PERAN PEMERIKSAAN HEMATOLOGI

PADA PENANGANAN COVID 19

STEANUS 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 The virus is now known
family of viruses that as the severe acute
can cause illnesses respiratory syndrome
such as the common coronavirus 2 (SARS-
cold, severe acute CoV-2). The disease it
respiratory syndrome causes is called
(SARS) and Middle East coronavirus disease
respiratory syndrome 2019 (COVID-19). In
(MERS). In 2019, a new March 2020, the World
coronavirus was Health Organization
identified as the cause (WHO) declared the
of a disease outbreak COVID-19 outbreak a
that originated in China pandemic.

https://www.mayoclinic.org/diseases-conditions/coronavirus/symptoms-causes/syc-20479963
 Tiredness
Aches
Runny nose
GEJALA KLINIK Sore throat
Headache
Diarrhea
Vomiting
 https://www.mayoclinic.org/covid-19-self-assessment-tool
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

CLINICAL SCREENING &

CBC CHEMISTRY DIAGNOSTIC
HEMATOLOGI CRP ANTIBODI
RUTIN: (ANTISARS
LFT
COV2)
RFT
Hb, Ht, RAPID TEST
JUMLAH SEL, CK
INDEKS
ERITROSIT, PROCALCIT
HITUNGJENIS, ONIN ANTIGEN:
LED DETEKSI
HFC
ANTIGEN /
VIRUS ATAU
MATERI
GENETIK
BERBASIS
MOLEKULER NEJM 2020, Clinical
Characeristic of Coronavirus
Disease 2019
HEMATOLOGI
HEMATOLOGI

• Routine blood test White blood cell count is

CBC
usually normal or reduced, with decreased
lymphocyte count，progressive
lymphocytopenia in severe cases.

• NLR is Neutrophil to Lymphocyte count Ratio,

it’s calculated from CBC result, easy-to-use

NLR 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

LIMFOPENIA &
• PASIEN RESPIRATIF CRP • GGO
• TANPA HIPOKSIA • PENURUNAN • RT PCR SWAB
LIMFOSIT <
1100/uL
• PENINGKATAN
CRP PENCITRAAN &
CBC & CRP MOLEKULER
DIAGNOSTIK
LIMFOPENIA

MEKANISME
SARS-COV2
PROGNOSIS
(LIMFOSIT T)
BURUK
LIMFOPENIA APOPTOSIS
MEKANISME LIMFOPENIA-SARS COV

APOPTOSIS

KELELAHAN
FUNGSIONAL
(NKG2A)

KAITAN
PASIEN
PEDIATRIK
HEMATOLOGI

NLR
NLR is meaningful
The NLR was the early Calculated parameters for
identification of risk factors for automatically (band prognosis and risk
2019-nCoV severe illness.
neutrophil + stratification
Patients with age ≥ 50 and NLR ≥
3.13 segmented management, which
facilitated severe illness and they neutrophil)/ would be helpful to
should rapidly access to lymphocyte alleviate insufficient
intensive care unit if necessary.
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

Parameter NLR
adalah parameter
yang mudah dan
efisien untuk
Lym% pemantauan
Neu%
inflamasi rutin.

Hematology Covid-19 related Mindray

HEMATOLOGI

HFC
MENDETEKSI SEL
MENGGUNAKAN
DENGAN TINGKAT MENGGAMBARKAN
METODE
KEMATANGAN ATIPIKAL LIMFOSIT &
FLUORESENSI DGN
RENDAH (EKSPRESI SEL BLAS
RESOLUSI TINGGI
DNA/RNA)

HEMATOLOGY ANALYZER MINDRAY

High Fluorescence Cell in Mindray
DIFF scattergram
Atypic

Confidential
© 2012 Mindray
18
al HFC* IMG*

Lymp.
& Blast
Monocyte Band

Lymphocyte Neu & Bas

NRBC Eosinophil
PLT Clump Infected RBC

HEMATOLOGY ANALYZER MINDRAY

PARAMETER LAIN

PENANDA INFLAMASI (CRP, LED, PCT dll)

KOAGULASI

RANTAI GLOBIN PADA HEMOGLOBIN??

PANDEMI COVID 19 – MASALAH GLOBAL

PENAPISAN SECARA LABORATORIUM

PENINGKATAN JUMLAH
KASUS COVID19 PERAN LABORATORIUM LAIN
(TANTANGAN CBC (LEUKOSIT, LIMFOSIT)
PENANGANAN)
PENANDA INFLAMASI
NLR

KOAGULASI
HFC

RANTAI GLOBIN
MARI DIAM DI
RUMAH !!!!!!!!

https://www.covid19.go.id/downl
oad/gembira-dan-sehat-dengan-
gizi-yang-seimbang/
SEKIAN &
TERIMKASIH