Vol. 38 No. 2 Maret 2021
MANIFESTASI NEUROLOGI PADA PASIEN COVID-19 DI RUMAH SAKIT UMUM DAERAH KOTA TANGERANG SEBAGAI PUSAT RUJUKAN COVID-19 PROVINSI BANTEN
Hananto Pratignyo,* Paulina Thiomas,* Hesti Setiastuti** Usynara,** Fitrie Rahayu,** Virginia Nuriah**
NEUROLOGICAL MANIFESTATIONS IN COVID-19 PATIENTS AT TANGERANG CITY REGIONAL GENERAL HOSPITAL AS COVID-19 REFERRAL HOSPITAL, BANTEN PROVINCE
ABSTRACT
Introduction: Coronavirus Disease 2019 (COVID-19), caused by SARS-CoV-2, first reported in Wuhan by December 2019, spreading rapidly to various countries. World Health Organization (WHO) has designated COVID-19 as a global pandemic. Although the main clinical manifestation is the respiratory system, neurological symptoms have been reported. There are little data on neurological manifestations in COVID-19 patients, especially in Indonesia.
Aim: To determine the neurological manifestations in COVID-19 patients.
Methods: This is a retrospective observational study. Data were collected from medical records of hospitalized COVID-19 patients at Tangerang City General Hospital in the period April-August 2020. Data collection based on age, sex, comorbidity, general symptoms, neurological symptoms, laboratory and radiological findings. Neurological examinations were done by two neurologists.
Results: Of 492 COVID-19 patients, there were 25 (5%) who had neurological manifestations, the proportion was male (52%) and aged over 60 years (44%). Of the 25 patients, 13 (52%) were confirmed COVID-19. Twenty patients (80%) have comorbidities such as hypertension, diabetes mellitus, vascular disease, tuberculosis, and chronic kidney disease. The neurological manifestations that were found were cerebrovascular disease (50%), meningoencephalitis (7.7%), vertigo (23%), anosmia (15.4%), and myalgia (3.8%). Seven patients (28%) died and 18 patients (72%) had clinical improvement.
Discussion: COVID-19 can be accompanied by a variety of neurological symptoms. The neurological manifestations can be found in the central nervous system, peripheral nerves, and musculoskeletal. During a pandemic, COVID-19 is considered a differential diagnosis in patients with neurological symptoms to increase awareness and prevent further transmission.
Keywords: Cerebrovascular, COVID-19, manifestation, neurology
ABSTRAK
Pendahuluan: Coronavirus Disease 2019 (COVID-19) yang disebabkan oleh SARS-CoV-2, dilaporkan pertama kali di Wuhan pada Desember 2019 dan menyebar dengan cepat ke berbagai negara. World Health Organization (WHO) menetapkan COVID-19 sebagai pandemi global. Walaupun manifestasi klinis utama adalah pada sistem respirasi, gejala neurologis dilaporkan pada beberapa kasus. Belum banyak data tentang manifestasi neurologi pada pasien COVID-19, khususnya di Indonesia.
Tujuan: Mengetahui manifestasi neurologi pada pasien COVID-19.
Metode: Penelitian studi observasional retrospektif. Data diambil dari rekam medis pasien rawat inap COVID-19 di RSUD Kota Tangerang periode April–Agustus 2020. Pengambilan data berdasarkan usia, jenis kelamin, komorbiditas, gejala umum, gejala neurologis, pemeriksaan laboratorium dan radiologi. Pemeriksaan neurologi dilakukan oleh dua orang dokter spesialis saraf.
Hasil: Dari 492 pasien COVID-19, 25 pasien (5%) mengalami manifestasi neurologi, proporsi pria (52%) dan usia lebih dari 60 tahun (44%). Dari 25 pasien, 13 pasien (52%) merupakan confirm COVID-19. Dua puluh pasien (80%) memiliki komorbid seperti hipertensi, diabetes melitus, penyakit vaskular, tuberculosis, dan penyakit ginjal kronik. Manifestasi neurologi yang ditemukan yaitu penyakit serebrovaskular (50%), meningoensefalitis (7,7%), vertigo (23%), anosmia (15,4%), dan mialgia (3,8%). 7 Tujuh pasien (28%) meninggal dunia dan 18 pasien (72%) perbaikan klinis.
Diskusi: COVID-19 dapat disertai gejala neurologis yang beragam. Manifestasi neurologi dapat ditemukan pada sistem saraf pusat, saraf perifer, dan musculoskeletal. Pada masa pandemi, COVID-19 dipertimbangkan sebagai diagnosis banding pada pasien dengan gejala neurologi untuk meningkatkan kewaspadaan dan mencegah transmisi lebih lanjut.
Kata Kunci: COVID-19, manifestasi, neurologi, serebrovaskular
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* Departemen Neurologi, Rumah Sakit Umum Daerah Kota Tangerang; **Departemen Pulmologi, Rumah Sakit Umum Daerah Kota Tangerang.
Korespondensi : drhananto@gmail.com
