1.Thromboelastography Parameter and Its Association with Survival of COVID-19 Patients: A Retrospective Cross-Sectional Study
Nita Wiyono ; Yetti Hernaningsih ; Arifoel Hajat ; Paulus Budiono Notopuro ; Narazah Mohd Yusoff ; Emmanuel Jairaj Moses
Malaysian Journal of Medicine and Health Sciences 2023;19(No.4):124-129
Introduction: Coagulopathy associated with Coronavirus disease 2019 (COVID-19) may cause life-threatening complications, especially in severe or critically ill COVID-19 patients. Thromboelastography (TEG) is an effective, dynamic, and reliable test to assess the complete coagulation process. This study aimed to determine the association
between selected TEG parameters and survival in COVID-19 patients. Methods: This study was a retrospective
observational study using data from medical records of COVID-19 patients who were hospitalized in Dr. Soetomo
Hospital, Surabaya, Indonesia. There were 94 COVID-19 patients consisting of 76 survivors and 18 non-survivors.
The association between TEG results and certain TEG parameters with survival status was considered significant if
the p-value ≤ 0.05. Results: Increased coagulation activity had a significant association with the survival status of
COVID-19 patients (p=0.04). There were no significant differences in all TEG parameters between COVID-19 patients who survived and those who did not survive (p > 0.05). Based on the TEG analysis tree, the most TEG results
found were secondary fibrinolysis (21.3%) and fibrinolytic shutdown (24.5%). No significant association was found
between the coagulability and fibrinolysis abnormality with the survival status in COVID-19 patients (p > 0.05).
Conclusion: There was no significant difference in TEG results between COVID-19 survivors and non-survivors.
However, based on the TEG result, an increase in coagulation activity is associated with a lower survival rate. Further study with detailed timing of TEG examination, disease severity and comorbidities stratification in COVID-19
patients may be needed.
2.Caspase 3 Expressions in Children with Acute Lymphoblastic Leukemia During Induction Phase Chemotherapy
Lukman Oktadianto ; Mia Ratwita Andarsini ; I Dewa Gede Ugrasena ; Yetti Hernaningsih ; Andi Cahyadi ; Maria Christina Shanty Larasati
Malaysian Journal of Medicine and Health Sciences 2023;19(No.3):91-97
Introduction: Caspase-3 is a crucial mediator of the extrinsic apoptosis pathway. The role of caspase-3 for extrinsic
apoptosis signalling is still a challenge and should be exploited in childhood ALL. This study aimed to compare
the caspase-3 expression in the patient’s bone marrow before and after the induction phase of chemotherapy in
childhood ALL. It will also to correlate the mean difference in caspase-3 expression between ALL standard-risk and
ALL high-risk patients. Methods: Seventeen newly diagnosed ALL subjects were enrolled in this study. Caspase-3
expression in bone marrow was assessed using flow cytometry and monoclonal antibodies. A T-test and a paired
T-test were used to compare between groups. The correlation coefficient between ALL groups was evaluated using
Spearman’s test and linear regression with a significant p-value of 0.05. Results: The caspase-3 expression is higher
after induction therapy. However, it showed an insignificant difference (16.56+12.91% vs 27.71+12.33%; p = 0.08,
p > 0.05). The mean difference of caspase-3 in ALL high-risk groups was significantly higher than in ALL standard-risk
groups with a positive correlation (p = 0.007, r = 0.756). Conclusion: The caspase-3 expression after induction phase
chemotherapy was increased in all standard-risk and high-risk patients; other lymphoblast apoptosis markers need to
be confirmed alongside caspase-3.