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All Journal International Journal of Integrated Health Sciences Majalah Kedokteran Bandung Althea Medical Journal The Indonesian Biomedical Journal Medika Kartika : Jurnal Kedokteran dan Kesehatan Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Jurnal Darma Agung Tunas Medika Jurnal Kedokteran & Kesehatan Jurnal Ilmu Faal Olahraga Indonesia Indonesian Journal of Health Science
Delita Prihatni
Department Of Clinical Pathology, Faculty Of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung
Humanities Biochemistry, Genetics & Molecular Biology Civil Engineering, Building, Construction & Architecture Computer Science & IT Decision Sciences, Operations Research & Management Dentistry Health Professions Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Library & Information Science Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Veterinary

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EFEK HEPATOTOKSIK ANTI TUBERKULOSIS TERHADAP KADAR ASPARTATE AMINOTRANSFERASE DAN ALANINE AMINOTRANSFERASE SERUM PENDERITA TUBERKULOSIS PARU Delita Prihatni; Ida Parwati; Idaningroem Sjahid; Coriejati Rita
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 12, No 1 (2005)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v12i1.831

Abstract

Tuberculosis (TB) is still a major health problem, especially in the developing countries. The combination of antituberculosis drugs are generally recommended for the treatment of tuberculosis. Van Crevel study in Jakarta found that most (70%) of patients with pulmonary TB who received combined antituberculosis drugs with standard (450 mg) dose rifampicin had very low plasma rifampicin level. Based on this results, TB Research and Clinical Trial Centre Bandung & University Medical Centre Nijmegen, The Netherlands conduct the study which compared clinical outcome between standard and high (600 mg) dose of rifampicin. Most of antituberculosis drugs currently available are very low in causing acute and chronic toxicities, however we must keep aware of side effect during the treatment. The most serious adverse effect of several drugs is liver damage (drug induced hepatitis) and potentially fatal hepatitis. To detect liver demage earlier aspartate aminotransferase( AST) and alanine aminotransferase (ALT) serum level were examined during antituberculosis treatment. The aim of this study was to determine AST and ALT serum level at intensif phase of antituberculosis treatment with standard and high dose rifampicin. The study had been done from August 2003 to September 2004 at Dr Hasan Sadikin Hospital and Balai Pengobatan Penyakit Paruparu, Bandung. The subjects were divided randomly into 2 groups. The first group consisted of patients with category I antituberculosis drugs with standard dose rifampicin and the second group patients also category I with high dose rifampicin. Aspartate aminotransferase and ALT serum level were examined at week 0 (before treatment), 2nd, 4th, and 8th. This was randomized clinical trial with paralel design study. Statistical analysis used paired t test to compare the dose effect of rifampicin to AST and ALT serum level changes, t independent test to compared mean difference of AST and ALT serum level changes which is projected by profile analysis. p value < 5%.. The prevalence of the hepatotoxicity were 17.39% of standard dose and 18.17% of high dose rifampicin. The hepatotoxicity were mild and moderate level,and it was already present at 2 weeks of therapy. There were no significant difference of AST and ALT serum level beetween those two groups. Conclusion: In this study antituberculosis drugs with high dose rifampicin were safe for TB patients.
COMPARATIVE RATIO OF BCR-ABL GENES WITH PCR METHOD USING THE CODIFICATION OF G6PD AND ABL GENES IN CHRONIC MYELOID LEUKEMIA PATIENTS (Perbandingan Angka Banding Gen BCR-ABL Metode PCR Menggunakan Baku Gen Glucosa-6-Phosphate Dehidrogenase dan Gen Abelson Kinase di Pasien Chronic Myeloid Leukemia) Tonggo Gerdina Panjaitan; Delita Prihatni; Agnes Rengga Indrati; Amaylia Oehadian
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 23, No 1 (2016)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v23i1.1186

Abstract

Chronic Myeloid Leukemia (CML) adalah keganasan hematopoetik pertama yang dihubungkan dengan jejas genetik. Chronic MyeloidLeukemia digolongkan sebagai penyakit mieloproliferatif kronis disebabkan translokasi resiprokal kromosom 9 dan 22 yang disebutkromosom Philadelphia (Ph). Kromosom Ph membentuk gen yang disebut BCR-ABL. Pemeriksaan molekuler CML bertujuan untukmengetahui aktivitas transkripsi mRNA gen BCR-ABL, yang berguna untuk menetapkan diagnosis dan pemantauan pengobatan pasienCML. Saat ini, WHO mempublikasikan ada sembilan (9) gen baku yang digunakan secara luas. Tujuan penelitian ini adalah untukmengetahui angka banding gen BCR-ABL/G6PD dan BCR-ABL/ABL di pasien CML dengan kromosom Ph (+) secara membandingkan.Penelitian ini menggunakan 79 bahan biologis tersimpan (BBT) mRNA Ph (+) dari leukosit pasien CML yang datang ke RSUPDr. Hasan Sadikin Bandung selama masa waktu antara bulan April 2012−April 2014. Pemeriksaan angka banding gen BCR-ABL/G6PDdengan metode Real-time Quantification PCR menggunakan alat LightCycler® Roche. Angka banding gen BCR-ABL/ABL diperiksamenggunakan alat Bioneer®. Gen baku G6PD dapat mendeteksi tipe b2a2, b3a2 dan e1a2. Gen baku ABL hanya dapat mendeteksi tipeb2a2 dan b3a2, tetapi lebih stabil bila dibandingkan dengan gen baku G6PD. Bentuk penelitian adalah perbandingan analitik denganrancangan kajian potong lintang. Analisis statistik menggunakan uji nonparametrik Wilcoxon. Hasil angka banding mRNA gen BCRABL/G6PD dan gen BCR-ABL/ABL [1,93% (0,0–59,7 fg) vs 15,37% (0,04–35,7 kopi), p<0,001]. Gen BCR-ABL tidak terdeteksi di 3 BBTdengan menggunakan gen baku ABL. Berdasarkan telitian ini, dapat disimpulkan, bahwa terdapat perbedaan bermakna antara angkabanding gen BCR-ABL/G6PD dan yang terkait BCR-ABL/ABL. Gen baku yang sama diperlukan untuk mendiagnosis dan memantaurespons pengobatan.
FUSI GEN BREAKPOINT CLUSTER REGION ABELSON KINASE (BCRABL) DAN UJI HEMATOLOGIS RUTIN Delita Prihatni; Ida Parwati; Rahmat Sumantri; Rully MA. Roesli; Nurizzatun Nafsi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 20, No 1 (2013)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v20i1.440

Abstract

Chronic myeloid leukemia (CML) is a type of Chronic myeloproliferative disorders in pluripotencial stem cell haematopoiesis cell disease caused by somatic mutation chromosomal translocation of the Abelson (ABL) and Breakpoint Cluster Region (BCR) genes on chromosomes 9 and 22. The Breakpoint Cluster Region Abelson Kinase (BCR-ABL) gene encodes different fusion transcripts of messenger Ribo Nucleic acid (m RNA)/type of fusion gene that vary in size depending on the breakpoint in the BCR gene. The majority of CMLcases have been shown to have either b3a2 or b2a2 fusion gene. This research is a preliminary study designed to know how to identify a quantification BCR-ABL gene and expression fusion of gene and its relation to routine haematological parameters. The researchers analyzed 12 adults who were positive using a quantification ratio BCR-ABL and Glucose-6-Phosphate Dehydrogenase (G6PDH) as a house keeping gene by real-time quantitative polymerase chain reaction (RQ PCR) of chronic phase of CML patients, qualitative of translocation of BCR-ABL gene by gel agarose and routine haematological tests by a haematologic analyzer. The average quantification ratio of BCRABL gene and G6PDH was 0.0881, 50% patients had b3a2 fusion gene, 41.6% had b2a2 dan 0.4% had e1a1. Fusion gene b3a2 showed a quantification ratio, haemoglobin level and leukocyte count higher compared to b2a2 fusion gene.
KADAR HEMOGLOBIN RETIKULOSIT DI ANEMIA DAN NONANEMIA AKIBAT DEFISIENSI BESI ABSOLUT DI GAGAL GINJAL TERMINAL TERKAIT HEMODIALISIS (Reticulocyte Hemoglobin Level of Absolute Iron Deficiency Anemia and NonAbsolute Iron Deficiency Anemia In End State Renal Disease Undergoing Maintenance Hemodialysis) Amelia Rachmiwatie; Noormartany Noormartany; Rubin Surachno Gondodiputro; Delita Prihatni
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 21, No 1 (2014)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v21i1.1256

Abstract

Absolute Iron Deficiency Anemia (IDA) is one of the complications in the End State Renal Disease (ESRD) patients undergoingmaintenance hemodalysis, with an incidence of 76.4%. If this condition is not properly addressed, it can lead to impaired cardiac functionand increased mortality. The incidence of this case is between 30−45%. The determination of the iron status in ESRD patients wqs setby the Perhimpunan Nefrologi Indonesia 2011 using serum ferritin and transferrin saturation, but they do not provide a meaningfulchange in the value of the initial state of the iron deficiency. This condition should be examined with other parameters combination aswell as those influenced by diurnal variation and infection-inflammation condition. Reticulocyte hemoglobin (Ret-He) parameter canbe used as a marker of bone marrow iron availability because these reticulocytes are young erythrocytes released from the bone marrowinto the circulation. These conditions were circulated only within a short time about 1-2 days before becoming mature erythrocytes. Theaim of this study was to determine the Ret-He level diferentiation between absolute IDA and non absolute IDA states in ESRD patientswhom underwent maintenance hemodialysis. This research was conducted in the Laboratory of Clinical Pathology-RSHS-Bandung fromSeptember 2012 to June 2013. The study design was cross-sectional. All subjects were ESRD patients undergoing hemodialysis maintenancefor at least three (3) months and consisted of absolute IDA and non-absolute IDA based on the results of the ferritin and transferrinsaturation calculations according to the criteria of Pernefri 2011 Reticulocyte hemoglobin levels were checked using a fluorescenceflowcitometry principle in the automated hematology analyzer. In this study it was found that the Ret-He mean in the absolute IDA was26.1 pg/cell and 35.9 pg/cell in non absolute IDA. Statistical analysis was performed using Independent T-test. A total of 61 undergoingmaintenance hemodialysis subjects participating in this study comprised patients with absolute IDA and non-absolute IDA who met theinclusion and exclusion criteria. It can be concluded that the Ret-He level in statistical analysis showed absolute IDA which was meaningfullower than nonabsolute IDA in ESRD patients undergoing maintenance hemodialysis (p<0.001).
UJI KESAHIHAN (VALIDITAS) PEMERIKSAAN D-DIMER CARA MENYARING KEKEBALAN (METODE IMUNOFILTRASI) DAN CARA MENGUKUR IMUNOTURBIDIMETRI David Rustandi; Delita Prihatni; Tiene Rostini; Nina Tristina
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 17, No 1 (2010)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v17i1.1049

Abstract

D-Dimer parameter is the most usefull laboratory assay to detect the present of activated coagulation. The D-Dimer fragment directlyindicate the fibrinolitic proccess whereas the increasing mark of D-Dimer is the most hemostatic parameter that was used to detectthe early stage of Disseminated Intravascular Coagulation (DIC) and has a correlation with the patient prognosis. D-Dimer assay byimmunoturbidimetric method was used to detect antigen-antibody reaction automatically and it can detect D-Dimer concentration lessthan 0.5 μg/mL. The immunoturbidimetric method has a good correlation with the ELISA method, but the proccess is complicated, ishigh costed, and need the competence of practical human resource. D-Dimer assay with immunofiltration method has the same principleas immunoturbidimetric method, but it's work more simpler, low cost and does not need the competence of practical human resource.The aim of this study is to compare the D-Dimer assay concentration between immunofltration and immunoturbidimetric method. Therewere 30 plasma samples assayed with these two methods (immunoturbidimetric and immunofiltration), and then compared betweenthem. The samples were collected between November until December 2008 at Rumah Sakit dr. Hasan Sadikin Bandung. The validity ofD-Dimer using immunofiltration method showed sensitivity 74%, specificity 95%, predictive value of negative test (PV-) 22%, predictivevalue of positive test (PV+) 95% with likelihood ratio 5.2. The conclusion of this study so far that the immunofiltration method has agood validity for diagnosing. D-Dimer work rapidly with low cost laboratory assay than the immunoturbidimetric method.
PERBANDINGAN KADAR HEMOGLOBIN ANTARA METODE SPECTROPHOTOMETER DENGAN METODE HEMOCUE PADA SAMPEL LEUKOSITOSIS Basti Andriyoko; Leni Lismayanti; Delita Prihatni
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 15, No 3 (2009)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v15i3.975

Abstract

Background and objective: The measurement of haemoglobin was carried out by using hematology analyzer with specthrophotometermethod which measured light absorbance at 540 nm. However, this measurement affected by increase turbidity as a result of leucocytosis.The turbidity can be eliminated by using HemoCue method that detect absorbance at 570 nm and 880 nm. The aim of this study wasto compare the measurement of haemoglobin obtained between specthrophotometer method and HemoCue method. Materials andmethod: Blood EDTA sample that have been measured with MEK-6318K Nihon Kohden hematology analyzer for haemoglobin levelswith spectrophotometer methods with leucocyte > 100.000/mm3 were included in this study. Blood sample are measured again forthe haemoglobin level with HemoCue B-Haemoglobin Analyzer. This study was conducted at Clinical Pathology Laboratory, Dr. HasanSadikin Hospital Bandung from August–October 2008. Result: Seventeen leucocytosis sample were enroled in this study. The meanhaemoglobin level from specthrophotometer method is higher than HemoCue method, however there was no statistically significantdifference between haemoglobin result from specthrophotometer method and HemoCue method (p = 0.742 > a = 0.05). Conclusion:There was no significant difference beetween specthrophotometer method and HemoCue method for haemoglobin measurement ofleucocytosis sample.
Korelasi antara Immature Total Ratios Berdasarkan Sediaan Apus Darah Tepi dan Immature Granulocyte Ratios Alat Hematology Analyzer pada Sepsis Neonatus Isti Noviani; Delita Prihatni; Nida Suraya
Tunas Medika Jurnal Kedokteran & Kesehatan Vol 5, No 2 (2019): Tunas Medika Jurnal Kedokteran & Kesehatan
Publisher : Tunas Medika Jurnal Kedokteran & Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Latar belakang Sepsis merupakan salah satu penyebab utama kematian neonatus. Tanda awal sepsis pada neonatus sering tidak spesifik dan sulit dibedakan dengan berbagai kondisi lain sehingga diperlukan pemeriksaan penunjang untuk membantu menegakkan diagnosis. Berbagai penelitian menunjukkan rasio granulosit immature (Rasio IG) dan rasio IT (Rasio granulosit immatur (I) terhadap netrofil (T)) dapat membantu menegakkan diagnosis sepsis pada neonatus.Tujuan Untuk mengetahui korelasi antara rasio IT yang diperiksa dengan sediaan apus darah tepi (SADT) dengan rasio IG yang diperiksa dengan hematology analyzer pada neonatus yang didiagnosis sepsis.Metode Subjek penelitian adalah neonatus dengan diagnosis sepsis yang dirawat di Neonatal Intensive Care Unit RS. Dr. Hasan Sadikin Bandung selama periode Juli – September 2012. Metode penelitian adalah observasional analitik korelatif dengan analisis Pearson Correlation Test yang menganalisis korelasi antara rasio IT berdasarkan SADT dengan rasio IG berdasarkan hematology analyser. Perhitungan statistik dilakukan dengan program SPSS for windows versi 18.0.Hasil penelitian Subjek penelitian terdiri dari 13 (43,3%) laki-laki dan 17 (56,7%) perempuan. Terdapat korelasi antara rasio IT berdasarkan SADT dengan rasio IG berdasarkan hematology analyser dengan nilai p=0, 026 dan koefisien korelasi 0,40.Simpulan. Terdapat korelasi bermakna antara rasio IT dan rasio IG pada neonatus yang menderita sepsis dengan kekuatan korelasi sedang.BACKGROUND. Sepsis is one of the leading causes of neonatal death. Early signs of neonatal sepsis are often non- specific and difficult to distinguish from other conditions requiring investigation to establish the diagnosis. Various studies show that immature granulocytes ratios (IG Ratios) and the IT ratios (the ratio of immature granulocytes (I) to neutrophils (T) ) can help establish the diagnosis of neonatal sepsis.PURPOSE. To assess the correlation between IT ratios by blood smear with IG ratios by Hematology Analyzer in neonatal sepsis.METHOD. The study subject were neonates with diagnosis of sepsis who were admitted to Neonatal Intensive care of Dr. Hasan Sadikin hospital during the period of July – September 2012. This is an observational, analytical, correlative study with the Pearson Correlation Test analysis that analysed the correlation between the IT ratios by blood smear with IG ratios by hematology analyzer. Statistical calculations performed using SPSS for Windows version 18.0.RESULT. The study subject consisted of 13 (43.3%) men and 17 (56,7%) women. There was a correlation between IT ratios by blood smear with IG ratios by hematology analyzer (p=0.026) with correlation coefficient of 0.40.CONCLUSION. There was significant correlation between IT ratios with IG ratios with moderate correlation strenght. KEY WORDS :  Sepsis, Neonates, IG ratios, IT ratios.
PROFIL SCATTERGRAM LIMFOSIT PADA LANSIA DENGAN NYERI TULANG DAN ANEMIA Taureni Hayati; Delita Prihatni; Nina Tristina
Jurnal Darma Agung Vol 30 No 2 (2022): AGUSTUS
Publisher : Lembaga Penelitian dan Pengabdian kepada Masyarakat Universitas Darma Agung (LPPM_UDA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46930/ojsuda.v30i2.1593

Abstract

Lanjut usia menurut World Health Organization tahun 2017, adalah seseorang yang telah memasuki usia 60 tahun ke atas. Akibat berbagai proses aging yang terjadi pada lansia, maka lansia akan mengalami banyak keluhan, salah satunya nyeri tulang dan anemia. Berbagai keadaan pada lansia dapat menyebabkan nyeri tulang dan anemia antara lain: osteoporosis, osteomalasia, osteodistrofi renal, osteonekrosis, keganasan atau metastasis pada tulang, dari berbagai keadaan ini dapat dilihat profil limfosit dengan mengunakan scattergram white blood cell differential pada area A, B, C, D, dan E, sesuai dengan tujuan penelitian, ingin mengetahui profil scattergram limfosit pada lansia dengan nyeri tulang dan anemia. Metode penelitian: Penelitian ini merupakan observasional deskriptif dengan metode rancangan cross-sectional. Penelitian dilakukan dari bulan Februari-Juni 2020. Subjek penelitian adalah pasien lansia yang mengalami nyeri tulang dan anemia. Nyeri tulang diukur dengan Numeric Rating Scale skala 1-10. Anemia diukur dengan pemeriksaan hemoglobin pada alat hematology analyzer, kemudian dilakukan analisis scattergram melalui WDF menggunakan Sysmex XN 1000. Hasil Penelitian: Dari subjek yang memenuhi kriteria inklusi dan ekslusi didapatkan 30 subjek, berumur antara 60 - 72 tahun, laki laki 23 subjek (77%), perempuan 7 subjek (23%). Anemia rentang 8 - 10,9 g/dL, didapatkan profil scattergram pada area B SSC (A2, A3); SFL (B2, C2, D3, E3) sebanyak 21 subjek (70%) penelitian dibandingkan profil scattergram pada area A SSC (A2, A3); SFL (B2, C2, D3) ditemukan sebanyak 9 subjek (30%). Kesimpulan : Profil scattergram limfosit pada sebagian besar subjek lansia dengan nyeri tulang dan anemia berada pada area SSC (A2, A3), SFL (B2, C2, D3, E3), artinya adalah banyak yang mengalami perubahan profil limfosit, lebih banyak sel limfosit atipik dan dicurigai kearah sel plasma ataupun sel limfosit abnormal.
Correlation between Slope 2 in Clot Waveform Analysis of Activated Partial Thromboplastin Time with Factor VIII Activity in Hemophilia A Raissa Yolanda; Delita Prihatni; Coriejati Rita; Dewi Kartika Turbawaty
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 28, No 3 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i3.1869

Abstract

Hemophilia A is an inherited factor VIII deficiency disease, related to X chromosome. Diagnosis of Hemophilia A is made based on Factor VIII assay. Nowadays, Hemophilia A therapy is by giving factor VIII concentrate, so that monitoring of this therapy must be done by examine Factor VIII activity, but examination of Factor VIII activity is currently still limited in facilities and quite expensive. One of activated partial thromboplastin time (aPTT) optical methods can provide information about every stage of coagulation through clot waveform analysis. Factor VIII activity can describe in slope 2 of clot waveform analysis, which deficiency of factor VIII will cause slope 2 slighter than normal, because the clot form is not optimal and the light transmission recorded at clot waves do not decrease maximally. The aim of this study was to analyze the correlation between slope 2 on the clot waveform analysis of the optical method on aPTT test with Factor VIII activity in hemophilia A subjects. This was a correlative observational study cross sectional study, conducted at Hasan Sadikin General Hospital Bandung in August 2018-September 2019. The subjects were member of Hemophilia A sufferers of West Java Hemophilia Society. The research subjects were assesed for Factor VIII activity and optical method of aPTT. Slope 2 calculated from the clot waveform analysis that formed in aPTT examination. This study involved 43 subjects, with a median age of 6 years, an age range of 1-45 years, and 51.2% of patients aged 6-17 years. The results of Factor VIII activity in this study had a median 0% with a range 0-25.9%, and the value of slope 2 had a median 1.0%T/sec with a range 0.5-3.5%T/sec. The correlation test between slope 2 and Factor VIII activity with 95% confidence interval using Spearman's correlation test showed very strong positive correlation which statistically significant (r = 0.854 and p <0.001). Conclusion: there was a statistically significant very strong positive correlation between slope 2 on the clot waveform analysis of aPTT optical method test with the activity of Factor VIII in Hemophilia A.
The Combination of NLR and D-dimer as Predictor Instrument for the Severity of COVID-19 Shofia Widya Murti; Delita Prihatni; Adhi Kristianto Sugianli
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 28, No 3 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i3.1998

Abstract

Coronavirus Disease-19 (COVID-19) is caused by Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS-CoV-2). In severe cases, the immune response may cause a cytokine storm. Neutrophil Lymphocyte Ratio (NLR) and D-dimer are parameters that may be used to predict the severity of COVID-19. This study aims to determine the diagnostic validity of the combination of NLR and D-dimer on the severity of COVID-19 patients. The study population was hospitalized COVID-19 patients whose diagnosis were confirmed by real time-PCR. This was a retrospective cross-sectional study. The cut-off value was based on the Area Under Curve (AUC) of the Receiver Operator Characteristic Curve (ROC) analysis and the combination of NLR and D-Dimer validity was tested against the severe and non-severe COVID-19 groups by assessing sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV), positive Likelihood Ratio (LR+) and negative Likelihood Ratio (LR-). There were 1,314 subjects. Seven hundred and forty-four were in the severe group, 570 in the non-severe group. The combination of NLR > 4.02 and D-dimer > 1.12 mg/L on the severity of COVID-19 showed a sensitivity value of 70.8%, specificity 98.3%, PPV 98.1%, NPV 72.1%, LR+ 40.38 and LR- 0.30. The combination of NLR >4.02 and D-dimer >1.12 mg/L for the severity of COVID-19 showed high specificity and PPV (98.3% and 98.1%). This was also supported by the LR+ value, which indicates that if NLR > 4.02 and D-dimer > 1.12 mg/L, it may cause severe COVID-19 by 40.38 times compared to NLR ≤4.02, and D-dimer ≤1.12 mg/L. The combination of NLR and D-Dimer can be used to predict the severity of COVID-19.
Co-Authors Adhi Kristianto Sugianli Agnes Rengga Indrati Amaylia Oehadian Amelia Rachmiwatie Ani Melani Maskoen Astri Astuti Basti Andriyoko Budi Handono Cakra Jati Pranata Coriejati Rita David Rustandi Dewi Kartika Turbawaty Edhyana Sahiratmadja Edhyana Sahiratmadja Filbert Lois Marcus Fransisca Mulyadi Ida Parwati Idaningroem Sjahid Isti Noviani Ivan Lumban Toruan Lastri Supriatin Lelani Reniarti Leni Lismayanti Lisa Milena Anabela M. Fuad M. Marthoenis Muhammad Alamsyah Aziz Mulyanusa Amrullah Ritonga Nida Suraya Nida Suraya Nina Tristina Noormartany Nur Akmal Nur Suryawan Nur Suryawan Nur Suryawan Nurizzatun Nafsi Pandji Irani Fianza Rahmat Sumantri Raissa Yolanda Raja Iqbal Mulya Harahap Renaldi Satria Handika Reni Farenia Reni Nurazizah Rizki Andriyani Roes, Bellya Affan Rubin Surachno Gondodiputro Rully Marsis Amirullah Roesli Shofia Widya Murti Taureni Hayati Tiene Rostini, Tiene Tonggo Gerdina Panjaitan Yohana Kusuma Angkasa Yoyos Dias Ismiarto