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"Although typically patients with coronavirus disease-19 (COVID-19) have pulmonary symptoms atypical cases can occasionally present with extra-pulmonary symptoms. We report an interesting case of COVID-19 female patient presenting with combination of central nervous system disorder and acute myocardial infarct as initial manifestation. Multiorgan involvement in COVID-19 might lead to multiple atypical presentation which could be overlooked by the physician."

"Coronavirus disease 19 (COVID-19) which is caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), has been a problem worldwide, particularly due to the high rate of transmission and wide range of clinical manifestations. Acute respiratory distress syndrome (ARDS) and multiorgan failure are the most common events observed in severe cases and can be fatal. Cytokine storm syndrome emerges as one of the possibilities for the development of ARDS and multiorgan failure in severe cases of COVID-19. This case report describes a case of a 53-year-old male patient who has been diagnosed with COVID-19. Further evaluation in this patient showed that there was a marked increase in IL-6 level in blood accompanied with hyperferritinemia, which was in accordance with the characteristic of cytokine storm syndrome. Patient was treated with tocilizumab, a monoclonal antibody and is an antagonist to IL-6 receptor. The binding between tocilizumab and IL-6 receptors effectively inhibit and manage cytokine storm syndrome. Although this case report reported the efficacy of tocilizumab in managing cytokine storm syndrome, tocilizumab has several adverse effects requiring close monitoring. Further clinical randomized control trial is required to evaluate the efficacy and safety of tocilizumab administration in participants with various clinical characteristics and greater number of subjects. "

"Cases of coronavirus disease 2019 (COVID-19) in Indonesia are still increasing and even higher in the last few weeks. Contact tracing and surveillance are important to locate cases in the community, including asymptomatic individuals. Diagnosis of COVID-19 depends on the detection of viral RNA, viral antigen, or indirectly, viral antibodies. Molecular diagnosis, using real time, reverse transcriptase polymerase chain reaction (RT-PCR), is the common standard method; however, it is not widely available in Indonesia and requires a high standard laboratory. Rapid, point-of-care antibody testing has been widely used as an alternative; however, interpretation of the results is not simple and now it is no longer used by the Indonesian government as a screening test for people travelling between locations. Thus, the rapid antigen detection test (Ag-RDT) is used by the Indonesian government as a screening test for travellers. As a result, many people buy the kit online and perform self-Ag-RDT at home. This raises the question of how safe and accurate it is to perform self-Ag-RDT at home. Before a test is applied, it is suggested to research its sensitivity and specificity, as compared to gold standard, and its limitations. In this article, laboratory diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is discussed, with an emphasis on Ag-RDT and the recommendation to use it properly in daily practice."

"Coronavirus Disease (COVID-19) merupakan infeksi sistem pernapasan yang disebabkan oleh severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Virus ini dapat menyebabkan pneumonia dan berkembang menjadi sindrom distres pernapasan akut/ARDS dan gagal ginjal akut. Pasien terkonfirmasi positif COVID-19 pada laporan ini datang dengan keluhan demam, batuk, sesak, dan terjadi penurunan saturasi oksigen. Hasil chest X-ray menunjukkan infiltrasi bilateral pada kedua lapang paru. Hasil pemeriksaan kimia darah menunjukkan peningkatan kadar kreatinin dan ureum, serta penurunan eGFR. Diagnosis keperawatan yang ditegakkan yakni gangguan pertukaran gas, gangguan ventilasi spontan, gangguan penyapihan ventilator, dan risiko perfusi renal tidak efektif. Intervensi keperawatan yang diberikan kepada pasien yakni pengaturan posisi, terapi oksigen, manajemen ventilasi mekanik, pemantauan respirasi, penyapihan ventilasi mekanik, dan pencegahan syok. Intervensi yang diberikan memberikan hasil yang fluktuatif setiap hari.

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Coronavirus Disease (COVID-19) is an infection of the respiratory system caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This virus can cause pneumonia and progress to acute respiratory distress syndrome/ARDS and acute kidney injury. The patient reported in this case report arrived Emergency Department with complaints of fever, cough, and respiratory distress. The chest X- ray showed bilateral infiltration in both lung fields. The results of the arterial blood gas showed increased levels of creatinine, urea, and decreased eGFR. The nursing diagnoses made were impaired gas exchange, impaired spontaneous ventilation, impaired ventilator weaning, and the risk of ineffective renal perfusion. Nursing interventions given to patients were positioning, oxygen therapy, mechanical ventilation management, respiration monitoring, mechanical ventilation weaning, and shock prevention. The given intervention gives fluctuating results every day."

"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

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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"

"Coronavirus Disease 2019 adalah penyakit menular yang disebabkan oleh Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Covid-19 telah dinyatakan sebagai pandemik sehingga perlu dilakukan upaya penanggulangan termasuk penguatan fungsi laboratorium yang berfungsi melakukan pemeriksaan spesimen, untuk menjamin kesinambungan pemeriksaan screening spesimen Coronavirus Disease 2019. Penelitian ini bertujuan untuk menganalisis implementasi hierarki pengendalian risiko dalam pencegahan penularan Covid-19 pada pekerja di Laboratorium Biomolekular PT X. Penelitian ini menggunakan metode penelitian kualitatif . Pengumpulan data dilakukan melalui data sekunder, wawancara dan observasi. Penelitian dilakukan dari November 2021-Juli 2022. Hasil penelitian menunjukkan proses kerja di PT. X terdiri enam jenis dari pengambilan sampel hingga pelaporan ke pasien. Masing-masing proses memiliki risiko masing-masing dalam pekerjaannya, dimana risiko tertinggi pada petugas pengambilan sampel. Pengetahuan dan perilaku pekerja terhadap hirarki pengendalian risiko dapat dikatakan sangat baik. Perilaku pencegahan Covid-19 yang dilakukan oleh pekerja di PT. X sudah ada upayanya, seperti mereka paham pentingnya bekerja dengan SOP dan menggunakan alat pelindung diri. PT.X telah mengimplementasikan hirarki pengendalian risiko meliputi pengendalian teknis seperti memberi pembatas dan pengaturan ventilasi, pengendalian administrasi seperti pembuatan SOP dan pengaturan shift kerja, dan penggunaan alat pelindung diri seperti masker, baju gown, sarung tangan, dsb. Terkait implementasi pengendalian risiko pada Laboratorium ada dua hal yang belum terpenuhi yaitu tidak adanya pengelolaan limbah padat B3 dan tidak ada manajemen biosecurity secara mandiri. Adapun saran yang dapat direkomendasikan adalah perlu memberikan edukasi, sosialisasi, maupun pelatihan secara berkala terkait manajemen pengendalian risiko dan melakukan upaya pengelolaan limbah B3 sendiri mengacu pada peraturan kementerian kesehatan untuk keamanaan baik para pekerja dan pelanggan yang berkunjung ke PT.X.

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Coronavirus Disease 2019 is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Covid-19 has been declared a pandemic so it is necessary to take countermeasures including strengthening the laboratory function that functions to examine specimens, to ensure the continuity of the 2019 Coronavirus Disease specimen screening examination. This study aims to analyze the implementation of the risk control hierarchy in preventing the transmission of Covid-19 to workers in Biomolecular Laboratory of PT X. This research uses qualitative research methods. Data was collected through secondary data, interviews and observations. The research was conducted from November 2021-July 2022. The results showed that the work process at PT. X consists of six types from sampling to reporting to patients. Each process has its own risks in its work, where the risk is highest for the sampling officer. Knowledge and behavior of workers on the hierarchy of risk control can be said to be very good. Covid-19 prevention behavior carried out by workers at PT. X has made an effort, as they understand the importance of working with SOPs and using personal protective equipment. PT.X has implemented a risk control hierarchy including technical controls such as providing barriers and ventilation settings, administrative controls such as making SOPs and setting work shifts, and the use of personal protective equipment such as masks, gowns, gloves, etc. Regarding the implementation of risk control in the laboratory, there are two things that have not been fulfilled, namely the absence of B3 solid waste management and no independent biosecurity management. The suggestions that can be recommended are that it is necessary to provide education, socialization, and periodic training related to risk control management and make efforts to manage B3 waste itself referring to the regulations of the ministry of health for the safety of both workers and customers who visit PT.X.

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"Background: Coronavirus Disease 2019 is an emerging respiratory disease that is now a pandemic. Indonesia is experiencing a rapid surge of cases but the local data are scarce. Methods: this is an analysis using data from the ongoing recapitulation of Epidemiological Surveillance (ES) by the Provincial Health Office of Jakarta from March 2nd to April 27th 2020. We evaluated demographic and clinical characteristics of all confirmed cases in association with death. Results: of the 4,052 patients, 381 (9.4%) patients were deceased. Multivariable analysis showed that death was associated with older age (odds ratio [OR] 1.03; 95% confidence interval [CI] 1.02, 1.05, per year increase; p<0.001), dyspnea (OR 4.83; 95% CI 3.20, 7.29; p<0.001), pneumonia (OR 2.46; 95%CI 1.56, 3.88; p<0.001), and pre-existing hypertension (OR 1.86; 95% CI 1.24, 2.78; p=0.003). Death was highest in the week of April 6th 2020 and declined in the subsequent weeks, after a large-scale social restriction commenced. Conclusion: older age, dyspnea, pneumonia, and pre-existing hypertension were associated with death. Mortality was high, but may be reduced by lockdown."

"Latar Belakang : Corona Virus Disease 2019 (COVID 19) merupakan penyakit infeksi yang disebabkan virus Sars Cov 2 yang baru diidentifikasi dan saat ini telah ditetapkan sebagai pandemi. Manifestasi klinis bervariasi dan progresivitas kondisi pasien COVID-19 dapat terjadi setelah satu minggu atau dalam waktu yang tidak dapat ditentukan. Dalam kondisi pandemi COVID-19, tenaga medis perlu untuk menentukan pasien yang harus ditatalaksana terlebih dahulu berdasarkan pertimbangan klinis serta prognosis pasien. Dibutuhkan parameter objektif yang dapat memperkirakan risiko mortalitas untuk memilah prioritas perawatan pasien. Hitung limfosit absolut dan C-reactive protein selama ini digunakan sebagai prediktor mortalitas berbagai penyakit, termasuk infeksi. Perlu ditentukan titik potong dan peran hitung limfosit absolut dan CRP kuantitatif saat admisi sebagai prediktor mortalitas pasien COVID19.Tujuan : Mengetahui titik potong dan peran hitung limfosit absolut dan CRP kuantitatif untuk memprediksi mortalitas pasien COVID 19.Metode : Penelitian kohort retrospektif terhadap 235 pasien probable dan terkonfirmasi COVID-19 di RSCM sejak Maret hingga Juni 2020 dengan metode consecutive sampling. Data yang digunakan adalah data sekunder. Hasil: Sebanyak 235 subjek dianalisis dan didapatkan mortalitas sebesar 27,7%. Titik potong hitung limfosit absolut yang bermakna adalah 977,67 sel/µL dengan nilai AUC sebesar 0.704 (p <0.001 dengan IK 95% 0,624-0,785), sensitivitas 67,69% , spesifisitas 70,0%, NDP 46,32% dan NDN 85,0%. Pada analisis untuk kadar CRP kuantitatif didapatkan nilai AUC sebesar 0.656 (p <0.001 dengan 95%CI 0,578-0,733). Didapatkan nilai titik potong untuk kadar CRP kuantitatif sebesar 88.5 mg/L dengan sensitivitas 52,3% , spesifisitas 68,2%, NDP39,33%, NDN 79,45%. Penggabungan kedua variabel tersebut menghasilkan nilai AUC sebesar 0.737. Keduanya bersifat signifikan meningkatkan risiko mortalitas 4.70 dan 2.34 kali lipat pada pasien COVID-19.Simpulan:Hitung limfosit absolut dan/atau kadar CRP saat admisi dapat digunakan untuk menilai risiko mortalitas pasien COVID-19.

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Background: Coronavirus disease 2019 (COVID-19), an infectious disease caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV2), has been declared as pandemic world wide. Various clinical manifestation and rapid deterioration from mild to severe symptoms , acute respiratory distress syndrome and deaths could occur in the first week of disease. In pandemic setting, physicians need rapid assessment and objective parameters to make clinical decisions to the patient. Absolute lymphocyte count (ALC) and C-reactive protein (CRP) have been used as mortality predictors in various disease. We need to determine cut off and the role of ALC and CRP in predicting mortality risk in COVID-19.

Objective : To determine the cut off and role of ALC and CRP as mortality predictors in COVID-19 patients.

Methods : A cohort retrospective study with consecutive sampling method. Subjects were adults that fulfilled criteria of probable and confirmed COVID-19 in WHO criteria in RSCM from March to June 2020. Data were obtained from medical record and electronic health record. Analysis was done by using SPSS Statitstic 20.0.

Results : A total of 235 subjects were analysed. The cut off of ALC was 977,67 cell/µL (Sn 68.2% ; Sp 70.4%; PPV 46,32%; NPV 85%) with AUC 0.704 (p<0,001 ; 95% CI [0.627—0.786]) and CRP was 88,5 mg/L (Sn 52,3% ; Sp 68,2%; PPV 39,33%; NPV 79,45%) with AUC 0.656 (p<0,001 ; 95% CI [0.572-0.728]). ROC analysis of ALC and CRP showed AUC 0.737 (p<0,001 ; 95% CI [648—0.792]). Adjusted OR of ALC and CRP showed that mortality risk increased 4.70 and 2.34 times by using the cut off.

Conclusions : ALC and CRP at admission could be used to determine mortality risk in COVID-19 patients."

"Pandemi Coronavirus disease 19 (Covid-19) berdampak pada komitmen perawat dalam memberikan asuhan keperawatan dan mempengaruhi kualitas asuhan, kepuasan kerja perawat, dan pencapaian tujuan pelayanan keperawatan. Penelitian ini bertujuan mengidentifikasi determinan komitmen perawat dalam memberikan asuhan keperawatan di era pandemi Covid-19. Desain penelitian yang menggunakan pendekatan cross sectional ini melibatkan 221 perawat pelaksana dan ketua tim di dua rumah sakit umum wilayah Kalimantan Barat. Pengambilan sampel dilakukan dengan teknik simple random sampling. Variabel determinan diukur menggunakan kuesioner dalam bentuk google form yang dikumpulkan secara online. Data dianalisis menggunakan regresi linier berganda. Hasil penelitian mendapatkan determinan komitmen perawat dalam memberikan asuhan keperawatan di masa pandemi Covid-19 adalah kecerdasan emosional (p=0,001) dan dukungan atasan ) p=0,009), yaitu setiap penambahan satu poin kecerdasan emosional dan dukungan atasan akan meningkatkan komitmen perawat dalam memberikan asuhan keperawatan sebesar 0,239 kali dan 0,125 kali. Faktor usia, lama kerja, jenis kelamin, tingkat pendidikan, status pernikahan, dan ruangan unit kerja tidak berhubungan dengan komitmen perawat (p> 0,05). Faktor yang paling berhubungan dengan komitmen perawat dalam memberikan asuhan keperawatan adalah kecerdasan emosional. Dari penelitian ini juga didapatkan kemampuan perawat menilai emosi orang lain dan keinginan perawat bertahan pada profesinya merupakan aspek kecerdasan emosional dan komitmen perawat yang masih perlu ditingkatkan. Hasil penelitian ini dapat digunakan sebagai dasar untuk mengembangkan kompetensi kecerdasan emosional perawat dan membuat strategi dukungan atasan untuk meningkatkan komitmen perawat dalam memberikan asuhan keperawatan.

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The Coronavirus disease 19 (Covid-19) pandemic has an impact on the commitment of nurses in giving nursing care and affects the quality of care, nurse job satisfaction, and the achievement of nursing service goals. This study aims to identify the determinants of nurses' commitment in giving nursing care in the era of the Covid 19 pandemic. The research design using a cross sectional approach involved 221 nurses and team leaders at two public hospitals in West Borneo. Sampling was done by simple random sampling technique. The determinant variable was measured using a questionnaire in the form of a google form which was collected online. Data were analyzed using multiple linear regression. The results showed that the determinants of nurses' commitment in giving nursing care during the Covid-19 pandemic were emotional intelligence (p=0.001) and supervisor support (p=0.009), that is, each addition of one point of emotional intelligence and support from supervisor will increase the commitment of nurses in giving nursing care by 0.239 times and 0.125 times. Factors of age, length of work, gender, education level, marital status, and work unit room were not related to nurse commitment (p> 0.05). The factor that is most closely related to the commitment of nurses in giving nursing care is emotional intelligence. From this study, it was also found that the nurse's ability to assess the emotions of others and the nurses's desire to stay in her profession are aspects of emotional intelligence and nurse commitment that still need to be improved. The results of this study can be used as a basis for developing nurses' emotional intelligence competencies and making supervisor support strategies to increase nurses' commitment in giving nursing care."

"Coronavirus Disease 2019 (COVID-19) adalah penyakit menular yang disebabkan oleh Severe Acute Respiratory Syndrome Coronavirus 2 (SARS- CoV-2). SARS-CoV-2 merupakan coronavirus jenis baru yang belum pernah diidentifikasi sebelumnya pada manusia. Dampak dari penyakit ini adalah menimbulkan pandemik dengan angka kematian yang sangat tinggi diseluruh dunia. Tujuan umum penelitian ini adalah untuk mengetahui hubungan penderita dengan komorbid hipertensi dengan kejadian kematian akibat Covid-19 di Kota Tangerang Selatan tahun 2020-2021. Desain penelitian yang digunakan desain penelitiaan adalah case control dengan pendekatan kuantitatif. Penelitian ini menggunakan data NAR Kota Tangerang Selatan dan cacatan khusus surveilan pada kasus kematian akibat Covid-19 di Kota Tangerang Selatan berjumlah 13.166 yang terdata sampai tanggal 29 Juni 2021. Data yang dapat dianalisa berjumlah 766 data sampel tersebut didapatkan dengan cara Simple Random Sampling. Teknik analisa data yang dilakukan pada penelitian ini bertahap, meliputi analisa univariat, bivariat, stratifikasi dan analisa multivariat yang diolah menggunakan program statistic. Hasil penelitian menunjukkan bahwa proporsi data dengan kematian akibat Covid-19 pada kelompok kasus dengan komorbid hipertensi sejumlah 189 (49,35%) pasien dan yang tidak komorbid pada kasus kematian yaitu 194 (50,65%), sedangkan yang tidak memiliki komorbid hipertensi dan tidak mengalami kematian akibat Covid-19 sebanyak 345 pasien (90,08%), serta yang memiliki komorbid hipertensi dan tidak mengalami kematian sebanyak 38 pasien (9,92%). Hasil analisis uji logistic regression model akhir menunjukkan hubungan yang signifikan antara komorbid hipertensi dengan kejadian kematian akibat covid-19 dengan OR 7,96 (95% CI: 5,19-12,2; p-value: 0,000) yang artinya bahwa komorbid Hipertensi pada kelompok kasus berisiko 7,96 kali lebih tinggi mengalami kematian akibat covid-19 dibanding kelompok kontrol setelah dikontrol dengan variabel umur, pekerjaan, adanya gejala awal dan penyakit lainnya.

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Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). SARS-CoV-2 is a new type of coronavirus that has never been previously identified in humans. The impact of this disease is causing a pandemic with a very high mortality rate throughout the world. The general purpose of this study was to determine the relationship between patients with comorbid hypertension and the incidence of death due to Covid-19 in South Tangerang City in 2020-2021. The research design used was a case control research design with a quantitative approach. This study uses NAR data from South Tangerang City and special surveillance records on cases of death due to Covid-19 in South Tangerang City totaling 13,166 recorded until June 29, 2021. The data that can be analyzed is 766. The sample data was obtained by means of Simple Random Sampling. Data analysis techniques carried out in this study were carried out in stages, including univariate, bivariate, stratification and multivariate analysis which were processed using statistical programs. The results showed that the proportion of data with deaths due to Covid-19 in the group of cases with comorbid hypertension was 189 (49.35%) patients and those who were not comorbid in cases of death were 194 (50.65%), while those without comorbid hypertension and 345 patients (90.08%) did not die from Covid-19, and 38 patients (9.92%) did not experience comorbid hypertension and did not experience death. The results of the final logistic regression test analysis showed a significant relationship between comorbid hypertension and the incidence of death due to covid-19 with an OR of 7.96 (95% CI: 5.19-12.2; p-value: 0.000) which means that comorbid hypertension the case group had a 7.96 times higher risk of dying from COVID-19 than the control group after controlling for variables of age, occupation, presence of early symptoms and have other diseases."