COVID-19 pada Lanjut Usia: Tinjauan Literatur

Desti Dwi Rahmah(1Mail),
(1) Fakultas Kedokteran Universitas Lampung, Indonesia

Mail Corresponding Author


DOI : https://doi.org/10.30604/well.149312021

Full Text:    Language : ind

Abstract


Kasus konfirmasi covid-19 di Indonesia hingga 16 Maret 2020 menunjukkan angka 4226 kasus. Sebesar 31% dari jumlah kasus tersebut merupakan kelompok usia lebih atau sama dengan 65 tahun dan 53% pasien covid-19 yang dirawat di ICU berusia lanjut. Tingkat kesembuhan covid-19 terendah terjadi pada pasien dengan usia lebih dari 60 tahun. Selain itu, pasien covid-19 usia lanjut yang telah menjalani perawatan di rumah sakit menunjukkan tingkat komorbiditas yang tinggi, yaitu sebesar 71%.  Pasien lansia memiliki kecenderungan untuk mengalami disfungsi organ multi-sistem termasuk gangguan komponen sistem imun yang menyebabkan adanya ‘inflammaging’. Gejala covid-19 yang umum dialami pasien usia lanjut meliputi gejala klasik seperti demam, batuk, dispnea, dan lemas. Gejala sakit tenggorokan, rinorea, anosnia, mual, muntah, diare, dan nyeri perut tidak dialami kebanyakan pasien lansia. Hasil pemeriksaan laboratorium khas yang ditemukan pada pasien lansia adalah limfositopenia yang terjadi pada 63,2% pasien. Kadar protein C-reaktif tinggi (lebih atau sama dengan 5mg/L) dan kelainan pemeriksaan limfosit, BUN, lactate dehydrogenase merupakan indikator prognosis buruk pada pasien lansia. Pemeriksaan CT dada juga cenderung menampilkan keterlibatan lebih banyak lobus paru, perubahan pada interstisial alveolar karena adanya infiltrasi dari sel-sel yang ter inflamasi, dan penebalan pleura dibandingkan pasien kelompok usia yang lebih muda.

 

Abstract: Covid-19 confirmed cases in Indonesia until March 16, 2020, showed the number of 4226. 31% of these cases occurred in the age group of more than 65 years and 53% of the covid-19 patients admitted to the ICU were elderly. The lowest covid-19 cure rate occurred in patients age more than 60 years. Furthermore, elderly covid-19 patients who had undergone treatment in the hospital showed a high comorbidity rate of 71%. Elderly patients tend to develop multi-system organ dysfunction, including disorders of the immune system components that cause ‘inflammaging’. Common symptoms of covid-19 in the elderly involve classic symptoms such as fever, cough, dyspnoea, and weakness. Symptoms of sore throat, rhinorrhoea, anosmia, nausea, vomiting, diarrhea, and abdominal pain are not experienced by most elderly patients. The common laboratory finding found in the elderly was lymphocytopenia which occurred in 63,2% of patients. High levels of C-reactive protein (more than 5mg/L) and abnormalities in lymphocyte examination, BUN, lactate dehydrogenase are indicators of poor prognosis in elderly patients. Chest CT examination also tends to show more lobes involvement, alveolar interstitial changes due to infiltration of inflamed cells, and pleural thickening compared to younger age group patients.

 


Keywords


covid-19; gejala klasik; lansia

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