•  
  •  
 

Abstract

Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). COVID-19 was the leading disease in terms of the highest number of hospital admissions and cause of death at the Tarakan Regional General Hospital (RSUD Tarakan) in 2022. COVID-19 patients who received treatment at the hospital were often individuals with underlying conditions, such as hypertension. Therefore, it is important to conduct research on comorbidities, specifically hypertension, and its relationship to COVID-19 mortality at the RSUD Tarakan’s inpatient in 2022, so the hospital can design spesific care plans for COVID-19 patients with hypertension. This study used a retrospective cohort design with secondary data from the RSUD Tarakan's SIMRS reports. A total of 534 samples met the criteria for analysis. The variables measured included COVID-19 mortality, patient’s age and gender, hypertension, type 2 Diabetes Mellitus (DM), heart failure, Chronic Kidney Disease (CKD), Acute Kidney Injury (AKI), sepsis, and Acute Respiratory Distress Syndrome (ARDS). Analysis was performed using cox proportional hazards regression. The results showed a significant association between hypertension and COVID-19 mortality (aRR= 0.406; 95% CI 0.250-0.659; p-value: 0.000) after controlling for age. This indicates that patients with hypertension were 59.4% less likely to die from COVID-19 compared to those without hypertension. It is important to note that there are other factors that were not considered in this study. Therefore, the researchers suggest conducting further studies which take into account the severity of hypertension and the impact of antihypertensive treatment on COVID-19 mortality.

References

1. Perhimpunan Dokter Paru Indonesia. Panduan Umum Praktik Klinis Penyakit Paru dan Pernapasan. Vol. 238. Jakarta: Perhimpunan Dokter Paru Indonesia; 2021.

2. Kementerian Kesehatan. Perkembangan Situasi Penyakit Infeksi Emerging. Kementerian Kesehatan; 2024.

3. Kementerian Kesehatan. Laporan Harian Covid-19. 2023;

4. Pemerintah Provinsi DKI Jakarta. Data Pemantauan COVID-19 DKI Jakarta [Internet]. 2023 [cited 2024 Oct 11]. Available from: https://corona.jakarta.go.id/id

5. CDC. Underlying Conditions and the Higher Risk for Severe COVID-19 [Internet]. 2024 [cited 2024 Oct 11]. Available from: https://www.cdc.gov/covid/hcp/clinical-care/underlying-conditions.html

6. BKPK Kemenkes. SKI 2023 Dalam Angka [Internet]. [cited 2024 Nov 30]. Available from: https://www.badankebijakan.kemkes.go.id/ski-2023-dalam-angka/

7. Kementerian Kesehatan. Laporan Nasional Riskesdas 2018. 2019 p. 674.

8. Oku K, Kimoto Y, Horiuchi T, Yamamoto M, Kondo Y, Okamoto M, et al. Risk factors for hospitalization or mortality for COVID-19 in patients with rheumatic diseases: Results of a nationwide JCR COVID-19 registry in Japan. Modern Rheumatology. 2023 Jul 4;33(4):768–76.

9. Oats A, Phung H, Tudehope L, Sofija E. Demographics, comorbidities and risk factors for severe disease from the early SARS‐CoV ‐2 infection cases in Queensland, Australia. Internal Medicine Journal. 2024 May;54(5):786–94.

10. Hengkrawit K, Thananon J, Telapol K, Chiewchalermsri C. Clinical Characteristics and Outcomes of Hospitalized COVID-19 Patients with Different Variants of SARS-CoV-2 in a Tertiary Care Hospital, Thailand. TropicalMed. 2024 Nov 5;9(11):266.

11. Lamers MM, Haagmans BL. SARS-CoV-2 pathogenesis. Nat Rev Microbiol. 2022 May;20(5):270–84.

12. Peng M, He J, Xue Y, Yang X, Liu S, Gong Z. Role of Hypertension on the Severity of COVID-19: A Review. Journal of Cardiovascular Pharmacology. 2021 Nov;78(5):e648–55.

13. Gubernur DKI Jakarta. Keputusan Gubernur DKI Jakarta Nomor 378 Tahun 2020 [Internet]. 2020 [cited 2024 Nov 28]. Available from: https://jdih.jakarta.go.id/dokumen/detail/2342/keputusan-gubernur-nomor-378-tahun-2020-tentang-penetapan-rumah-sakit-rujukan-penanggulangan-penyakit-coronavirus-disease-covid-19-produk-hukum-aktual

14. Gubernur DKI Jakarta. Keputusan Gubernur Nomor 14 Tahun 2021 tentang Perubahan Ketiga Atas Keputusan Gubernur Nomor 378 Tahun 2020 tentang Penetapan Rumah Sakit Rujukan Penanggulangan Penyakit Coronavirus Disease (covid-19). 2021.

15. Visualisasi Data - Layanan Permintaan Data | Kementerian Kesehatan RI [Internet]. [cited 2024 Dec 19]. Available from: https://layanandata.kemkes.go.id/katalog-data/covid-19/visualisasi-data/tren-harian-vaksin-covid-19

16. Kementerian Kesehatan. Laporan Harian Covid-19 (17) [Internet]. 2023. Available from: https://services.dataviz-unicef.id/uploads/dto_ketahanan_kesehatan/20230702213440-2023-07-02tbl_ketahanan_kesehatan213435.pdf

17. Guan W jie, Liang W hua, Zhao Y, Liang H rui, Chen Z sheng, Li Y min, et al. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. Eur Respir J. 2020 May;55(5):2000547.

18. Jaspard M, Sow MS, Juchet S, Dienderé E, Serra B, Kojan R, et al. Clinical presentation, outcomes and factors associated with mortality: A prospective study from three COVID-19 referral care centres in West Africa. International Journal of Infectious Diseases. 2021 Jul;108:45–52.

19. Marcello RK, Dolle J, Grami S, Adule R, Li Z, Tatem K, et al. Characteristics and outcomes of COVID-19 patients in New York City’s public hospital system. PLoS One. 2020 Dec;15(12):e0243027.

20. Dorjee K, Kim H, Bonomo E, Dolma R. Prevalence and predictors of death and severe disease in patients hospitalized due to COVID-19: A comprehensive systematic review and meta-analysis of 77 studies and 38,000 patients. PLoS One. 2020 Dec;15(12):e0243191.

21. Schönfeld D, Arias S, Bossio JC, Fernández H, Gozal D, Pérez-Chada D. Clinical presentation and outcomes of the first patients with COVID-19 in Argentina: Results of 207079 cases from a national database. Di Gennaro F, editor. PLoS ONE. 2021 Feb 11;16(2):e0246793.

22. Vahey GM, McDonald E, Marshall K, Martin SW, Chun H, Herlihy R, et al. Risk factors for hospitalization among persons with COVID-19—Colorado. PLoS One. 2021 Sep;16(9):e0256917.

23. Lowhorn RJ, Chowdhury M, Kimitei S, Haskin S, Masum M, Rahman AKMF. Comorbidities and their association with COVID-19 mortality in Mexico between January 2020 and August 2021. Pongpirul K, editor. PLoS ONE. 2024 Apr 17;19(4):e0296895.

24. Matangila JR, Nyembu RK, Telo GM, Ngoy CD, Sakobo TM, Massolo JM, et al. Clinical characteristics of COVID-19 patients hospitalized at Clinique Ngaliema, a public hospital in Kinshasa, in the Democratic Republic of Congo: A retrospective cohort study. Serra R, editor. PLoS ONE. 2020 Dec 18;15(12):e0244272.

25. Shah R, Shah J, Kunyiha N, Ali S, Sayed S, Surani S, et al. Demographic, Clinical, and Co-Morbidity Characteristics of COVID-19 Patients: A Retrospective Cohort from a Tertiary Hospital in Kenya. IJGM. 2022 Apr;Volume 15:4237–46.

26. Sivaselvi C, Manju R, Jayalakshmi R, Vishnukanth G, Vemuri MB, Subathra A, et al. Characterization of Post-COVID-19 Clinical Manifestations Among Patients Visiting a Post-COVID-19 Clinic in a Tertiary Care Center: A Descriptive Study. Cureus [Internet]. 2023 [cited 2024 Dec 11];15(7). Available from: https://www.proquest.com/publiccontent/docview/2859450549/abstract/6690F743A4F5486APQ/1

27. Deeb A, Khawaja K, Sakrani N, AlAkhras A, Al Mesabi A, Trehan R, et al. Impact of Ethnicity and Underlying Comorbidity on COVID-19 Inhospital Mortality: An Observational Study in Abu Dhabi, UAE. Soares MA, editor. BioMed Research International. 2021 Mar 1;2021:1–7.

28. Clinical Research Center, Hospital Seberang Jaya, Institute for Clinical Research, Ministry of Health Malaysia, Pulau Pinang, Malaysia, Danial M, Arulappen AL, Pharmacy Department, Hospital Seberang Jaya, Ministry of Health Malaysia, Pulau Pinang, Malaysia, Soelar SA, Clinical Research Center, Sultanah Bahiyah Hospital, Institute for Clinical Research, Ministry of Health Malaysia, Pulau Pinang, Malaysia, et al. Clinical Characteristics of Individuals Died with COVID-19 in Malaysia. MJPS. 2022 Nov 16;20(2):105–20.

29. Je D, O’Brolchain A, Ulett KB, Zainudheen A, Gerrard J, Alcorn K, et al. Demographics, clinical characteristics and outcomes among 197 patients with COVID ‐19 in the Gold Coast area. Internal Medicine Journal. 2021 May;51(5):666–72.

30. Aqmarina A. Hubungan Komorbid Hipertensi dengan Kematian Kasus Konfirmasi COVID-19 di Indonesia Periode Januari-Juni 2022. University of Indonesia; 2023.

31. Wulandari EW. Hubungan Komorbid Diabetes Melitus dengan Kematian pada Kasus Konfirmasi Coronavirus Diseases (COVID-19) Di DKI Jakarta, Periode Maret-Agustus 2020. University of Indonesia; 2021.

32. Juliane Z. Hubungan Hipertensi dan Diabetes Melitus Terhadap Kesintasan Pasien COVID-19 di RSJPD Harapan Kita Jakarta Maret 2020 - April 2021. University of Indonesia; 2022.

33. Rufaidah MF. Hubungan Hipertensi dengan Kejadian Mortalitas Pasien COVID-19 Tahun 2021 di RSUD Pasar Minggu, Jakarta, Indonesia. University of Indonesia; 2021.

34. Ssentongo P, Ssentongo AE, Heilbrunn ES, Ba DM, Chinchilli VM. Association of cardiovascular disease and 10 other pre-existing comorbidities with COVID-19 mortality: A systematic review and meta-analysis. Hirst JA, editor. PLoS ONE. 2020 Aug 26;15(8):e0238215.

35. Chidambaram V, Tun NL, Haque WZ, Majella MG, Sivakumar RK, Kumar A, et al. Factors associated with disease severity and mortality among patients with COVID-19: A systematic review and meta-analysis. PLoS One. 2020 Nov;15(11):e0241541.

36. Bepouka B, Situakibanza H, Sangare M, Mandina M, Mayasi N, Longokolo M, et al. Mortality associated with COVID‐19 and hypertension in sub‐Saharan Africa. A systematic review and meta‐analysis. J of Clinical Hypertension. 2022 Feb;24(2):99–105.

37. Trougakos IP, Stamatelopoulos K, Terpos E, Tsitsilonis OE, Aivalioti E, Paraskevis D, et al. Insights to SARS-CoV-2 life cycle, pathophysiology, and rationalized treatments that target COVID-19 clinical complications. J Biomed Sci. 2021 Jan 12;28(1):9.

38. Salah HM, Calcaterra G, Mehta JL. Renin-Angiotensin System Blockade and Mortality in Patients With Hypertension and COVID-19 Infection. J Cardiovasc Pharmacol Ther. 2020 Nov;25(6):503–7.

39. Huang NX, Yuan Q, Fang F, Yan BP, Sanderson JE. Systematic review and meta-analysis of the clinical outcomes of ACEI/ARB in East-Asian patients with COVID-19. Mogi M, editor. PLoS ONE. 2023 Jan 12;18(1):e0280280.

40. Gao C, Cai Y, Zhang K, Zhou L, Zhang Y, Zhang X, et al. Association of hypertension and antihypertensive treatment with COVID-19 mortality: a retrospective observational study. European Heart Journal. 2020 Jun 7;41(22):2058–66.

41. McFarlane E, Linschoten M, Asselbergs FW, Lacy PS, Jedrzejewski D, Williams B, et al. The impact of pre-existing hypertension and its treatment on outcomes in patients admitted to hospital with COVID-19. Hypertens Res. 2022 May;45(5):834–45.

42. Bhatia KS, Sritharan HP, Ciofani J, Chia J, Allahwala UK, Chui K, et al. Association of hypertension with mortality in patients hospitalised with COVID-19. Open Heart. 2021 Dec;8(2):e001853.

Bahasa Abstract

Corona Virus Disease 2019 (COVID-19) merupakan suatu penyakit menular yang disebabkan oleh Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). COVID-19 merupakan penyakit nomor satu dalam daftar kasus terbanyak dirawat inap sekaligus penyebab kematian tertinggi di Rumah Sakit Umum Daerah (RSUD) Tarakan pada tahun 2022. Pasien COVID-19 yang menjalani perawatan RS merupakan orang memiliki penyakit penyerta, seperti hipertensi. Oleh karena itu, penting dilakukannya penelitian terkait penyakit penyerta hipertensi dan hubungannya dengan kematian pasien COVID-19 di Layanan Rawat Inap RSUD Tarakan Tahun 2022 sehingga RS dapat menentukan tatalaksana khusus bagi pasien COVID-19 dengan hipertensi. Penelitian ini menggunakan desain kohort retrospektif dengan data sekunder dari laporan SIMRS RSUD Tarakan. Jumlah sampel yang memenuhi kriteria untuk dianalisis sebanyak 534. Variabel yang diukur adalah kematian pasien COVID-19, usia dan jenis kelamin pasien, hipertensi, Diabetes Melitus (DM) tipe 2, gagal jantung, Penyakit Ginjal Kronik (PGK), Penyakit Ginjal Akut (PGA), sepsis, dan Acute Respiratoru Distress Syndrome (ARDS). Analisis dilakukan dengan cox proportional hazards regression. Hasil yang didapatkan menunjukkan terdapat hubungan antara hipertensi dan kematian pasien COVID-19 (aRR= 0,406; 95%CI 0,250-0,659; p-value: 0,000) setelah dikontrol variabel usia. Artinya pasien hipertensi berisiko 59,4% lebih rendah untuk mengalami kematian COVID-19 dibandingkan kelompok yang tidak memiliki hipertensi. Hal yang perlu menjadi catatan adalah terdapat faktor lain yang belum diperhitungkan dalam penelitian ini, sehingga peneliti menyarankan untuk dilakukan penelitian mendalam yang memperhitungkan derajat kasus hipertensi dan pengaruh pengobatan antihipertensi dalam kejadian kematian pasien COVID-19.

Download

Share

COinS
 
 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.