The high mortality rate due to Covid-19, cannot be separated from hypertension and obesity as comorbidities (congenital diseases) as well as blood coagulation in Covid-19 patients. This is revealed from the results of research conducted by researchers from the Faculty of Medicine, Universitas Indonesia (FKUI) and has been published in the international journal Global Heart. The study entitled “Cardiometabolic Morbidity and Other Prognostic Factors for Mortality in Adult Hospitalized Covid-19 Patients in North Jakarta, Indonesia” is the first study in Indonesia on the prognostic factors of death from Covid-19.
Prognostic factors are factors that are believed to have a relationship with cases that can develop into terminal disease—either recovered, residual symptoms, worsening, causing damage, or causing death. In the context of Covid-19, prognostic factors must be recognized so that the handling of Covid-19 patients becomes faster and exact so that patient mortality can be reduced.
Indonesia is the country with the highest death toll in Asia, and the third most in the world – after India and Iran. At the end of 2020, in Indonesia there were at least 735,000 diagnosed cases of Covid-19 and 22,138 deaths due to Covid-19. Unfortunately, in the face of the Covid-19 pandemic, Indonesia has to deal with critical care capacity and limited funding. Apart from these challenges, not many people know about the prognostic factors of death in Indonesia. In fact, knowledge of these factors is important as a tool for detecting Covid-19 patients with high risk.
Using the retrospective cohort method, this study was conducted on 243 Covid-19 patients at Koja Hospital, Tanjung Priok, Jakarta, for the period 20 March–31 July 2020. Data on the group of survivors and those who died from Covid-19 were taken from the patient’s medical records to explore prognostic factors. . The data includes demographics, clinical examination, laboratory, and radiology of patients.
As a result, patients with congenital diseases, requiring immediate oxygen, abnormal RDW (red cell distribution width) status, and those undergoing chloroquine therapy (an antimalarial drug) have a higher risk of dying from Covid-19.
Covid-19 patients who died were more likely to have congenital diseases, such as hypertension, diabetes mellitus, and obesity. Likewise patients who experience blood clotting. This thrombotic situation may increase the risk of cardiac injury in Covid-19 patients. In addition, patients with an immediate need for oxygen also indicate the severity of the disease. Very low levels of oxygen in the blood cause excessive inflammation and progressive lung damage.
Other prognostic factors in patients with Covid-19 are higher variations in red blood cell size (RDW), low lymphocyte levels, and treatment with chloroquine. It is feared that the administration of antimalarial drugs could cause side effects for Covid-19 patients, especially on the heart and vascular system.
The study on the prognostic factors of death due to Covid-19 was chaired by dr. Arvin Pramudita and guided by Prof. Dr. dr. Bambang Budi S, Sp.JP(K), FISHR, FAsCC, FAPSC from the Department of Cardiology and Vascular Medicine FKUI- Harapan Kita National Heart Center, this involved a number of researchers from the Covid-19 service team at Koja Hospital, Tanjung Priok, Jakarta. There were six researchers involved in the study, namely dr. Siti Rosidah, dr. Novi Yudia, dr. Jeffri Simatupang, dr. Wulan Pingkan Sigit, dr. Rita Novariani, Sp.P., and dr. Priscilia Myriarda, Sp.JP.
Although the research data were collected from one hospital, this study is unique because RSUD Koja Tanjung Priok, Jakarta, has diverse patient demographics that reflect the general population. It is hoped that this research can be a guide for the government to prevent the collapse of the health system due to the pandemic. The complete research results can be read and downloaded at the link https://globalheartjournal.com/articles/10.5334/gh.1019/.
