PENGARUH KOMORBIDITAS DAN STATUS VAKSINASI TERHADAP KEMATIAN PASIEN COVID-19: STUDI KASUS-KONTROL DI RSUD SANJIWANI GIANYAR

Ni Luh Cica Kusumadewi; I Gede Peri Arista

doi:10.31004/prepotif.v9i3.52955

Authors

Ni Luh Cica Kusumadewi Program Studi Magister Ilmu Kesehatan Masyarakat, Fakultas Kedokteran, Universitas Udayana, Denpasar, Bali
I Gede Peri Arista Program Studi Doktor Ilmu Biomedis, Fakultas Kedokteran, Universitas Udayana, Denpasar, Bali

DOI:

https://doi.org/10.31004/prepotif.v9i3.52955

Keywords:

COVID-19, comorbidity, vaccination, mortality, case control.

Abstract

COVID-19 meningkatkan risiko kematian terutama pada pasien dengan komorbid. Diabetes melitus hipertensi penyakit jantung penyakit paru obstruktif kronik dan tuberkulosis paru memperberat perjalanan penyakit melalui inflamasi kronis dan disfungsi organ. Status vaksinasi memengaruhi luaran klinis pasien COVID-19. Penelitian ini menganalisis hubungan komorbid dan status vaksinasi terhadap kematian pasien COVID-19 di RSUD Sanjiwani Gianyar. Penelitian ini menggunakan desain case-control dengan 310 pasien meninggal sebagai kasus dan 620 pasien sembuh sebagai kontrol. Peneliti menerapkan total sampling pada kelompok kasus dan purposive sampling pada kelompok kontrol. Peneliti memperoleh data melalui ekstraksi rekam medis elektronik SIMRS. Riwayat komorbid dan status vaksinasi ditetapkan sebagai variabel independen sedangkan status kematian ditetapkan sebagai variabel dependen. Analisis regresi logistik binomial menghasilkan Odds Ratio (OR) dan 95% Confidence Interval (CI). Penyakit jantung menunjukkan risiko kematian tertinggi (OR = 49.59, 95% CI = 11.59–212.24). Tuberkulosis paru meningkatkan risiko kematian (OR = 27.77, 95% CI = 3.38–227.84). Hipertensi meningkatkan risiko kematian (OR = 14.88, 95% CI = 6.65–33.27). Penyakit paru obstruktif kronik meningkatkan risiko kematian (OR = 7.60, 95% CI = 3.68–15.71). Diabetes melitus meningkatkan risiko kematian (OR = 3.97, 95% CI = 2.57–6.12). Stroke meningkatkan risiko kematian (OR = 3.68, 95% CI = 1.69–8.04). Penyakit ginjal kronis meningkatkan risiko kematian (OR = 2.14, 95% CI = 1.21–3.77). Kanker dan HIV-AIDS tidak menunjukkan hubungan bermakna. Kelompok kontrol menunjukkan proporsi vaksinasi lengkap yang lebih tinggi dibandingkan kelompok kasus. Komorbid kardiometabolik dan gangguan paru menentukan peningkatan risiko kematian pasien COVID-19. Vaksinasi lengkap memberikan efek protektif terhadap mortalitas.

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