UNAIR NEWS – Faculty of Medicine Universitas Airlangga (FK UNAIR) made a brilliant achievement at the international level. The FK UNAIR team won 4th Place for “Best Paper Award” in the Health Science field in the prestigious ASEAN-ITTP COVID-19 event. The team’s research results are like opening Pandora’s box regarding an insightful perspective on handling Covid-19 patients, especially with acute respiratory distress syndrome (ARDS).
The team consists of Prof. Dr. Aryati, dr, MS, SpPK(K) as the corresponding author, dr. Ferdy Royland Marpaung SpPK as the main researcher and speaker, and dr. Victoria Mayasari as the research member. The endocrine supervisor at Clinical Pathology is Dr. Sidarti Soehita SFHS, dr, MS, SpPK(K), and the clinical supervisor is dr. Bambang Pujo Semedi SpAn-KIC.
Research on Covid-19 management in patients with ARDS
Ferdy Royland Marpaung, dr, SpPK explained that the team’s research is very impactful for the management of Covid-19, especially those experiencing ARDS. The study was an analytic observational study with a prospective cohort design, as the team kept observing the patients on the 7th and 30th days after the hormone levels were checked.
Currently, research on critically ill Covid-19 patients from the endocrine side is very limited, especially those related to the Hypothalamus-Pituitary-Adrenal (HPA) axis. The hormones that play a role in the HPA axis are ACTH (adrenocorticotropic hormone) and cortisol. These two hormones play a critical role in maintaining the body.
“We see that there is a research gap between SARS and Covid-19 research. The research data show that a decrease in cortisol in SARS patients is associated with mortality, whereas in Covid-19 patients, an increase in cortisol is associated with an increase in mortality. Unfortunately, the role of ACTH is not explained,” he explained.
Dr. Ferdy continued, measuring ACTH concentrations can provide important feedback information on HPA axis function in critically ill patients with Covid-19. It is even more important in the case of exogenous steroid administration (such as dexamethasone and methylprednisolone), as it will have a significant negative impact on ACTH secretion and, consequently, HPA axis function.
Furthermore, almost all critically ill Covid-19 patients are given corticosteroids, which are natural steroids. Then, will administering steroids without checking the patients’ cortisol and ACTH levels significantly impact therapy?
“From this condition, we thought about evaluating ACTH and cortisol levels in Covid-19 patients with ARDS,” he continued.
In terms of handling management of Covid-19 patients with ARDS, the results of this study are like opening Pandora’s box because this study found that the dynamics of ACTH and cortisol were still well maintained in living patients. Meanwhile, in patients who died within 30 days of evaluation, there was no correlation.
“The implication is that we must consider the use of external glucocorticoids (steroids) properly by using appropriate laboratory data such as ACTH and cortisol,” he explained.
FK UNAIR team won the 4th Place for “Best Paper Award” in Health Science field in the ASEAN-ITTP COVID-19 event. (Photo: By courtesy)
The doctor, who also serves as the Head of the Clinical Chemistry Division, Department of Clinical Pathology FK UNAIR-RSUD Dr. Soetomo, explained that the research must be continued by looking at the ACTH and cortisol levels after the provision of external glucocorticoid and observing their impact on the patient. Thus, the rationalization of glucocorticoids use in critically ill Covid-19 patients can work well.
“I am touched by the incredible contribution of the team. I am so grateful to have such an amazingly kind and caring mentor. I am moved by the upbringing and motivation that was always taught by my supervisor, Prof dr. Aryati and the team even though they have a busy schedule,” he concluded. (*)
Author: Sandi Prabowo
Editor : Binti Q. Masruroh (YA/AP)
