Indonesia is one of the countries with the highest mortality rate for COVID-19 cases. The elderly group contributed the highest COVID-19 death outcome, which was 48.9% of the total COVID-19 death cases in Indonesia. This study aims to determine the factors related to outcome and length of stay of elderly patients with COVID-19 at the Mataram University Hospital in 2020-2021. This study is a cross-sectional study using the consecutive sampling method obtained from the medical records of elderly patients with confirmed COVID-19 that had met the inclusion and exclusion criteria at the Mataram University Hospital. Univariate and bivariate data analysis using chi-square test. The results showed that 66.7% of the elderly with death outcomes were aged 60-70 years, 77.8% were male, 88.9% had >1 comorbidity and 66.7% had a critical illness degree. Based on length of hospital stay, 53.3% of the elderly with length of hospital stay >14 days were >70 years old, 73.3% were male, 73.3% had >1 comorbidity, and 46.7% had moderate disease. Factors related to the outcome were comorbidities (p=0.015) and disease degree (p<0.001). Factors related to the length of hospital stay were age (p=0.049) and comorbidities (p=0.029). There is a significant relationship between comorbidities and disease severity with the outcome. There is a significant relationship between age and comorbidities with the length of hospital stay.
Penyakit Coronavirus Disease 2019 (COVID-19) adalah penyakit saluran pernafasan menular yang disebabkan oleh Coronavirus jenis baru yang belum pernah diidentifikasi sebelumnya yaitu SARS-CoV-2. Tingginya kasus kematian pada pasien COVID-19 dikaitkan dengan adanya penyakit penyerta seperti hipertensi, diabetes melitus, penyakit kardiovaskular, penyakit paru obstruktif kronis, penyakit ginjal, kanker dan penyakit hati. Mekanisme patofisiologi komorbid dalam memperburuk gejala serta meningkatkan risiko mortalitas pada pasien COVID-19 sangat kompleks dan beragam. Pada penderita hipertensi, penyakit paru obstruktif kronis, dan penyakit ginjal terjadi peningkatan ekspresi reseptor ACE-2 menyebabkan sangat rentan terinfeksi COVID-19. Penurunan dan melemahnya sistem imun tubuh memainkan peran penting dalam perburukan gejala penyakit COVID-19 pada pasien kanker, penyakit hati dan penyakit kardiovaskular. Pada pasien diabetes, gangguan fungsi sel T dan peningkatan kadar interleukin-6 (IL-6) berperan dalam meningkatnya derajat penyakit COVID-19. Sedangkan pada pasien asma, ikatan silang IgE serta menurunnya produksi interferon menyebabkan pasien asma lebih rentan terinfeksi virus dan dapat memperburuk gejala serta eksaserbasi asma.
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