-19 yang dirawat inap di Rumah Sakit Islam Sultan Agung Semarang pada penelitian ini dinyatakan meninggal.
3. Kekuatan korelasi antara nilai Absolute Lymphocyte Count (ALC) dengan mortalitas pasien COVID-19 yang dirawat inap di Rumah Sakit Islam Sultan Agung Semarang termasuk dalam kategori yang cukup (r = -0,465).
5.2. Saran
Penelitian selanjutnya mempertimbangkan batasan rentang usia dan derajat keparahan yang dapat mempengaruhi nilai ALC.
DAFTAR PUSTAKA
Aguilar, C., Malphettes, M., Donadieu, J., Chandesris, O., Coignard-Biehler, H., Catherinot, E., Pellier, I., Stephan, J. L., Le Moing, V., Barlogis, V., Suarez, F., Gérart, S., Lanternier, F., Jaccard, A., Consigny, P. H., Moulin, F., Launay, O., Lecuit, M., Hermine, O., Oksenhendler, E., … Lortholary, O. (2014). Prevention of infections during primary immunodeficiency. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 59(10), 1462–1470.
https://doi.org/10.1093/cid/ciu646
Azab, B., Camacho-Rivera, M., & Taioli, E. (2014). Average values and racial differences of neutrophil lymphocyte ratio among a nationally representative sample of United States subjects. PloS one, 9(11), e112361. https://doi.org/10.1371/journal.pone.0112361
Beldi-Ferchiou, A., & Caillat-Zucman, S. (2017). Control of NK Cell Activation by Immune Checkpoint Molecules. International journal of molecular sciences, 18(10), 2129. https://doi.org/10.3390/ijms18102129
Chen, L., Zhao, J., Peng, J., Li, X., Deng, X., Geng, Z., Shen, Z., Guo, F., Zhang, Q., Jin, Y., Wang, L., & Wang, S. (2020). Detection of SARS-CoV-2 in saliva and characterization of oral symptoms in COVID-19 patients. Cell proliferation, 53(12), e12923. https://doi.org/10.1111/cpr.12923
Diao, B., Wang, C., Tan, Y., Chen, X., Liu, Y., Ning, L., Chen, L., Li, M., Liu, Y., Wang, G., Yuan, Z., Feng, Z., Zhang, Y., Wu, Y., & Chen, Y. (2020).
Reduction and Functional Exhaustion of T Cells in Patients with Coronavirus Disease 2019 (COVID-19). Frontiers in immunology, 11, 827. https://doi.org/10.3389/fimmu.2020.00827
Di Gennaro, F., Pizzol, D., Marotta, C., Antunes, M., Racalbuto, V., Veronese, N.,
& Smith, L. (2020). Coronavirus Diseases (COVID-19) Current Status and Future Perspectives: A Narrative Review. International journal of environmental research and public health, 17(8), 2690.
https://doi.org/10.3390/ijerph17082690
Domingo, J. L., Marquès, M., & Rovira, J. (2020). Influence of airborne transmission of SARS-CoV-2 on COVID-19 pandemic. A review.
Environmental research, 188, 109861.
https://doi.org/10.1016/j.envres.2020.109861
Du, L., He, Y., Zhou, Y., Liu, S., Zheng, B.-J., & Jiang, S. (2009). The spike protein of SARS-CoV - a target for vaccine and therapeutic development.
Nature Reviews Microbiology, 7(3), 226–236. doi:10.1038/nrmicro2090
36
Fan, B. E., Chong, V., Chan, S., Lim, G. H., Lim, K., Tan, G. B., Mucheli, S. S., Kuperan, P., & Ong, K. H. (2020). Hematologic parameters in patients with COVID-19 infection. American journal of hematology, 95(6), E131–E134. https://doi.org/10.1002/ajh.25774
Guan, W. J., Ni, Z. Y., Hu, Y., Liang, W. H., Ou, C. Q., He, J. X., ... & Zhong, N.
S. (2020). Clinical characteristics of coronavirus disease 2019 in China.
New England journal of medicine, 382(18), 1708-1720.
Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., Zhang, L., Fan, G., Xu, J., Gu, X., Cheng, Z., Yu, T., Xia, J., Wei, Y., Wu, W., Xie, X., Yin, W., Li, H., Liu, M., Xiao, Y., … Cao, B. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet (London, England), 395(10223), 497–506. https://doi.org/10.1016/S0140- 67362030183-5
Hutasuhut, Fatmah. (2006). RESPONS IMUNITAS YANG RENDAH PADA TUBUH MANUSIA USIA LANJUT. Seri Kesehatan (Health Series);
Vol 10, No 1 (2006): Juni. 10.
Kim, J. S., Lee, J. Y., Yang, J. W., Lee, K. H., Effenberger, M., Szpirt, W., Kronbichler, A., & Shin, J. I. (2021). Immunopathogenesis and treatment of cytokine storm in COVID-19. Theranostics, 11(1), 316–329.
https://doi.org/10.7150/thno.49713
Kim, L., Whitaker, M., O'Halloran, A., Kambhampati, A., Chai, S. J., Reingold, A., Armistead, I., Kawasaki, B., Meek, J., Yousey-Hindes, K., Anderson, E. J., Openo, K. P., Weigel, A., Ryan, P., Monroe, M. L., Fox, K., Kim, S., Lynfield, R., Bye, E., Shrum Davis, S., … COVID-NET Surveillance Team (2020). Hospitalization Rates and Characteristics of Children Aged
<18 Years Hospitalized with Laboratory-Confirmed COVID-19 - COVID-NET, 14 States, March 1-July 25, 2020. MMWR. Morbidity and
mortality weekly report, 69(32), 1081–1088.
https://doi.org/10.15585/mmwr.mm6932e3
Kumar, M., & Al Khodor, S. (2020). Pathophysiology and treatment strategies for COVID-19. Journal of translational medicine, 18(1), 353.
Lapostolle, F., Schneider, E., Vianu, I., Dollet, G., Roche, B., Berdah, J., Michel, J., Goix, L., Chanzy, E., Petrovic, T., & Adnet, F. (2020). Clinical features of 1487 COVID-19 patients with outpatient management in the Greater Paris: the COVID-call study. Internal and emergency medicine, 15(5), 813–817. https://doi.org/10.1007/s11739-020-02379-z
LaRosa, D. F. and Orange, J. S. (2008) ‘1. Lymphocytes’, Journal of Allergy and Clinical Immunology, 121(2 SUPPL. 2), pp. 364–369. doi:
10.1016/j.jaci.2007.06.016.
37
Leng, Z. et al. (2020) ‘Transplantation of ACE2- Mesenchymal stem cells improves the outcome of patients with covid-19 pneumonia’, Aging and Disease, 11(2). doi: 10.14336/AD.2020.0228.
Mao, L., Jin, H., Wang, M., Hu, Y., Chen, S., He, Q., Chang, J., Hong, C., Zhou, Y., Wang, D., Miao, X., Li, Y., & Hu, B. (2020). Neurologic Manifestations of Hospitalized Patients with Coronavirus Disease 2019 in Wuhan, China. JAMA neurology, 77(6), 683–690.
https://doi.org/10.1001/jamaneurol.2020.1127
Mazzoni, A. et al. (2020) ‘Impaired immune cell cytotoxicity in severe COVID- 19 is IL-6 dependent’, Journal of Clinical Investigation, 130(9). doi:
10.1172/JCI138554.
McCusker, C., & Warrington, R. (2011). Primary immunodeficiency. Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology, 7 Suppl 1(Suppl 1), S11.
https://doi.org/10.1186/1710-1492-7-S1-S11
Moore, J. B., & June, C. H. (2020). Cytokine release syndrome in severe COVID- 19. Science (New York, N.Y.), 368(6490), 473–474.
Moraes-Pinto, M. I., Ono, E., Santos-Valente, E. C., Almeida, L. C., Andrade, P.
R., Dinelli, M. I., Santos, A. M., & Salomão, R. (2014). Lymphocyte subsets in human immunodeficiency virus-unexposed Brazilian individuals from birth to adulthood. Memorias do Instituto Oswaldo Cruz, 109(8), 989–998. https://doi.org/10.1590/0074-0276140182
Ni, L. et al. (2020) ‘Detection of SARS-CoV-2-Specific Humoral and Cellular Immunity in COVID-19 Convalescent Individuals’, Immunity, 52(6). doi:
10.1016/j.immuni.2020.04.023.
Padmaprakash, K., Ashta, K. K., Raman, N., Vardhan, V., Thareja, S., Muthukrishnan, J., Rajmohan, K., Dubey, S., Nauhwaar, D., Kumar, A.
and Basavaraj, P. (2021) ‘Prognostic significance of absolute lymphocyte count, absolute neutrophil count, and neutrophil-to-lymphocyte ratio in COVID-19’, Journal of Marine Medical Society, 23(2), p. 159. doi:
10.4103/JMMS.JMMS_3_21.
Romera-Liebana, L., Orfila, F., Segura, J. M., Real, J., Fabra, M. L., Möller, M., Lancho, S., Ramirez, A. and Marti, N. (2020) ‘Down-regulated gene expression spectrum and immune responses changed during the disease progression in COVID-19 patients’, Clinical Infectious Diseases.
Rothan, H. A., & Byrareddy, S. N. (2020). The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. Journal of autoimmunity, 109, 102433. https://doi.org/10.1016/j.jaut.2020.102433
38
Sopiyudin Dahlan, M. (2013) ‘Besar Sampel dan Cara Pengambilan Sampel dalam Penelitian Kedokteran dan Kesehatan’, Salemba Medika. ISBN:
9786028570367.
Sultana, G. S., Haque, S. A., Sultana, T., Rahman, Q., & Ahmed, A. N. (2011).
Role of red cell distribution width (RDW) in the detection of iron deficiency anaemia in pregnancy within the first 20 weeks of gestation.
Bangladesh Medical Research Council bulletin, 37(3), 102–105.
https://doi.org/10.3329/bmrcb.v37i3.9122
Wang, W., Zhao, Z., Liu, X., Liu, G., Xie, D., Xu, Z., Zhao, J., & Zhang, J.
(2020). Clinical features and potential risk factors for discerning the critical cases and predicting the outcome of patients with COVID-19.
Journal of clinical laboratory analysis, 34(10), e23547.
https://doi.org/10.1002/jcla.23547
Wagner, J., DuPont, A., Larson, S., Cash, B., & Farooq, A. (2020). Absolute lymphocyte count is a prognostic marker in Covid-19: A retrospective cohort review. International journal of laboratory hematology, 42(6), 761–765. doi: 10.1111/IJLH.13288.
Woodruff, M. et al. (2020) ‘Critically ill SARS-CoV-2 patients display lupus-like hallmarks of extrafollicular B cell activation.’, medRxiv : the preprint server for health sciences.
Yang, L., Jin, J., Luo, W., Gan, Y., Chen, B. and Li, W. (2020) ‘Risk factors for predicting mortality of COVID-19 patients: A systematic review and meta-analysis’, PLOS ONE, 15(11), p. e0243124. doi:
10.1371/JOURNAL.PONE.0243124.
Yang, S., Lee, G. W., Chen, C. M., Wu, C. C., & Yu, K. P. (2007). The size and concentration of droplets generated by coughing in human subjects.
Journal of aerosol medicine: the official journal of the International Society for Aerosols in Medicine, 20(4), 484–494.
https://doi.org/10.1089/jam.2007.0610
Zafar, Mansoor et al. (2021) ‘A Retrospective Observational Study: Is Absolute Lymphocyte Count a Prognostic Marker in COVID-19?’, Cureus, 13(7).
doi: 10.7759/CUREUS.16554.
Zhao, Q., Meng, M., Kumar, R., Wu, Y., Huang, J., Deng, Y., Weng, Z., & Yang, L. (2020). Lymphopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A systemic review and meta-analysis.
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 96, 131–135.
https://doi.org/10.1016/j.ijid.2020.04.086