Hubungan Merokok Dengan Derajat Keparahan Dan Mortalitas Pasien COVID-19 Rawat Inap di RS Saiful Anwar Malang
Authors: Listyoko Aditya Sri , Djajalaksana Susanthy , Astuti Triwahju 
Published: August 2020

Latar Belakang: Sejak Desember 2019 ketika pertama kali kasus COVID-19 diidentifikasi di Wuhan, China, SARS-CovV-2 menyebar ke seluruh dunia dan memberikan angka penyebaran infeksi dan mortalitas yang terus meningkat. Merokok memberikan dampak negatif terhadap kesehatan paru. Merokok sampai saat ini diasumsikan merupakan faktor risiko berbagai penyakit paru dan pernapasan seperti PPOK, kanker paru, termasuk pengaruh terhadap sistem pertahanan jalan napas terhadap berbagai mikroorganisme patogen. Prevalensi merokok di Indonesia sangat tinggi, dimana masih sedikit sekali studi yang dilakukan di Indonesia khususnya menilai risiko riwayat merokok terhadap derajat keparahan dan mortalitas pada pasien COVID-19 yang dilakukan rawat inap.
Tujuan: Menganalisis riwayat merokok pada pasien COVID-19 yang dirawat di RS rujukan utama dan hubungannya dengan derajat keparahan penyakit dan mortalitas.
Metode: Kami melakukan analisis observasional dengan pendekatan cross sectional, single-center, pada 77 pasien terkonfirmasi COVID-19. Data diambil antara bulan April-Juli 2020 pasien yang dirawat di Ruang COVID RS Dr. Saiful Anwar Malang, Indonesia. Uji statistik dipergunakan untuk menilai hubungan riwayat merokok dengan derajat keparahan dan mortalitas.
Hasil: Subjek terdiri 77 pasien terkonfirmasi COVID-19 terbagi 2 kelompok yaitu 31 (40,25%) pasien ringan-sedang dan 46 (59,74%) pasien kelompok berat. Subjek dikelompokkan menjadi luaran hidup 52 (68,42%) dan meninggal 24 (31,57%) untuk analisis mortalitas. Analisis statistik menunjukkan riwayat merokok berkaitan dengan derajat keparahan penyakit (p=0,008; OR: 4,75, 95%CI 1,426-15,817) dan mortalitas (p=0,045, OR: 2,821, 95%CI 1,007-7,900) pasien COVID-19 yang dilakukan rawat inap di rumah sakit. Kesimpulan: Merokok berkaitan dengan risiko COVID berkembang ke derajat berat serta mortalitas pada pasien COVID-19 yang dilakukan rawat inap.
Kata kunci: COVID-19, Keparahan, Mortalitas, Merokok

Background: Since December 2019, when the COVID-19 case was first identified in Wuhan, China, SARS-CoV-2 has spread worldwide and increased the incidence and mortality. To date, smoking is assumed to be a risk factor for various respiratory diseases such as COPD, lung cancer, also influences the airway defense system against various pathogenic microorganisms. The prevalence of smoking in Indonesia is very high where very few studies have been conducted in Indonesia especially assessing the risk of smoking and disease severity and mortality in hospitalized COVID-19 patients. Objective : To determine the risk of smoking history among hospitalized COVID-19 patients in tertiary care referral hospital and its association with disease severity and mortality. Methods: A cross-sectional single-center study was performed of 77 admitted laboratory-confirmed patients in a tertiary hospital in Malang City, East Java, Indonesia from April-July 2020. Statistical analysis was performed to evaluate the association between smoking and disease severity and mortality in COVID-19 patients. Results: A total of 77 patients with laboratory-confirmed COVID-19 were included in our analysis. Subjects divided in the mild-moderate and severe group 31 patients (40,25%) and 46 patients (59,74%) respectively. For mortality analysis, subjects divided into survivor 52 patients (68,42%) and non-survivor 24 patients (31,57%). Statistical analysis determine smoking associated with disease severity (p=0,008; OR : 4,75, 95%CI 1,426-15,817) and mortality (p=0.045, OR : 2,821, 95%CI 1,007-7,900) in hospitalized COVID-19 patients. Conclusion: In our cross-sectional study demonstrated history of smoking associated with disease severity and mortality in hospitalized COVID-19 patients.
Keywords: COVID-19, Mortality, Severity, Smoking