Hubungan Komorbid dengan Mortalitas Pasien Covid-19 di Ruang Isolasi RS Universitas Sumatera Utara

Abstract

Background: COVID-19 is still a pandemic and a global health problem. Previous studies have found that several comorbidities have an effect on the mortality of COVID-19 patients, but the extent to which these comorbid specifically have an impact on mortality is still being debated. This study aims to examine the extent to which comorbidities affect mortality and the factors that influence this relationship. Objective: the relationship between comorbidities and mortality and the factors that influence this relationship in COVID-19 patients at Universitas Sumatera Utara Hospital. Material and Methods: This research is a descriptive study with a cross-sectional design using data from the medical records of patients diagnosed with COVID-19 who were treated in the isolation room at the Universitas Sumatera Utara (USU) General Hospital from April 2020 to October 2021. Data analysis used logistic regression to determining the relationship between comorbidities and mortality and the factors that influence it. Analysis of the relationship between comorbidities and mortality used bivariate analysis and was considered significant if the p value < 0.05, then followed by a multivariate analysis of comorbidities with a p > 0.25 to determine the factors that influence this relationship. Results: Out of a total of 242 samples, 78 subjects (32.6%) with comorbid hypertension were found, then the second most was diabetes mellitus as many as 52 subjects (21.8%), the next was comorbid heart disease as many as 39 subjects (16.3%), kidney failure 22 subjects (9.2%), 18 subjects (7.5%) pregnant, malignancy 8 subjects (3.3%), COPD 7 subjects (2.9%), stroke 6 subjects (2.5 %), asthma 5 subjects (2.1%), obesity 5 subjects (2.1%), tuberculosis 4 subjects (1.7%), while comorbid that were the least encountered were autoimmune and comorbid in 1 subject (0, 4%). A total of 82 subjects (34.3%) had no comorbidities. In this study, comorbidities that were associated with mortality were kidney failure (p-value; 95% CI 4.29 -33.62) and malignancy (p value 95% CI 1.5 – 30.7). In multivariate analysis, it was found that the only comorbid that had a relationship with mortality was the malignancy comorbid (p-value 0.015; OR 14.2; 95% CI 1.68-120.4) with the confounding variables being the number of comorbidities, degree of disease, procalcitonin Conclusion: This study found that comorbidities that had an effect on mortality were renal failure with malignancy, this was different from previous studies. However, this study has differences because it examines the factors that can influence this relationship.