The Correlation Results of Examination of Hemoglobin and The
Erythrocyte Index in Patients With Suspected Covid-19 in The
Hospital of Kendari City
Sri Aprilianti Idris1, Firdayanti1, Susanti1, Muh. Azdar Setiawan2
1

Study Program Medical
Laboratory Technology, Politeknik
Bina Husada Kendari, Kendari,
Southeast Sulawesi, Indonesia
2

Study Program Pharmacy,
Politeknik Bina Husada Kendari,
Kendari, Southeast Sulawesi,
Indonesia
Correspondence:
Sri Aprilianti Idris,
Politeknik Bina Husada Kendari
Jl. Sorumba, Anaiwoi, Kec. Kadia,
Kota Kendari, Southeast Sulawesi,
Indonesia
Zip Code: 93117
Email:
sriaprilianti.aakkdi@gmail.com
Received: Mei 17, 2021
Revised: Januari 10, 2022
Accepted: Maret 8, 2022
Published: April 28, 2022
DOI: 10.33086/ijmlst.v4i1.2105

Abstract
Coronavirus disease 2019 has become a global problem
causing hundreds of thousands of deaths worldwide.
Haemoglobin is more susceptible to COVID-19 virus
attacks. Haemoglobin functions as a carrier of oxygen to
organs in the body. When the concentration of haemoglobin
in the blood circulation is low, the transport of oxygen to
several organs in the body can be disrupted. SARS-CoV-2
interacts with haemoglobin in red blood cells. This
interaction causes the virus to break the haemoglobin chain
and cause hemolysis. The erythrocyte index which consists
of mean corpuscular volume (MCV), mean corpuscular
hemoglobin (MCH), and mean corpuscular hemoglobin
concentration (MCHC) values are used to indicate the
occurrence of anemia in COVID-19 patients. This research
method used descriptive analytic with a cross sectional
study design. The population of this study was suspected
COVID-19 patients with a sample of 27 people. Sampling
was carried out using purposive sampling. This study aims
to determine the relationship between haemoglobin
examination results and erythrocyte index in suspected
COVID-19 patients.The instrument in this study used
secondary data which included the results of examination of
haemoglobin values and erythrocyte index. The results of
the test using a parametric statistical approach with the
correlation analysis method showed that there was a
correlation between the results of the haemoglobin and
MCV test (P-value 0.057 > 0.05), while the haemoglobin
and MCH test had no correlation (P-value 0.777 > 0.05), and
there is no correlation between haemoglobin and MCHC
examination (P-value 0.372 > 0.05).
Keywords
Anemia, Erythrocyte Indeks, Haemoglobin.

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use,
distribution, and reproduction in any medium, provided the original work is properly cited. ©2021 by author.

71

Sri Aprilianti Idris, et al.

The first COVID-19 was reported in

INTRODUCTION
Coronavirus disease 2019 (COVID-19)

Indonesia on March 2, 2020 (4). By April 9,

has become a global problem causing

2020 the pandemic had spread to all

hundreds of thousands of deaths worldwide

provinces in Indonesia after Gorontalo

since December 2019. The main challenge in

confirmed its first case, with Jakarta, West

handling this new outbreak is the limited data

Java, and East Java being the worst-affected

regarding

and

provinces. So far, Indonesia has recorded 496

epidemiological findings (1). In December

deaths, more than any other Southeast Asian

2019, in Wuhan, Hubei Province, China, 44

country. The fatality rate is also one of the

cases of pneumonia were reported due to

highest in the world. The researchers suggest

infection with a new type of coronavirus that

the main reason for this high number might

had not been identified. The virus was later

be a lack of testing, hence many cases went

known as SARS-CoV-2 because it has 82%

undetected (5).

variations

in

clinical

similarity in its genome sequence to severe

In Southeast Sulawesi, 332 COVID-19

acute respiratory syndrome-corona virus

cases were confirmed as positive cases, with

(SARS-CoV) which became an outbreak of

113 patients undergoing treatment, 214

the disease in Guangzhou, China in 2003.

declared cured and 5 people died. While 535

The disease caused by infection of SARS-

cases were asymptomatic (OTG), 15 cases

CoV-2 is then referred to as coronavirus

were patients under surveillance (PDP), and

disease 2019 (COVID-19). Since March 11,

39

2020, World Health Organization (WHO)

Monitoring (ODP). Meanwhile, in Kendari

has designated COVID-19 as a global

City the number of positive cases was 66

pandemic (1,2).

cases, with 57 cases of patients were declared

According to WHO, data as of March 30,
2020, there were 693,224 cases and 33,106

declared

as

People

Under

cured, and 3 cases of patients dead (6).
Coronavirus is a positive single-strain

North

RNA virus, encapsulated and unsegmented.

America have become the epicenter of the

Coronavirus belongs to the order Nidovirales

COVID-19 pandemic, with cases and deaths

of the Coronaviridae family. The structure of

surpassing China. The United States ranks

the coronavirus forms a cube-like structure

first with the most COVID-19 cases with the

with the S protein located on the surface of

addition of 19,332 new cases on March 30,

the virus. S protein or spike protein is one of

2020, followed by Spain with 6,549 new

the main viral antigen proteins and is the

cases. Italy has the highest mortality rate in

main structure for gene writing. This S

the world at 11.3% (3).

protein plays a role in the attachment and

deaths

72

were

worldwide.

Europe

and

Ina. J. Med. Lab. Sci. Tech. 2022; 4(1): 71–80

Sri Aprilianti Idris, et al.

entry of the virus into host cells (interaction

cough, shortness of breath); history of travel

of protein S with its receptors on the host

or living in a community area of COVID-19;

cell). Coronavirus is sensitive to heat and can

Age 16 - 53 years; gender male or female;

be effectively inactivated by disinfectants

and

containing chlorine, lipid solvents at 56oC for

erythrocyte index examinations.

patients

with

haemoglobin

and

30 minutes, ether, alcohol, peroxyacetic acid,
non-ionic detergents, formalin, oxidizing

Exclusion Criteria

agents, and chloroform (7).

Patients with suspected COVID-19 who

Haemoglobin is more susceptible to
COVID-19 virus attacks. In patients with

do not perform haemoglobin and erythrocyte
index examinations (8).

COVID-19 cases, most of them come with

To address the research objectives, this

complaints of shortness of breath, causing

research used secondary sources, which

less and less haemoglobin that can carry

included the results of the examination of

oxygen and carbon dioxide to be spread

haemoglobin values and erythrocyte index.

throughout the body, so that it can interfere

The erythrocyte index consists of the value of

with the respiratory tract. The attack of the

Mean Corpuscular Haemoglobin (MCH),

COVID-19 virus can damage many organs

Mean Corpuscular Volume (MCV), Mean

and cause inflammation that occurs in the

Corpuscular

human lungs.

(MCHC).

Haemoglobin
Haemoglobin

Concentrate
values

and

erythrocyte index were obtained from the
results of routine blood examinations at the

MATERIALS AND METHODS
This research method used descriptive-

laboratory of suspected COVID-19 patients

analytic with a cross-sectional study design

.

that was carried out from June 2020 to July

Statistical Analysis

The population of this study was

In this research, all data analyses were

suspected COVID-19 patients at the Kendari

performed by using SPSS for Windows

City General Hospital with a sample of 27

Version 20.0 (SPSS Inc., Chicago) and

people, and sampling was carried out using

Microsoft Excel. Data consist of the

purposive sampling with sample criteria.

haemoglobin

2020.

and

erythrocyte

index

examinations. These data were tested for
correlation, including to determine the

Inclusion Criteria
Patients with suspected COVID-19 with
(fever

and

at

least

one

sign/symptom of respiratory illness, such as
Ina. J. Med. Lab. Sci. Tech. 2022; 4(1): 71–80

between

haemoglobin,

erythrocyte index, and suspected COVID-19
patients.

73

symptoms

relationship

Sri Aprilianti Idris, et al.

with low examination results were 1 patient

RESULTS
This research was conducted at the

(3.70%).

Kendari City General Hospital with a total of
27 patients. The patients were suspected
COVID-19 patients who came to the hospital
with COVID-19 symptoms. Table 1-7 shows
classification of patients with suspected
COVID-19

based

on

haemoglobin

examination results.

Table 2. Classification of patients with
suspected COVID-19 based on
MCV results
Result of MCV
(fL)
Normal
Low
Amount

Frequency
(n)
25

(%)
92.6
7.40
100

2

27

The type of data used in this study is
quantitative

data

(medical

records

of

COVID-19 patients at the Kendari City
General Hospital) in the form of haemoglobin
and erythrocyte index examination results
{Mean Corpuscular Volume (MCV), Mean
Corpuscular Hemoglobin (MCH), Mean

examination of MCV values with normal
values were 25 people (92.6%) while patients
with low examination results were 2 patients
(7.40%).

(MCHC)}. These data were evaluated by

Table 3. Classification of patients with
suspected COVID-19 based on
MCH results

using a parametric statistical, since data does

Result of MCH (pg)

Corpuscular

Hemoglobin

Concentration

Table 1. Classification of patients with
suspected COVID-19 Based on
Haemoglobin examination results
Results of
Haemoglobin
(g/dl)
Normal
Low
Amount

Frequency
(n)
10
17
27

Normal
Low
Amount

follow normal distribution.

Frequency
(n)

(%)

26
1
27

96.29
3.70
100

(%)
37.4
62.7
100

Based on Table 3, the results of the
examination of MCH values with normal
examination

results

were

10

patients

(37.4%), while patients with low examination

Table 1 shows laboratory result of patient
enrolled in this study. Based on Table 1,
patients with suspected COVID-19 with
normal haemoglobin examination results

74

Based on Table 2, the results of the

were 26 patients (96.29%), while patients

results were 17 patients (62.7%).

Table 4. Classification of patients with
suspected COVID-19 based on
MCHC
Result of
MCHC (g/dl)
Normal
Low
Amount

Frequency
(n)
10
17
27

(%)
37.4
62.7
100

Ina. J. Med. Lab. Sci. Tech. 2022; 4(1): 71–80

Sri Aprilianti Idris, et al.

Based on Table 4, the results of the

Based on Table 7, the significant value is

examination of MCHC values with normal

above 0.05 (0.372), which means that there is

examination

patients

no relationship between the results of the

(37.4%), while patients with low examination

haemoglobin examination and the MCHC

results were 17 patients (62.7%).

value.

results

were

10

Table 5. Correlation test for suspected
COVID-19 patients based on the
results of the haemoglobin and
erythrocyte index examination
Correlation
Category
test
Low
Normal
Haemoglobin
1
26
Mean
Corpuscular
2
25
Volume
*Statistically significant (p<0.05)

Sig.
0.057

Based on Table 5, the results of the

Table 7. Correlation test for suspected
COVID-19 patients based on the
results of the haemoglobin and
erythrocyte index examination
Correlation
test

Category
Low
Normal

Haemoglobin
1
26
Mean
Corpuscular
17
10
Haemoglobin
Concentration
*Statistically significant (p<0.05)

Sig.
0.372

correlation analysis obtained a probability
value of 0.057>0.05, which means that there
is no relationship between the results of the

DISCUSSION
There were 26 patients with suspected

haemoglobin examination and the MCV

COVID-19

value. A p-value less than 0.05 (typically ≤

examination results (96.29%), while 1 patient

0.05) is statistically significant

with low test result. In this case, the results of
haemoglobin

with

normal

examination

haemoglobin

found

more

Table 6. Correlation test for suspected
COVID-19 patients based on the
results of the haemoglobin and
erythrocyte index examination

normal results, this study is in line with

Correlation test

results in COVID-19 patients.

Category
Low
Normal
1
26

Haemoglobin
Mean
Corpuscular
17
10
Haemoglobin
*Statistically significant (p<0.05)

Sig.
0.777

previous research Mahrania et al., (1), which
found normal haemoglobin examination

The results of the examination of MCV
values with normal values were 25 people
(92.6%) while patients with low examination
results were 2 patients (7.40%). The results
of this examination are following previous

above 0.05 (0.777) which indicates that there

research conducted by Mahrania et al., (1),

is no relationship between the results of

many normal results were also found in the

haemoglobin examination and the MCH

MCV value. A low MCV value indicates that

value.

the red blood cell volume is below normal, a

Ina. J. Med. Lab. Sci. Tech. 2022; 4(1): 71–80

75

Based on Table 6, the probability value is

Sri Aprilianti Idris, et al.

condition also known as microcytosis (small

haemoglobin

cells). Erythrocytes that are too small mean

haemoglobin and MCH, and there was no

that they are only able to carry oxygen in

correlation

small amounts, causing the body to become

MCHC.

weak or tired easily (9).

MCV,

between

as

well

haemoglobin

as

and

These results indicate that haemoglobin

The results of the examination of more

levels do not affect the erythrocyte index

MCH values obtained low examination

value in suspected

results as many as 17 patients (62.7%). Low

Although normal haemoglobin levels are not

MCH levels are usually affected by various

followed by erythrocyte index values. At the

types of anemia, such as microcytic anemia,

beginning of the COVID-19 infection,

which occurs when red blood cells are too

especially in suspected patients, they showed

small to contain a certain amount of

normal

haemoglobin. The main cause is a lack of

including haemoglobin and erythrocyte index

nutrients or nutrients from food, especially

examinations.

iron. In addition, other conditions cause low

positive patients, the virus can attack the

MCH, namely iron deficiency anemia, celiac

haemoglobin in the red blood cells through a

disease,

excessive

series of cellular actions, which ultimately

menstruation, and vitamin B deficiency (10).

makes the red blood cells unable to carry

gastric

surgery,

The results of the examination of MCHC
value

76

and

found

that

the

results

of the

COVID-19 patients.

hematological

oxygen,

examinations

However,

resulting

in

in

a

COVID-19

decrease

in

haemoglobin levels (12).

examination were low in 17 patients (62.7%).

Several research literatures reported that

In this case, if the MCHC value is low, it

the results of blood examinations from

means that the haemoglobin level in each red

COVID-19

blood cell is lower which indicates the cells

results, namely a decrease in the patient's

are hypochromic. Where the causes of low

haemoglobin and neutrophil values, while the

MCHC values are usually caused by

opposite results were shown in the serum

hypochromic

iron

ferritin index, erythrocyte sedimentation rate,

deficiency, premature destruction of red

C-reactive protein, albumin, and lactate

blood cells, lead poisoning, cancer, and

dehydrogenase

parasitic infections (11).

significantly elevated (12).

microcytic

anemia,

patients

in

showed

many

abnormal

patients, was

Based on the results of the correlation

A decrease in the value of haemoglobin

test analysis of the haemoglobin and

implies that the body will accumulate a lot of

erythrocyte index results, it was found that

harmful

there

inflammation in the body and an increase in

was

no

correlation

between

iron

ions,

which

will

form

Ina. J. Med. Lab. Sci. Tech. 2022; 4(1): 71–80

Sri Aprilianti Idris, et al.

C-reactive protein and albumin, causing cells

respiratory tract infections with viruses such

to experience oxidative stress and will react,

as respiratory syncytial virus and influenza

causing inflammation (13).

virus. In contrast, in children infected with

The effect of SARS-Cov-2 other than on

COVID-19, patients have relatively mild

red blood cells, namely on white blood cells

symptoms in general compared to adults. The

(leukocytes) (13). In COVID-19 positive

reason for this discrepancy is still not clearly

patients, a decrease in the number of white

understood, as recent reports have shown a

blood cells, and lymphocytes and an increase

correlation between the severity of COVID-

in neutrophils was found. The substantial

19 and the amount of viral load (virus

decrease in the total number of lymphocytes

shedding) that infects children less than

indicates that the coronavirus affects many

adults (15).

immune cells and inhibits the function of the

The following is a summary of post-acute

cellular immune system. An increase in the

COVID-19 by organ system:

number of neutrophils and a decrease in the

1. Respiratory disorders

number of lymphocytes was found in COVID

Complications that most often occur due

19 patients. An increase in the number of

to corona virus infection are disorders of the

neutrophils indicates the intensity of the

respiratory tract, such as respiratory failure or

inflammatory response, while a decrease in

ARDS

the number of lymphocytes indicates a

Syndrome) and pneumonia. This condition

damaged immune system (14).

occurs when the lung tissue becomes

SARS-CoV-2, the pathogen responsible

inflamed

(Acute

and

Respiratory

filled

with

Distress

fluid,

thus

for COVID-19, has caused morbidity and

interfering with the breathing process. When

mortality at an unprecedented scale globally.

experiencing complications, patients with

Scientific and clinical evidence is evolving

corona virus infection can experience a lack

on the subacute and long-term effects of

of oxygen. This developes and increase many

COVID-19, which can affect multiple organ

COVID-19 patients requires respiratory

systems. Early reports suggest residual

assistance, such as installing a ventilator and

effects of SARS-CoV-2 infection, such as

giving oxygen.

fatigue, dyspnea, chest pain, cognitive

2. Cardiovascular

disturbances, arthralgia and decline in quality

Corona virus infection can make the

of life. Cellular damage, a robust innate

heart work harder, making it dangerous for

immune response (14).

people who have a history of heart problems,
such as heart disease and heart failure.

high risk for admission to hospital for

Several studies have also shown that the risk

Ina. J. Med. Lab. Sci. Tech. 2022; 4(1): 71–80

77

Infants and young children are usually at

Sri Aprilianti Idris, et al.

of dying from COVID-19 is much higher in

COVID-19 that appear are mild and this

people with a history of heart disease than in

disease can heal by itself. On the other hand,

previously healthy people (14).

if the immune system is unable to fight the

3. Kidney and liver disorders

corona virus, severe COVID-19 symptoms

Several case reports related to corona
virus infection stated that some patients with

appear

and there

is a

risk of

complications (14).

severe symptoms may experience impaired

Bergamaschi et al., (16) reported that

kidney and liver function. Until now, the

patients who were heavily infected with

cause of these complications is not known.

COVID-19

However, the body's immune reaction to the

values. Patients with anemia will have low

corona virus is thought to be one of the

haemoglobin levels. In the circulation

causes (14)

system, haemoglobin serves as a carrier for

4. Gastrointestinal and hepatobiliary

oxygen to target organs in the body. When

produced

low

haemoglobin

Gastrointestinal disturbances can occur

the concentration of the haemoglobin in the

in patients with COVID-19 even after a

circulation is low, the transport of oxygen to

negative

several organs in the body will be disrupted,

nasopharyngeal

swab

result.

COVID-19 has the potential to alter the gut

therefore

causing

hypoxia

microbiome,

eventually

result

in

including

enrichment

of

that

multiple

will
organ

opportunistic organisms and depletion of

dysfunction, especially respiratory organ

beneficial commensals (14).

dysfunction. Multiple organ dysfunction will

5. Dermatologic

contribute to the development of severe

Hair loss (Baldness) is the predominant
symptom

and

has

been

reported

in

approximately 20% of COVID-19 survivors
(15).

outcomes in COVID-19 infection. Moreover,
in COVID-19 infections, the state of anemia
in the patients could be worsened (17-21).
There are some limitations in our study,

In addition to some of the complications

namely the number of samples (patient) and

above, patients with corona virus infection

multiple blood samples were not taken at

are also at risk of developing sepsis. This

different time points of the disease course to

condition is more likely to occur in many

see the status of RBC profiles. Further, the

patients with severe COVID-19 showed

comprehensive

general signs of shock, weak and have been

parameters (size, shape, and quality of RBC)

hospitalized for a long time (14).

with many samples would be helpful for early

A strong immune system is able to fight

78

can

the corona virus well so that the symptoms of

analysis

of

the

RBC

identification and better management of
COVID-19 disease.
Ina. J. Med. Lab. Sci. Tech. 2022; 4(1): 71–80

Sri Aprilianti Idris, et al.

validation. Muh. Azdar Setiawan: data

CONCLUSIONS
To conclude, this study highlighted and
compared haemoglobin and MCV, MCH and

analysis,

methodology.

Susanti:

data

collection.

MCHC examinations of COVID-19 patient
cases in Kendari City Hospital. Our study

ACKNOWLEDGEMENTS

results indicate that there is no correlation

We would like to thank the Kendari City

between the results of haemoglobin and

Regional General Hospital and the Bina

MCV, MCH and MCHC examinations.

Husada Kendari Politeknik.

AUTHOR CONTRIBUTIONS

CONFLICT OF INTEREST

Sri

Aprilianti

conceptualization,

dan

Firdayanti:

writing-reviewing,

REFERENCES
1.

2.

There are no conflicts of interest

Mahrania, Hana KPF, Paramita K, Iffa M, Fitriana
NR, Sarah SM, Gadistya NA, Uti NS, Pukovisa P.
Mild COVID-19 cases in medical personnel:
Evaluation of clinical findings and transmission
Risk. J Indon Med Assoc. 2020,70(4): 80-84.
Wu Z, McGoogan JM. Characteristics of and
important lessons from the Coronavirus Disease
2019 (COVID-19) outbreak in China: Summary
of a report of 72314 cases from the Chinese
Center for disease control and prevention. JAMA.
2020;323(13):1239-1242.
doi:10.1001/jama.2020.2648
World Health Organization. Situation report–10
[Internet]. 2020 [updated 2020 January 30; cited
2020
March
15].
Available
from:
https://www.who.int/docs/defaultsource/coronaviruse/situation-reports/20200130sitrep-10-ncov. pdf?sfvrsn=d0b2e480_2.

4.

Ministry of Health of the Republic of Indonesia.
Information on emerging infections of the
Indonesian Ministry of Health. [Internet]. 2020
[updated 2020 March 30; cited 2020 March 31].
Available
from:
https://
infeksiemerging.kemkes.go.id/.

5.

Barker A, Souisa H. 2020. Coronavirus COVID19 death rate in Indonesia is the highest in the
world. Experts say it is because reported case
number are too low. Retrieved Juni, 2020, from
ABC News: https://www.abc.net.au/news/202003-23/why-is-indonesia-coronavirus-death-ratehighest-in-world/12079040.

Ina. J. Med. Lab. Sci. Tech. 2022; 4(1): 71–80

Southeast Sulawesi Provincial Health Office
2020. Gugus Tugas Percepatan Penanganan
Covid-19.

7.

Yuliana. Corona Virus Disease (Covid-19): A
Literature Review. Wellness and Healthy
Magazine. 2020.2(1): 2-5.

8.

Diah H, Dwi RH, Fathiyah I, Erlina B, Heidy A.
Corona Virus Disease. Jurnal Respirologi
Indonesia. 2020. VOL. 40, (119) No. 2.

9.

Riswanto. Hematology laboratory examination.
Alfamedika dan Kanal Medika. 2013.Yogyakarta.

10. Gandasoebrata R. Clinical Laboratory Guide.
2013. Dian Rakyat. Jakarta
11. Muhammad R, Eka Y, Hermawan I. The
relationship between Erythrocyte Index and
Hemoglobin Levels on tumor locations in
colorectal cancer patients. Case study at Dr.
RSUP. Kariadi. 2014. J Media Medika Muda.
2014.3(1).
12. Zhang H, Penninger JM, Li Y, Zhong N, Slutsky
AS. Angiotensin-converting enzyme 2 (ACE2) as
a SARS-CoV-2 receptor: molecular mechanisms
and potential therapeutic target. Intensive Care
Med. 2020 Apr;46(4):586-590.
13. Hariyanto T, Andre K. Transfusion and Apheresis
Science “Anemia is associated with severe
coronavirus disease 2019 (COVID-19) infection”.
2020.
PubMed.
59(6).
http:
//doi:
10.1016/j.transci.2020.102926. Epub 2020 Aug
28.

79

3.

6.

Sri Aprilianti Idris, et al.

14. Ani N , Kartik S , Aakriti G, Elaine YW. Postacute COVID-19 syndrome. Nature Medicine.
Volume
27.
April
2021(601–615). doi:
https://doi.org/10.1038/S41591-021-01283-Z
15. Koichi Y, Miho F, Sophia K. COVID-19
pathophysiology:
A
review.
Clinical
Immunology. Elsevier. Clinical Immunology 215
(2020)
10842.
https://doi.org/10.1016/j.clim.2020.108427.
16. Bergamaschi G, Andreis FB, Aronico N, Lenti
MV, Barteselli C, Merli S, Pellegrino I, Coppola
L, Cremonte EM, Croce G, Mordà F, Lapia F,
Ferrari S, Ballesio A, Parodi A, Calabretta F,
Ferrari MG, Fumoso F, Gentile A, Melazzini F,
Sabatino AD. Anemia in patients with Covid-19:
pathogenesis and clinical significance. Clin Exp
Med. Volume 21. January 2021 (239-246). Doi:
https://dx.doi.org/10.1007%2Fs10238-02000679-4

18. Susilo A. Coronavirus disease 2019: A Literature
Review.
J Penyakit Dalam Indonesia. 2020,
7(1): 45-54.
19. Widmann FK. Clinical Review of Laboratory
Examination Results. EGC. 2005. Jakarta.
20. Wenzhong L, Hualan L. COVID-19: attacks the
1-Beta chain of hemoglobin and captures the
porphyrin to inhibit Human Heme Metabolism.
ChemRxiv.
Preprint.
2020.
https://doi.org/10.26434/chemrxiv.11938173.v9
21. Gaetano B, Federica BA. Internal medicine
Covid-19 collaborators. Anemia in patients
with Covid-19:
pathogenesis
and clinical
signifcance. Springer. Clinical and Experimental
Medicine.
2021.
Volume 21, 239–246.
https://doi.org/10.1007/s10238-020-00679-4.

80

17. Ratcliffe R. First coronavirus cases confirmed in
Indonesia amid fears nation is ill prepared for
outbreak. Retreived Juni, 2020, March, From

Guardian
News
&
Media
Limited:
https://www.theguardian.com/world/2020/mar/0
2/first-coronavirus-cases-confirmed-inindonesia-amid-fears-nation-is-ill-prepared-foroutbreak.

Ina. J. Med. Lab. Sci. Tech. 2022; 4(1): 71–80