Hubungan Merokok Dengan Derajat Keparahan Dan Mortalitas Pasien COVID-19 Rawat Inap di RS Saiful Anwar Malang

Authors

  • Aditya Sri Listyoko Pulmonologi dan Kedokteran Respirasi Fakultas Kedokteran Universitas Brawijaya, Indonesia
  • Susanthy Djajalaksana Pulmonologi dan Kedokteran Respirasi Fakultas Kedokteran Universitas Brawijaya, Indonesia
  • Triwahju Astuti Pulmonologi dan Kedokteran Respirasi Fakultas Kedokteran Universitas Brawijaya, Indonesia

DOI:

https://doi.org/10.36408/mhjcm.v7i1A.464

Keywords:

COVID-19, Keparahan, Mortalitas, Merokok

Abstract

Latar Belakang: Sejak Desember 2019 ketika pertama kali kasus COVID-19 diidentifikasi di Wuhan, China, SARS-CovV-2 menyebar ke seluruh dunia dan memberikan angka penyebaran infeksi dan mortalitas yang terus meningkat. Merokok memberikan dampak negatif terhadap kesehatan paru. Merokok sampai saat ini diasumsikan merupakan faktor risiko berbagai penyakit paru dan pernapasan seperti PPOK, kanker paru, termasuk pengaruh terhadap sistem pertahanan jalan napas terhadap berbagai mikroorganisme patogen. Prevalensi merokok di Indonesia sangat tinggi, dimana masih sedikit sekali studi yang dilakukan di Indonesia khususnya menilai risiko riwayat merokok terhadap derajat keparahan dan mortalitas pada pasien COVID-19 yang dilakukan rawat inap.

Tujuan: Menganalisis riwayat merokok pada pasien COVID-19 yang dirawat di RS rujukan utama dan hubungannya dengan derajat keparahan penyakit dan mortalitas.

Metode: Kami melakukan analisis observasional dengan pendekatan cross sectional, single-center, pada 77 pasien terkonfirmasi COVID-19. Data diambil antara bulan April-Juli 2020 pasien yang dirawat di Ruang COVID RS Dr. Saiful Anwar Malang, Indonesia. Uji statistik dipergunakan untuk menilai hubungan riwayat merokok dengan derajat keparahan dan mortalitas.

Hasil: Subjek terdiri 77 pasien terkonfirmasi COVID-19 terbagi 2 kelompok yaitu 31 (40,25%) pasien ringan-sedang dan 46 (59,74%) pasien kelompok berat. Subjek dikelompokkan menjadi luaran hidup 52 (68,42%) dan meninggal 24 (31,57%) untuk analisis mortalitas. Analisis statistik menunjukkan riwayat merokok berkaitan dengan derajat keparahan penyakit (p=0,008; OR: 4,75, 95%CI 1,426-15,817) dan mortalitas (p=0,045, OR: 2,821, 95%CI 1,007-7,900) pasien COVID-19 yang dilakukan rawat inap di rumah sakit. Kesimpulan: Merokok berkaitan dengan risiko COVID berkembang ke derajat berat serta mortalitas pada pasien COVID-19 yang dilakukan rawat inap.

Kata kunci: COVID-19, Keparahan, Mortalitas, Merokok

 

Background: Since December 2019, when the COVID-19 case was first identified in Wuhan, China, SARS-CoV-2 has spread worldwide and increased the incidence and mortality. To date, smoking is assumed to be a risk factor for various respiratory diseases such as COPD, lung cancer, also influences the airway defense system against various pathogenic microorganisms. The prevalence of smoking in Indonesia is very high where very few studies have been conducted in Indonesia especially assessing the risk of smoking and disease severity and mortality in hospitalized COVID-19 patients. Objective : To determine the risk of smoking history among hospitalized COVID-19 patients in tertiary care referral hospital and its association with disease severity and mortality. Methods: A cross-sectional single-center study was performed of 77 admitted laboratory-confirmed patients in a tertiary hospital in Malang City, East Java, Indonesia from April-July 2020. Statistical analysis was performed to evaluate the association between smoking and disease severity and mortality in COVID-19 patients. Results: A total of 77 patients with laboratory-confirmed COVID-19 were included in our analysis. Subjects divided in the mild-moderate and severe group 31 patients (40,25%) and 46 patients (59,74%) respectively. For mortality analysis, subjects divided into survivor 52 patients (68,42%) and non-survivor 24 patients (31,57%). Statistical analysis determine smoking associated with disease severity (p=0,008; OR : 4,75, 95%CI 1,426-15,817) and mortality (p=0.045, OR : 2,821, 95%CI 1,007-7,900) in hospitalized COVID-19 patients. Conclusion: In our cross-sectional study demonstrated history of smoking associated with disease severity and mortality in hospitalized COVID-19 patients.

Keywords: COVID-19, Mortality, Severity, Smoking

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References

1. Lu H, Stratton CW, Tang YW. The Wuhan SARS?CoV?2—What's next for China. J. Med. Virol. 2020 Jun;92(6):546-7.
2. World Health Organization. WHO Director-General’s opening remarks at the media briefing on COVID-19. https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020. Dipublikasikan 11 Maret 2020. Diakses 14 Juli 2020 jam 10.00.
3. Kemenkes RI. Infeksi Emerging : Media Informasi Resmi Terkini Penyakit Infeksi Emerging. https://infeksiemerging.kemkes.go.id/. Dipublikasikan 17 Agustus 2020. Diakses 17 Agustus 2020 jam 19.00.
4. Pemerintah Provinsi Jawa Timur. Jatim Tanggap Covid-19. http://infocovid19.jatimprov.go.id/. Dipublikasikan 17 Agustus 2020. Diakses 17 Agustus 2020 jam 19.00.
5. Pemerintah Kota Malang. Peta Persebaran Covid-19 di Kota Malang per 17 Agustus 2020. https://malangkota.go.id/2020/08/17/peta-persebaran-covid-19-di-kota-malang-per-17-agustus-2020/. Dipublikasikan 17 Agustus 2020. Diakses 17 Agustus 2020 jam 19.00.
6. Kemenkes RI. Hasil Utama Riset Kesehatan Dasar Tahun 2018. Kementrian Kesehatan Republik Indonesia. 2018:1-00.
7. Baskaran V, Murray RL, Hunter A, Lim WS, McKeever TM. Effect of tobacco smoking on the risk of developing community acquired pneumonia: A systematic review and meta-analysis. PloS one. 2019 Jul 18;14(7):e0220204.
8. Wong CM, Yang L, Chan KP, Chan WM, Song L, Lai HK, et al. Cigarette smoking as a risk factor for influenza?associated mortality: evidence from an elderly cohort. Influenza and other respiratory viruses. 2013 Jul;7(4):531-9.
9. Halim AA, Alsayed B, Embarak S, Yaseen T, Dabbous S. Clinical characteristics and outcome of ICU admitted MERS corona virus infected patients. Egyptian Journal of Chest Diseases and Tuberculosis. 2016 Jan 1;65(1):81-7.
10. Kementrian Kesehatan Republik Indonesia. Pedoman Kesiapsiagaan Menghadapi COVID-19 Revisi 4, 27 Maret 2020. Jakarta: Kementerian Kesehatan Republik Indonesia. 2020; 45-47
11. World Health Organization. WHO report on the global tobacco epidemic 2019: Offer help to quit tobacco use. 2019; 19
12. Gakidou E, Afshin A, Abajobir AA, Abate KH, Abbafati C, Abbas KM, Abd-Allah F, Abdulle AM, Abera SF, Aboyans V, Abu-Raddad LJ. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet. 2017 Sep 16;390(10100):1345-422.
13. Perez-Warnisher MT, de Miguel MP, Seijo LM. Tobacco use worldwide: legislative efforts to curb consumption. Annals of global health. 2018;84(4):571.
14. Feldman C, Anderson R. Cigarette smoking and mechanisms of susceptibility to infections of the respiratory tract and other organ systems. Journal of Infection. 2013 Sep 1;67(3):169-84.
15. Duffney PF, Embong AK, McGuire CC, Thatcher TH, Phipps RP, Sime PJ. Cigarette smoke increases susceptibility to infection in lung epithelial cells by upregulating caveolin-dependent endocytosis. PloS one. 2020 May 21;15(5):e0232102.
16. Brake SJ, Barnsley K, Lu W, McAlinden KD, Eapen MS, Sohal SS. Smoking upregulates angiotensin-converting enzyme-2 receptor: a potential adhesion site for novel coronavirus SARS-CoV-2 (Covid-19). J. Clin. Med. 2020, 9(3), 841
17. Kozak R, Prost K, Yip L, Williams V, Leis JA, Mubareka S. Severity of coronavirus respiratory tract infections in adults admitted to acute care in Toronto, Ontario. J Clin Virol. 2020 May; 126: 104338.
18. Hu L, Chen S, Fu Y, Gao Z, Long H, Ren HW, et al. Risk factors associated with clinical outcomes in 323 COVID-19 patients in Wuhan, China. Medrxiv. 2020 Jan 1.
19. Zhao, Q, Meng, M, Kumar, R, et al. The impact of COPD and smoking history on the severity of COVID?19: A systemic review and meta?analysis. J Med Virol. 2020; 1– 7.
20. Perrotta F, Matera MG, Cazzola M, Bianco A. Severe respiratory SARS-CoV2 infection: Does ACE2 receptor matter?. Respiratory Medicine. 2020 Apr 25:105996.
21. Cai G, Bossé Y, Xiao F, Kheradmand F, Amos CI. Tobacco smoking increases the lung gene expression of ACE2, the receptor of SARS-CoV-2. American journal of respiratory and critical care medicine. 2020 Apr 24(ja).
22. World Health Organization. Smoking and COVID-19 Scientific Brief. https://www.who.int/news-room/commentaries/detail/smoking-and-covid-19. Dipublikasikan 30 Juni 2020. Diakses 16 Juli 2020.

Additional Files

Published

2020-08-28

How to Cite

1.
Listyoko AS, Djajalaksana S, Astuti T. Hubungan Merokok Dengan Derajat Keparahan Dan Mortalitas Pasien COVID-19 Rawat Inap di RS Saiful Anwar Malang. Medica Hospitalia J. Clin. Med. [Internet]. 2020 Aug. 28 [cited 2024 Apr. 27];7(1A):137-43. Available from: http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/464

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