Hubungan Derajat Keparahan Gejala, D-Dimer dan Rasio PaO2/FiO2 Pada Analisa Gas Darah terhadap Kejadian ARDS pada Pasien Covid-19 di Rumah Sakit Umum Pusat Haji Adam Malik Medan Sumatera Utara

Abstract

Background : Global experience of managing patients with COVID-19-related acute respiratory distress syndrome (ARDS) is growing rapidly, along with an increasing number of reports on respiratory system mechanics and ventilator management. Over the past two decades, ARDS heterogeneity has become increasingly recognized, and efforts have been made to describe subgroups of patients with different clinical and biological characteristics, clinical outcomes, and treatment responses. Given the importance of mechanical ventilation of lung protectors in ARDS. With the increase in COVID-19 cases, the purpose of this study is how the relationship of the severity of symptoms, d-dimer and pao2/FiO2 ratio in blood gas analysis of ards incidence in COVID 19 patients at RSUP H Adam Malik Medan, North Sumatra. Method: The design of this study is analytical research with cross sectional design using data on the medical records of patients diagnosed as COVID-19 patients with ARDS and non-ARDS who are treated in the isolation room of Adam Malik Hajj Central General Hospital. Results : In this study, in terms of the severity of symptoms, there was a meaningful relationship (p=0.000). It was later found a significant association between d-dimer levels in early admission patients with ARDS incidence in COVID-19 patients and a 7.3 times higher risk of d-dimer being ARDS, according to the Mert O et all study. In older age (>40 years) can not be meaningful relationships (p = 0.284), but older age is more experienced ARDS. Results : There is no meaningful relationship between age, gender, cough, loss of smell, loss of taste, fever, nausea, myalgia, colds, diarrhea, smoking habits, comorbid factors, PaO2/FiO2 ratio of ARDS incidence. Then, there is a link between shortness of breath, severity of symptoms and d-dimer values against ARDS events. Thoracic photos cannot be assessed because all research subjects have bilateral infiltrates. Then there was the meaningful relationship between the sexes and the incidence of ARDS (p=0.005), men at 3.8 times higher risk of becoming ARDS. In terms of complaints, shortness of breath and loss of smell are quite significant (p=0.000, p=0.000), not by coughing, loss of taste, fever, nausea, muscle aches, chest pain, colds, and diarrhea (p=0.312, p=1,000, p=0.750, p=1,000, p=0.059, p=0.460, p=0.255, p=0.589, respectively). There was a significant association between smoking habits and ARDS incidence and when further analysis was conducted, patients with smoking habits 2.8 times developed into ARDS compared to non-smoking patients. The thoracic photo relationship to ards events cannot be assessed because all research subjects have bilateral infiltrates. The relationship of comorbid factors to ARDS events, 29 of which were found to be comorbid, but statistically, there is no meaningful relationship between comorbid factors and ARDS events. Conclusion: There is no meaningful relationship between age, cough, loss of smell, loss of taste, fever, nausea, muscle pain, colds, diarrhea, smoking habits, comorbid factors, PaO2/FiO2 ratio there is an incidence of ARDS. Then, there is a meaningful relationship between the severity of symptoms, d-dimer values, gender and shortness of breath to the incidence of ARDS. Thoracic photos cannot be assessed because all research subjects have bilateral infiltrates.