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Abstrak :
Latar Belakang: Aktivasi komplemen dapat menyebabkan respon imun berlebihan dan merupakan salah satu faktor yang berpengaruh terhadap morbiditas serta mortalitas pasien COVID-19. Beberapa penghambat aktivasi komplemen saat ini sedang dipelajari untuk menghambat aktivasi sistem komplemen yang berlebihan pada pasien COVID-19. Resiko, keuntungan, waktu pemberian dan bagian dari sistem yang akan ditargetkan perlu dipertimbangkan pada saat akan menggunakan penghambat komplemen, oleh karena itu telaah sistematis ini dibuat untuk mengambil kesimpulan apakah pemberian terapi penghambat sistem komplemen dapat menurunkan mortalitas pasien COVID-19 yang dirawat di Rumah Sakit berdasarkan penelitian-penelitian yang tersedia. Tujuan: Mengetahui efek pemberian terapi penghambat sistem komplemen terhadap mortalitas pasien COVID-19 yang dirawat di Rumah Sakit. Metode: Dengan menggunakan kata kunci spesifik, dilakukan pencarian artikel potensial secara komprehensif pada PubMed, Embase, Cochrane, dan Scopus database dengan pembatasan waktu 2019 sampai dengan sampai 31 Desember 2022. Protokol studi ini telah diregistrasi di PROSPERO (CRD42022306632). Semua penelitian pemberian terapi penghambat komplemen pada pasien COVID-19 dimasukkan. Analisis statistik dilakukan dengan menggunakan perangkat lunak Review Manager 5.4. Hasil: 5 penelitian memenuhi kriteria dan dimasukkan dalam telaah sistematis serta meta-analisis dengan total 739 pasien COVID-19. Hasil analisis Forest plot menunjukan bahwa pemberian terapi penghambat sistem komplemen menurunkan mortalitas sebesar 28% pada pasien COVID-19 yang dirawat di Rumah Sakit (RR 0,72; 95% CI: 0,46 – 1,14, I2 = 61%, P-value = 0.16). Kesimpulan: Pemberian terapi penghambat sistem komplemen secara statistik tidak signifikan menurunkan mortalitas pada pasien COVID-19 yang dirawat di Rumah Sakit ......Background: Complement activation can cause an exaggerated immune response and is one of the factors that influence the morbidity and mortality of COVID-19 patients. Several complement activation inhibitors are currently being studied to inhibit excessive complement activation in COVID-19 patients. The risks, benefits, time of administration and the part of the system to be targeted need to be considered when using complement inhibition, therefore this systematic review was made to conclude whether the administration of complement system inhibition therapy can reduce the mortality of COVID-19 patients who are hospitalized based on available studies. Objective: To determine the effect of complement system inhibitory therapy on the mortality of hospitalized COVID-19 patients Methods: Using specific keywords, we comprehensively searched the PubMed, Embase, Cochrane, and Scopus databases for potential articles from 2019 to December 31, 2022. The research protocol was registered with PROSPERO (CRD42022306632). All studies administering complement inhibitory therapy to COVID-19 patients were processed. Statistical analysis was performed using Review Manager 5.4 software. Result: 5 studies met the criteria and were included in a systematic review and meta-analysis of a total of 739 COVID-19 patients. The results of the Forest plot analysis showed that administration of complement system inhibitor therapy reduced mortality by 28% in hospitalized COVID-19 patients (RR 0.72; 95% CI: 0.46 – 1.14, I2 = 61%, P -value = 0.16). Conclusion: Providing complement system inhibitor therapy did not statistically significantly reduce mortality in hospitalized COVID-19 patients

Abstrak :
ABSTRACT
Pendahuluan: Penduduk pemukiman kumuh dan nonkumuh memiliki pola pajanan pathogen yang berbeda sehingga diduga menyebabkan perbedaan profil imun. Rasio albumin globulin dan komplemen C3, fraksi β-globulin yang berfungsi sebagai pusatkonvergensi sistem komplemen yang merupakan sistem imun bawaan, diduga memiliki profil yang berbeda berdasarkan tipe pemukiman dan pola pajanannya. Metode: Studi potong lintang ini melibatkan masing-masing 20 orang dari penduduk sekitar TPU Bantar Gebang yang mewakili populasi kumuh dan civitas Fakultas Kedokteran Universitas Yarsi, Jakarta yang mewakili populasi nonkumuh. Nilai rasio albumin globulin diukur dengan cara membandingkan nilai albumin dengan selisih antara protein total dengan albumin. Komplemen C3 diukur menggunakan metode radial immunodiffusion. Hasil: Populasi kumuh memiliki nilai rasio albumin globulin lebih rendah signifikan dibanding populasi nonkumuh (p =0,004). 65% populasi kumuh memiliki ekspresi komplemen C3 tinggi (>1275,0) sedangkan 70% populasi nonkumuh memiliki ekspresi komplemen C3 rendah (≤1275,0) (p = 0,027). Rasio albumin globulin dan komplemen C3 memiliki tren korelasi negatif (R= −0,251, p = 0,062). Lima puluh persen populasi kumuh memiliki rasio albumin globulin rendah (≤1,38) dan ekspresi komplemen C3 tinggi (>1275,0) (p = 0,018). Kesimpulan: Terdapat perbedaan rerata rasio albumin globulin dan perbedaan proporsi ekspresi komplemen C3 yang signifikan pada populasi kumuh dan nonkumuh. Terdapat tren hubungan terbalik antara rasio albumin globulin dan ekspresi komplemen C3. Proporsi rasio albumin globulin rendah dan ekspresi komplemen C3 tinggi lebih banyak

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ABSTRACT
Introduction: Slum and non-slum dwellers have different pathogenic exposure patterns that are thought to cause differences in immune profile. The ratio of albumin globulin and C3 complement, the β-globulin fraction that functions as a center convergence of the complement system which is the innate immune system, is thought to have a different profile based on the type of settlement and its exposure patterns. Method - This cross-sectional study involved 20 people from each population around the Bantar Gebang TPU which represents the slum population and the Yarsi University Faculty of Medicine community, Jakarta representing the non-slum population. The value of albumin globulin ratio is measured by comparing the value of albumin with the difference between total protein with albumin. C3 supplements are measured using the radial immunodiffusion method. Results: Slum populations have significantly lower albumin globulin ratios compared to non-slum populations (p = 0.004). 65% of the slum population has high C3 complement expression (> 1275.0) while 70% of the non-slum population has low C3 complement expression (≤1275.0) (p = 0.027). The ratio of albumin globulin and complement C3 has a negative correlation trend (R = −0.251, p = 0.062). Fifty percent of the slum population had a low albumin globulin ratio (≤1.38) and high C3 complement expression (> 1275.0) (p = 0.018). Conclusion- There is a significant difference in the ratio of albumin globulin and a significant difference in the proportion of C3 complement expression in slum and non-slum populations. There is a trend of an inverse relationship between albumin globulin ratio and C3 complement expression. The proportion of albumin globulin ratio is low and the expression of high C3 complement is higher