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IN T E R P R E T A S I R A PID T E S T A N T IB O D Y S A R S CoV-2

Waktu pembacaan hasil sesuai dengan waktu yang disarankan kit reagen.

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Catatan Saran :

□ H a s il n o n re aktif tid a k m e n y in g k ir k a n k e m u n g k in a n te rin fe k si □ U la n g p em eriksaa n rapid test a n tib o d y 10 S A R S - C o V - 2 s e h in g g a m a s ih b e r is ik o m e n u la r k a n k e o r a n g hari kem udian

lain. □ Tetap m enjaga social/physical distancin g

□ H a s il n o n reaktif d a p a t terjadi p a d a k o n d isi: □ Pertahankan prilaku h id u p bersih dan - S e s e o r a n g b e lu m / tid a k te rin fe k si sehat

terbentuk)

- Imunokompromais

- Kadar antibodi dibawah level deteksi alat

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PATOLOGI KLINIK DAN KEDOKTERAN LABORATORIUM INDONESIA

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Hasil Tes

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+ - - Pasien k e m u n g k in a n b e ra d a d a la m window period in fe k s i + + - Pasien k e m u n g k in a n b e ra d a pada fase a w a l in fe k s i

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- +

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k e m u n g k in a n false-negative

% fk.unand.ac.id

A guide to C O V ID -1 9 Testing M eth ods

B y A n n a P a t e m n o s t o A O p h e lie G u illo u e t-L a m y

net magazine.com, net- magazine apri!-2020/a-guide-to-covKi-19-testing- methods/

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Pemeriksaan untuk derajat keparahan, prognosis, monitoring

Pemahaman mekanisme pathogenesis virus, seluler dan kerusakan organ

Identifikasi penanda laboratorium

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U N IV E R S IT A S AN DA LA S rM u.r<s uuuK itiuii u m E « n ua<o u u

P a to fis io lo g i tro m b o s is pada pa sie n k r itis den ga n COVIO-19

Understanding pathophysiology

of hemostasis disorders in critically ill patients with COVID-19

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https./doiotg/10-1007/sOQ13402006088-1

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LOCAL A M O S Y S T E M IC INFLA M M A TO R Y R E S P O N S E (S IR S )

H Y P E R C O A G U L A B IL IT Y

• Im h u h m a i a t p r o c o o g iiiin l trS anlrcssagultinl proteins

A ctivation of E C . p to m M a le u k o c y te s a n d m o n o c y te s

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END O T H E L tO PAT H Y

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V A C R O T H R O M f lO S B V o n o u s a n d fv te ria l throm boem txjiic event?

P u l m o n a r y e m b o l i s m

M IC R O T H R O M B O S IS M utli -organ kxiiore

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Pembentukan trombus pada COVID-19

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Cytokines c o a g u la t io n

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Angiotensin II Angiotensin 1-7

Critical Cart 09201 24360

The unique characteristics of COVID-19 coagulopathy

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Table 3. Studies with m ain findings of coagulation abnormalities and their clinical correlations.

Author Sam p le size A bnorm al coagulation param eters Clinical correlation

G uan et al. [10] 1099 Elevated d-dim er M ore severe disease

W u et al. [17] 201 Elevated d-dim er an d PT A R D S (d-dimer, PT) and death (d-dimer)

Z h o u et al. [19] 191 Elevated d-dim er In-hospital deaths

G u o et al. [56] 187 Elevated d-dimer, PT an d APTT Carcfiac injury

T ang et al. [23] 183 Elevated d-dimer, PT, APTT and fibrin degradation products Increased mortality

W a n g et al. [12] 138 Elevated d-dim er an d PT ICU adm ission

H u an g et al. [54] 41 Elevated d-dim er a n d PT ICU adm ission

H e m a to lo g ic a l m a n ife s ta tio n s o f COVID-19 Alain M inaab, Koen van Besien* and Leonidas C. Platanias* b '*

Leukemia & Lymphoma. DO L 10.1080/10428194.2020-1788017

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UNTV ERSITAS AN D A LAS FAXULTASKtDOKItKAK 1

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T ab le 1. Studies w ith m e n tio n of lym phopenia an d re la te d clinical im plications.

Author Sample size Prevalence of lymphopenia Clinical findings

Guan et aL [ I Q 1099 83.20% Lymphopenia is more prominent in

severe disease (96.1%) compared to norvsevere disease (80.4%)

W u et al. [17] 201 64.00% Lymphopenia is associated more

severe disease and ARDS

W ang et al. [12] 138 70.30% Degree of lymphopenia correlated

with a higher likelihood of iCU admission

Tan et al. [34] 90 ^* Lymphocyte counts at 2 time

points {Days 10-12, and days 17-19) that were less than 2 0 % and 5 % respectively were associated with the worst clinical outcomes.

Bhatraju et al. [33] 24 75.00% Prevalence of lymphopenia was

elevated despite a white blood count (W8C)>10,000/mm3 in 3 8 % of patients (median WBC of 8430/mm3)

A re n a et al. [32] 21 67.00% ARDS was present in 100%

of patients H em atological m anifestations of COVID-19

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Alain Minaab, Koen van Besienc and Leonidas C. P!atanias*-M

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N eutrophil-to-lym phocyte R atio Predicts Severe Illness Patients w ith 2019 Novel ( oronavirus in the F.arly M ag e JttSMiau Ian1 ’ . Yao Lin1 *. Pan Lm Pu*. Haofcns Xious'. C h in n dung U . Mm* Zhang'. Junl>o Tan1. Yauli Xn'. Ru> Song’- Molina Song*. Lui Wane’. Wo /'liana' Bins Han’. Li Y a w r. Xiaojing Wang' (miqin Zhou'. T ax Zhang*. Boi I.»*.

Yantai) Wang* *. Zbihai O io r'“. Xnnbo Wansr *

doi: https ://doi ofgHO.1101/2020 02 10.20021584.

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NLR < 3.13

NLR > 3.13

NLR >3.13

Tidak ada risiko, sa r a n : Isolasi rumah

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1 Risiko sedang,

saran: rawat r.isolasi monitoring respirasi

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Risiko tinggi, s a r a n : rawat ICU

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Table 1. Biom arker abnorm alities in C 0 V ID -1 9 patients w ith severe system ic disease and potential new biomarkers.

H em atologic biom arkers_____________ Biochemical biom arkers Coagulation biom arkers Inflam m atory biom arkers Potential new biom arkers

t 1 1 i T 1 J l

Lym phocyte co u n t ALT Albumin PT ESR Hey Ang-(1-7)

Platelet co u n t AST D-dimer CRP Ang II Ang-(1-9)

Eosinophil count Total bilirubin Serum ferritin NLR A lam andine

T cell count Blood urea nitrogen p a MLR

B cell count CK IL-2

NK cell co u n t LDH IL-6

Myoglobin IL-8

CK-MB IL-10

Cardiac troponin 1 Creatinine WBC count

Neutrophil count

WBC: w hite blood cell; NK: natural killer; ALT: alanine am inotransferase; AST: aspartate am inotransferase; CK: creatine kinase; LDH: lactate dehydrogenase;

PT: prothrom bin time; ESR: erythrocyte sedim entation rate; CRP: C-reactive protein; PCT: p io cakitonin; IL: interleukin; Hey: hom ocysteine; Ang; angiotensin;

NLR: n eu trophil-lym phocyte ratio; MLR: m onocyte-lym phocyte ratio.

Biomarkers associated with COViD-19 disease progression

G iovanni Ponti*, M onia M accaferrib, Cristel Ruiniac, A ldo Tomasi® a n d Tom ris O z b en d

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CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES . https-yf'doi.org/l0.1080/104083632020.1770685

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| B. DIAGNOSIS 1. Hematologi

a. Hitung limfosit absolut / absolute lymphocyte count (ALC) <1500/|i,L

b. Neutrophil Lymphocyte Ratio (NLR) > 3,13 2. CRP > lOmg/L

3. Pemeriksaan molekuler (TCM, Real Time PCR), atau 4. Kombinasi rapid test antibodi dan

PCR (konvensional/TCM/ffeo/ Time PCR)

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USULAN PANDUAN PEM ERIKSAAN LABO RATO RIUM COVID-19 A. Skrinning

1. Hematologi

a. Hitung limfosit absolut / absolute lymphocyte count (ALC) <1500/pL b. Netrophile Lymphocyte Ratio (NLR) > 3,13

2. CRP > lOmg/L

3. Pemeriksaan molekuler (TCM, Real Time PCR), atau

4. Rapid Test Antigen/Antibody (bila pemeriksaan molekuler tidak tersedia)

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C . P E M A N T A U A N

1. P e m a n ta u a n s e ria l s e tia p 1-3 h a ri, d ise su a ika n ko n d is i k lin is 2. P e m e riksa a n la b o ra to riu m

a. H e m a to lo g i 1) H e m o g lo b in 2) Ju m lah le u k o s it 3) N e u tro fil

4) H itu n g lim fo s it a b s o lu t (ALC) 5) N e u tro p h il ly m p h o c y te ra tio (NLR 6) Ju m la h tr o m b o s it

b. CRP c. F e ritin

d. A n a lisa Gas Darah e. E le k tro lit

f. P e m e riksa a n ta m b a h a n

1) h e m o s ta s is : PT, APTT, D -D im e r 2) Fungsi g in ja l: u re u m , c re a tin in e 3) Fungsi h a t i : SGOT,SGPT, LDH

4) P e m e riksa a n la in n ya sesuai k o m o rb id pasien g. PCR (k o n v e n s io n a l/T C M /R e o / Time PCR)

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D, SURVEILANS/ CONTACT TRACING

Pemeriksaan Laboratorium Kombinasi rapid test antibody

dan PCR (konvensional/TCM/Reo/ Time-PCR)

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Dalam dokumen KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS ANDALAS (Halaman 37-47)

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