PERAN PEMERIKSAAN HEMATOLOGI PADA PENANGANAN COVID 19 STEANUS LEMBAR PDSPATKLIN – PATELKI FKIK UNIKA ATMA JAYA
PERAN PEMERIKSAAN HEMATOLOGI
PADA PENANGANAN COVID 19STEANUS LEMBAR
PDSPATKLIN – PATELKI
FKIK UNIKA ATMA JAYA
LATAR BELAKANG
SITUASI TERKINI
GAMBAR UPDATE COVID 19 DI
INDONESIA (PASIEN POSITIF,
SEMBUH DAN MENINGGAL)
https://www.covid19.go.id/
CORONA VIRUS INFECTIOUS
DISEASE 19 (COVID19)
Coronaviruses are a family of viruses that can cause illnesses such as the common cold, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). In 2019, a new coronavirus was identified as the cause of a disease outbreak that originated in China
The virus is now known as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease it causes is called coronavirus disease 2019 (COVID-19). In March 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a pandemic.
https://www.mayoclinic.org/diseases-conditions/coronavirus/symptoms-causes/syc-20479963
GEJALA KLINIK
https://www.mayoclinic.org/covid-19-self-assessment-tool
Tiredness
Aches
Runny nose
Sore throat
Headache
Diarrhea
Vomiting
Loss of smell or
taste.
PERJALANAN
PENYAKIT
TREATMENT
CAUSES RISK FACTORS COMPLICATONS
https://www.mayoclinic.org/diseases-conditions/coronavirus/symptoms-causes/syc-20479963
LABORATROIUM COVID 19
ANTIBODI (ANTISARS
COV2) RAPID TEST
ANTIGEN: DETEKSI
ANTIGEN / VIRUS ATAU
MATERI GENETIK
BERBASIS MOLEKULER
SCREENING & DIAGNOSTIC
CRP
LFT
RFT
CK
PROCALCITONIN
CLINICAL CHEMISTRY
HEMATOLOGI RUTIN:
Hb, Ht, JUMLAH SEL,
INDEKS ERITROSIT,
HITUNGJENIS, LED
HFC
CBC
NEJM 2020, Clinical
Characeristic of Coronavirus
Disease 2019
HEMATOLOGI
HEMATOLOGI
CBC• Routine blood test White blood cell count is
usually normal or reduced, with decreased lymphocyte count,progressive
lymphocytopenia in severe cases.
NLR
• NLR is Neutrophil to Lymphocyte count Ratio, it’s calculated from CBC result, easy-to-use parameter.
• ➢ Study6 in Beijing showed that cut-off value of NLR is 3.13, sensitivity is 0.875 and specificity is 0.717
PERUBAHAN PARAMETER
HEMATOLOGI
CBC
•PASIEN RESPIRATIF
•TANPA HIPOKSIA
CBC & CRP
•PENURUNAN LIMFOSIT < 1100/uL
•PENINGKATAN CRP
LIMFOPENIA & CRP •GGO
•RT PCR SWAB
PENCITRAAN & MOLEKULER DIAGNOSTIK
LIMFOPENIA
LIMFOPENIA
PROGNOSIS BURUK
MEKANISME SARS-COV2
(LIMFOSIT T)
APOPTOSIS
MEKANISME LIMFOPENIA-SARS COV
APOPTOSIS
KELELAHAN FUNGSIONAL
(NKG2A)
KAITAN PASIEN
PEDIATRIK
HEMATOLOGI
NLR
The NLR was the early identification of risk factors for
2019-nCoV severe illness.
Patients with age ≥ 50 and NLR ≥ 3.13
facilitated severe illness and they should rapidly access to
intensive care unit if necessary.
Calculated automatically (band
neutrophil + segmented neutrophil)/ lymphocyte
NLR is meaningful parameters for
prognosis and risk stratification
management, which would be helpful to alleviate insufficient medical resources.
https://doi.org/10.1101/2020.02.10.20021584
NLR Sebagai Penentu Tindakan
RS Umum atau isolasi
mandiri
Ruang isolasi umum
Kamar isolasi dengan alat
bantu pernafasan
ICU dengan alat bantu
pernafasan invasif
Hematology Covid-19 related Mindray
NLR NEUTROPHIL TO LYMPHOCYTE
RATIO
Neu%
Lym%
Parameter NLR
adalah parameter
yang mudah dan
efisien untuk
pemantauan
inflamasi rutin.
Hematology Covid-19 related Mindray
HEMATOLOGI
HFC
MENGGUNAKAN METODE
FLUORESENSI DGN RESOLUSI TINGGI
MENDETEKSI SEL DENGAN TINGKAT
KEMATANGAN RENDAH (EKSPRESI
DNA/RNA)
MENGGAMBARKAN ATIPIKAL LIMFOSIT &
SEL BLAS
HEMATOLOGY ANALYZER MINDRAY
High Fluorescence Cell in Mindray
© 2
012 M
ind
ray
Co
nfid
en
tial
18
DIFF scattergram
Lymphocyte
Monocyte
NRBC
HFC*
Neu & Bas
Eosinophil
IMG*
Band
PLT Clump Infected RBC
Atypic
al
Lymp.
& Blast
HEMATOLOGY ANALYZER MINDRAY
PARAMETER LAIN
PENANDA INFLAMASI (CRP, LED, PCT dll)
KOAGULASI
RANTAI GLOBIN PADA HEMOGLOBIN??
PANDEMI COVID 19 – MASALAH GLOBAL
PENINGKATAN JUMLAH KASUS COVID19 (TANTANGAN PENANGANAN)
PENAPISAN SECARA LABORATORIUM
CBC (LEUKOSIT, LIMFOSIT)
NLR
HFC
PERAN LABORATORIUM LAIN
PENANDA INFLAMASI
KOAGULASI
RANTAI GLOBIN
MARI DIAM DI
RUMAH !!!!!!!!
https://www.covid19.go.id/downl
oad/gembira-dan-sehat-dengan-
gizi-yang-seimbang/
SEKIAN & TERIMKASIH