peran pemeriksaan hematologi pada ... pemeriksaan...rft ck procalcit onin clinical chemistry...

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