Efektivitas Terapi Tocilizumab Terhadap Mortalitas Pasien COVID-19 Derajat Berat di Rumah Sakit “X” Surabaya: studi observasional

Vania Denise Djunaidy, Ida Ayu Andri Parwitha, Intan Sari Yati Dinillah, Galuh Nawang Prawesti, Nika Lestyaningtyas

Abstract


Tocilizumab merupakan agen inhibitor IL-6 yang direkomendasikan untuk terapi pasien COVID-19 derajat berat hingga kritis. Beberapa penelitian menunjukan hasil yang bervariasi terkait waktu pemberian tocilizumab yang optimal. Peningkatan kadar sitokin yang terjadi pada fase awal COVID-19 memunculkan hipotesis bahwa pemberian tocilizumab lebih awal dapat menurunkan resiko mortalitas pasien. Penelitian ini bertujuan untuk mengetahui efektivitas pemberian tocilizumab dalam waktu 72 jam setelah dirawat di rumah sakit dalam menurunkan angka mortalitas pasien COVID-19 derajat berat yang dirawat di rumah sakit X di Surabaya. Desain penelitian yang digunakan adalah observasional retrospektif pada pasien COVID-19 derajat berat. Subyek dipilih dengan menyamakan karakteristik demografi menggunakan metode propensity score matching untuk kelompok kontrol. Analisis hasil luaran mortalitas dianalisis menggunakan multivariable logistic regression. Sebanyak 98 pasien COVID-19 derajat berat diikutsertakan dalam penelitian, 49 subyek (50%) mendapatkan terapi tocilizumab dan 49 subyek tidak mendapatkan tocilizumab. Dari 49 subyek yang mendapat terapi tocilizumab, sebanyak 30 subyek mendapatkan terapi tocilizumab dalam waktu 72 jam setelah masuk rumah sakit. Hasil penelitian menunjukkan bahwa pemberian tocilizumab dapat menurunkan angka mortalitas yang tidak signifikan (aOR: 0,79; 95% CI: 0,305 - 2,049; p: 0,629). Penurunan angka mortalitas yang lebih besar teramati pada subyek yang mendapatkan tocilizumab lebih awal (aOR: 0,77; 95% CI: 0,42 – 1,85). Pemberian tocilizumab dalam waktu 72 jam pada pasien COVID-19 derajat berat dapat menurunkan resiko mortalitas yang tidak signifikan.


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Keywords


Tocilizumab ; Covid-19 Derajat Berat ; Mortalitas ; Efektivitas

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DOI: https://doi.org/10.33508/jfst.v11i1.5378