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"Rapid swab antigen SARS-CoV-2 merupakan pemeriksaan alternatif dalam mendeteksi SARS-CoV-2. Salah satu faktor yang mempengaruhi pemeriksaan rapid swab antigen SARS-CoV-ialah viral load yang direpresentasikan dengan cycle threshold (CT) pada pemeriksaan rRT-PCR. Hasil CT yang tinggi membuat sensitivitas pemeriksaan rapid swab antigen SARS-CoV-2 rendah. Tujuan utama pada penelitian ialah untuk menentukan nilai CT tertinggi pada pemeriksaan rRT-PCR yang mampu memberikan hasil reaktif pada pemeriksaan COVID-19 Ag (Standard Q SD Biosensor). Penelitian merupakan penelitian observasional dengan metode potong lintang dilakukan pada poliklinik demam RS dr. Cipto Mangunkusumo pada tanggal Juli 2020- Desember 2021. Total subjek dalam penelitian berjumlah 235 terdiri dari 24,7% subjek dengan rRT-PCR SARS-CoV-2 positif dan 75,3% subjek dengan rRT-PCR SARS-CoV-2 negatif. Median CT tertinggi pada pemeriksaan rRT-PCR SARS-CoV-2 yang mampu memberikan hasil reaktif pada pemeriksaan COVID-19 Ag (Standard Q SD Biosensor) ialah 28,22 (13,33- 39,16), sedangkan median CT tertinggi pada COVID-19 Ag (Standard Q SD Biosensor) non-reaktif ialah 34,45 (26,08-39,65). Sensitivitas, spesifisitas, NPV, PPV, dan LR positif dan LR negatif hasil COVID-19 Ag (Standard Q SD Biosensor) pada CT ≤ 40 adalah 63.8%, 99.4%, 89.3%, 97.4%, 112.9, dan 0.4. Pada CT ≤ 33 sensitivitas, spesifisitas, NPV, PPV, dan LR positif dan LR negatif ialah 77.1%, 99.4%, 95.7%, 96.4%, 136.5, dan 0.2 sedangkan pada CT ≤ 25 sensitivitas, spesifisitas, NPV, PPV, dan LR positif dan LR negatif adalah 92.3%, 99.4%, 99.4%, 92.3%, 163.4, dan 0.1. Titik potong CT rRT-PCR SARS-CoV-2 tertinggi ialah 26,06 dengan hasil sensitivitas 100% dan spesifisitas 99,4%. Pemeriksaan COVID-19 Ag (Standard Q SD Biosensor) dapat dipakai untuk keperluan diagnosis, contact tracing atau community surveilance.

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SARS-CoV-2 rapid antigen swab is an alternative test for detecting SARS-CoV-2 infection. One of the factors that influence the examination is viral load, which is represented by the cycle threshold (CT) in the rRT-PCR examination. The higher CT value will result in lower sensitivity of SARS-CoV-2 rapid antigen swab examination. The main objective of the study was to determine the highest CT value in rRT-PCR examination which still able to give reactive results on the COVID-19 Ag test (Standard Q SD Biosensor). The study was a cross-sectional study carried out at the fever polyclinic in dr. Cipto Mangunkusumo Hospital between July 2020 - December 2021. The study consisted of 235 subjects, 24.7% of subjects were SARS-CoV-2 positives and 75.3% of subjects were negative for SARS-CoV-2 infections. Median highest CT value in the SARS-CoV-2 rRT-PCR examination which able to give reactive results on the COVID-19 Ag (Standard Q SD Biosensor) test was 28.22 (13.33-39.16) while the median CT value on the non-reactive COVID-19 Ag (Standard Q SD Biosensor) was 34.45 (26.08-39.65). The sensitivity, specificity, NPV, PPV, and LR positive and LR negative results of COVID-19 Ag (Standard Q SD Biosensor) were 63.8%, 99.4%, 89.3%, 97.4%, 112.9, and 0.4 at CT value ≤ 40. The sensitivity, specificity, NPV, PPV, and LR positive and LR negative at CT value ≤ 33 were 77.1%, 99.4%, 95.7%, 96.4%, 136.5, and 0.2, while at CT ≤ 25 sensitivity, specificity, NPV, PPV, and LR positive and LR negative were 92.3%, 99.4%, 99.4%, 92.3%, 163.4, and 0.1. The cut-off point for the highest CT value was 26.06 with a sensitivity of 100% and a specificity of 99.4%. In conclusion, COVID-19 Ag (Standard Q SD Biosensor) was acceptable for diagnosis, contact tracing or community surveillance."

"Latar belakang: Infeksi SARS-CoV-2 menyebabkan disregulasi sistem imun sehingga memperberat klinis pasien. Penilaian CT dan parameter inflamasi pejamu (neutrofil, limfosit, CRP dan feritin) saat admisi diharapkan membantu klinisi memberi tatalaksana efektif bagi pasien berisiko perburukan.Tujuan: Mengetahui pengaruh nilai CT dan parameter inflamasi pejamu saat admisi terhadap derajat penyakit COVID-19 dalam 14 hari sejak onset gejala.Metode: Studi kohort retrospektif dengan menelusuri rekam medis pasien COVID-19 berusia >18 tahun yang dirawat di RSCM dan RS Medistra pada Juni 2020-Februari 2021. Dilakukan analisis bivariat antara nilai CT, neutrofil, limfosit, CRP, feritin saat admisi dengan keparahan COVID-19, dilanjutkan analisis ROC untuk mendapatkan titik potong optimal. Setelahnya, dilakukan analisis multivariat dan membuat model klinis terbaik menilai kemungkinan keparahan COVID-19.Hasil: Dari 336 subjek didapatkan COVID-19 berat-kritis sejumlah 75,3%. Tidak terdapat hubungan antara nilai CT rendah-sedang dan CT rendah-tinggi terhadap keparahan COVID-19 dengan nilai p masing-masing 0129 dan 0,913, sementara itu terdapat hubungan signifikan antara neutrofil, limfosit, CRP dan feritin terhadap keparahan COVID-19 dengan masing-masing nilai p<0,001. Dari analisis ROC, didapat titik potong optimal neutrofil (>71,5%), limfosit (<18,5%), CRP (>17,2 mg/dL), feritin (270 ng/mL) terhadap terjadinya COVID-19 berat-kritis dalam 14 hari sejak onset gejala. Hasil analisis multivariat menujukkan faktor yang mempengaruhi COVID-19 berat-kritis antara lain neutrofil (aRR 1,850 [IK 95% 1,482-2,311]), limfosit (aRR 1,877 [IK 95% 1,501 – 2,348]), CRP (aRR 2,068 [IK 95% 1,593 – 2,685]), dan feritin (aRR 1,841 [IK 95% 1,438 – 2,357]). Model klinis kombinasi neutrofil, limfosit, CPR dan feritin terhadap COVID-19 berat-kritis memiliki nilai AUC 0,933 (IK 95% 0,902 – 0,963). Kesimpulan: nilai CT tidak mempengaruhi COVID-19 tidak berat dan berat-kritis. Neutrofil, limfosit, CRP, dan feritin saat admisi mempengaruhi terjadinya COVID-19 tidak berat dan berat-kritis Kombinasi neutrofil, limfosit, CRP dan feritin merupakan model klinis terbaik menilai kemungkinan keparahan COVID-19 dalam 14 hari sejak onset gejala.

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Background: SARS-CoV-2 infection leads to immune dysregulation and hyperinflammation, thus potentially exacerbating clinical outcomes. Assessing CT value and host inflammatory parameters such as neutrophils, lymphocytes, CRP, and feritin upon admission may assist clinicians in providing effective management, especially for patient at risk of severe-critical condition.

Objective: To analyze the effect of CT values and host inflammatory parameters upon admission on the severity of COVID-19 within 14 days of symptom onset.

Methods: A retrospective cohort study tracing COVID-19 patient’s medical records aged >18 years admitted to RSUPN Ciptomangunkusumo and RS Medistra from June 2020 to February 2021. Bivariate analysis was conducted between CT values, neutrophils, lymphocytes, CRP, feritin on admission with COVID-19 severity, then ROC analysis to determine the optimal cut off points. Multivariate analysis was performed to control confounding factors. The best clinical model was analyzed for severe-critical outcome within 14 days of symptom onset.

Results: Out of 336 subjects, 75,3% had severe-critical COVID-19. There was no association between low-moderate CT value and low-high CT value with COVID-19 severity, with p value 0,129 and 0,913 respectively. However, there was significant association between neutrophils, lymphocytes, CRP, and feritins with COVID-19 severity, each with p<0.001. ROC analysis determined optimal cut off for neutrophils (>71.5%), lymphocytes (<18.5%), CRP (>17.2 mg/dL), and feritin (270 ng/mL) for the occurrence of severe-critical COVDI-19 within 14 days symptom onset. Multivariate analysis revealed factors influencing severe-critical COVID-19 including neutrophils (aRR 1.850 [95% CI 1.482-2.311]), lymphocytes (aRR 1.877 [95% CI 1.501 – 2.348]), CRP (aRR 2.068 [95% CI 1.593 – 2.685]), and feritin (aRR 1.841 [95% CI 1.438 – 2.357]). Combination of neutrophil, lymphocytes, CRP, and feritin was the best clinical model for severe-critical COVID-19 with AUC value 0.933 (95% CI 0.902 – 0.963).

Conclusion: Neutrophils, lymphocytes, CRP, and feritin value upon admission effect COVID-19 severity within 14 days of symptom onset"

"Latar Belakang. Saat ini sedang terjadi pandemi COVID-19 di seluruh dunia, pandemi ini dimulai dari Wuhan, Cina. Virus SARS-CoV-2 penyebab COVID-19 sangat menular dan penyebarannya sangat cepat, sehingga memerlukan penanganan khusus seperti isolasi atau karantina. Gejala penyakit COVID-19 menyerupai gejala infeksi saluran pernapasan akut yang disebabkan oleh patogen lain seperti SARS, influenza, rhinovirus, dll. Diagnosis penyakit COVID-19 perlu ditentukan untuk membedakan dari ISPA yang diakibatkan oleh patogen lain. Beberapa uji diagnostik telah di kembangkan untuk deteksi cepat penyebab COVID-19.Tujuan. Tujuan penelitian ini adalah membandingkan alat diagnostik kit antigen ”Genbody COVID-19 Test Ag®” dengan rRT-PCR yang menjadi refensi test, untuk mendapatkan alat diagnostik yang murah, cepat dan akurat serta memiliki kemampuan yang setara dengan rRT-PCR.Metode. Penelitian ini merupakan uji banding dengan desain penelitian potong lintang dan metode pengumpulan spesimen secara consecutive sampling pada pasien contact tracing COVID-19. Penelitian dilakukan di Fasilitas Pelayanan Kesehatan (FASYANKES) Puskesmas Kecamatan Tanah Abang, Sawah Besar, Senen dan Laboratorium Mikrobiologi Klinik (LMK) FKUI pada bulan Oktober 2020-Desember 2020. Sampel penelitian merupakan swab Nasofaring dan oropharing dari pasien contact tracing COVID-19 yang dilakukan pemeriksaan rRT-PCR menggunakan reagen LiliF COVID-19 Real Time PCR kit dan pemeriksaan antigen menggunakan “Genbody COVID-19 Test Ag®”. Analisis penelitian ini menggunakan tabel 2x2.Hasil. Dari 233 sampel sebanyak 80 (34,33%) sampel positif rRT-PCR dan 53 (22,74%) sampel yang positif pada kit antigen. Kit antigen yang digunakan pada penelitian ini mempunyai sensitivitas 66,25% (55,89-76,61), spesifisitas 100% (100-100), Nilai Duga Positif (NDP) 100% (100-100), Nilai Duga Negatif (NDN) 85% (79,78-90,22) dan akurasi 88,41%. Pada hasil rRT-PCR dengan CT < 20, kit test antigen mempunyai sensitivitas 97,14% (91,62-102,66), spesifisitas 100% (100-100) dan pada CT ≥ 21-≥ 30 sensitivitas kit antigen terus menurun.Kesimpulan. Pemeriksaan COVID-19 menggunakan kit test antigen “Genbody COVID-19 Test Ag®” mempunyai sensitivitas rendah yang tidak sesuai dengan rekomendasi WHO. Kit antigen ini mempunya sensitivitas yang tinggi pada sampel dengan hasil rRT-PCR pada CT rendah (CT <20).

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Introduction. Currently, the COVID-19 pandemic is happening over the world, this pandemic started in Wuhan, China. The SARS-CoV-2 virus that causes COVID-19 is highly contagious, spreads very quickly and requiring special handling such as isolation or quarantine. The symptoms of COVID-19 resemble an acute respiratory infection caused by other pathogens such as SARS, influenza, rhinovirus, etc. The diagnosis of COVID-19 disease needs to be determined to distinguish it from acute respiratory infection caused by other pathogens. Several diagnostic tests have been developed for rapid detection of the cause of COVID-19.

Aim. The research aims to compare the antigen kit "Genbody COVID-19 Test Ag®" with rRT-PCR as a reference test to obtain an affordable, fast and accurate diagnostic tool and have equivalent capabilities as rRT-PCR.

Method. The research is a comparative testing with a cross-sectional design and consecutive sampling method for collecting specimens in COVID-19 contact tracing patients. The research was conducted at the Health Service Facility (FASYANKES) Puskesmas Kecamatan Tanah Abang, Sawah Besar, Senen and Laboratorium Mikrobiologi Klinik (LMK) FKUI in October 2020-December 2020. The research samples were nasopharyngeal and oropharyngeal swabs from COVID-19 contact tracing patients who were carried out rRT-PCR test using LiliF COVID-19 Real Time PCR kit and antigen test using “Genbody COVID-19 Test Ag®”. The research analysis used a 2x2 table.

Results. Of the 233 samples, 80 (34.33%) were positive for rRT-PCR and only 53 (22.74%) were positive for the antigen kit. The antigen kit used in this research had a sensitivity of 66.25% (55.89-76.61), specificity 100% (100-100), Positive Prediction Value (NDP) 100% (100-100), Negative Suggestion Value ( NDN) 85% (79.78-90.22) and accuracy 88.41%. On the results of rRT-PCR with CT < 20, the antigen test kit had a sensitivity of 97.14% (91.62-102.66), specificity 100% (100-100) and at CT 21-30 the sensitivity of the antigen kit continued to decrease.

Summary. The COVID-19 examination using the “Genbody COVID-19 Test Ag®” antigen test kit has a low sensitivity which is not in accordance with WHO recommendations. This antigen kit has high sensitivity in rRT-PCR results at CT (CT < 20)."

"Respons antibodi spesifik SARS-CoV-2 dapat diperoleh dari paparan virus ketika infeksi ataupun dari vaksinasi. Studi mengenai rasio CD4+/CD8+ sebagai penanda status imunitas masih belum banyak dilakukan pada dewasa sehat. Vitamin D yang memiliki efek imunomodulatori pada sistem imun adaptif dan alamiah, mampu memodulasi pembentukan antibodi dan regulasi dari sel T. Penelitian ini bertujuan melihat hubungan kadar 25(OH)D serum terhadap titer antibodi SARS-CoV-2 dan rasio CD4+/CD8+ sebagai penanda status imunitas individu. Studi potong lintang ini dilakukan terhadap tenaga kesehatan di tiga rumah sakit rujukan COVID-19 di Jakarta dan Depok pada periode Juli–Desember 2021. Pengambilan data yang dilakukan berupa wawancara kuesioner data sosiodemografik, pemeriksaan tanda-tanda vital, pengukuran antropometri, dietary assessment menggunakan 24-h food recall dan SQ-FFQ. Pengambilan sampel darah dilakukan untuk menilai kadar 25(OH)D serum, rasio CD4+/CD8+, dan titer antibodi SARS-CoV-2. Didapatkan 154 tenaga kesehatan usia 22-53 tahun dalam kondisi sehat dan tanpa riwayat penyakit kronis. Median asupan vitamin D subjek penelitian sebesar 2,42 mcg/hari (1,23–4,00) dengan 94,7% subjek memiliki asupan vitamin D yang kurang. Median kadar serum 25(OH)D pada subjek sebesar 14,4 ng/mL (9,50–18,62) dengan 81,8% subjek mengalami defisiensi dan 14,9% subjek mengalami insufisiensi vitamin D. Median rasio CD4+/CD8+ 1,14 (0,88–1,34), 85,7% subjek memiliki titer antibodi SARS-CoV-2 >250 U/mL dan 14,3% subjek memiliki titer antibodi ≤250. Tidak ditemukan adanya hubungan yang siginifikan antara kadar 25(OH)D dengan titer antibodi SARS-CoV-2 (p 0,209 OR 4,101 95% CI 0,45–37,04) dan Rasio CD4/CD8 (p 0,385 𝛃 -0,005 95% CI -0,0015–0,006). Asupan dan kadar vitamin D pada subjek penelitian masih tergolong rendah. Penelitian ini tidak berhasil membuktikan adanya hubungan antara kadar serum 25(OH)D dengan rasio CD4+/CD8+ dan titer antibodi SARS-CoV-2.

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SARS-CoV-2 specific antibody response can be generated from exposure to the virus during infection or from vaccination. There is limited data on CD4+/CD8+ ratio in healthy individuals as a marker of immunity status. Vitamin D, which has an immunomodulatory effect on both  innate and adaptive immune systems, is able to modulate antibody formation and regulation of T cells. This study aimed to examine the association between serum 25(OH)D levels and SARS-CoV-2 antibody titers along with CD4+/CD8+ ratio as a marker of immunity status. This cross-sectional study was conducted on healthcare workers at three COVID-19 referral hospitals in Jakarta and Depok in the period of July–December 2021. Data collection was carried out using questionnaire, examination of vital signs, anthropometric measurements, dietary assessment using 24-h food recall, and SQ-FFQ. Blood samples were taken to assess serum 25(OH)D levels, CD4+/CD8+ ratio, and SARS-CoV-2 antibody titers. 154 healthcare workers aged 22-53 years who were in good health and had no history of chronic disease were examined in this study. The median intake of vitamin D was 2.42 mcg/day (1.23-4.00), with 94.7% of participants having insufficient intake of vitamin D. The median serum 25(OH)D level was 14.4 ng/mL (9.50-18.62), with 81.8% participants are vitamin D deficiency and 14.9% are insufficient. Median CD4+/CD8+ ratio was 1.14 (0.88 to 1.34). 85.7% participants had SARS-CoV-2 antibody titers >250 U/mL, while 14.3% were below 250 U/mL. There was no significant relationship of serum 25(OH)D levels to SARS-CoV-2 antibody titers (p 0.209 OR 4.101 95% CI 0.45–37.04) and CD4+/CD8+ ratio (p 0.385 o-0.005 95% CI -0.0015–0.006). Vitamin D intake and serum 25(OH)D levels are relatively low. This study disproves relationship between serum 25(OH)D levels with CD4+/CD8+ ratio and SARS-CoV-2 antibody."

"Latar Belakang: COVID-19 merupakan penyakit yang disebabkan oleh infeksi SARS-CoV-2 yang dapat mengalami mutasi sehingga membentuk beberapa varian baru. Perubahan varian tersebut dapat menyebabkan proses transmisi virus yang cepat hingga meningkatnya mortalitas dan morbiditas pada pasien COVID-19. Adanya mikrobiota pada saluran pernafasan yang merupakan bagian dari sistem kekebalan tubuh dapat memberikan perlindungan dari infeksi dan pathogenesis SARS-CoV-2 pada tubuh manusia. Akan tetapi, patogenesis virus dari beberapa varian SARS-CoV-2 yang berbeda dapat menghambat homeostasis dari komunitas mikroba pada saluran pernafasan. Oleh sebab itu perlu dilakukan identifikasi varian SARS-CoV-2 dan profil komunitas bakteri pada sampel swab naso/orofaring pasien COVID-19, untuk mendapatkan data awal profil komunitas mikroba dan korelasinya dengan varian SARS-CoV-2.Metode: Penelitian menggunakan sampel swab naso/orofaring pasien COVID-19. Sekuensing sampel dilakukan sebanyak dua kali. Sekuensing pertama bertujuan untuk mengidentifikasi varian SARS-CoV-2 menggunakan Whole Genome Sequencing (WGS) dari Oxford Nanopore Technologies (ONT). Sekuensing kedua bertujuan untuk mengidentifikasi keragaman bakteri pada naso/orofaring pasien COVID-19 menggunakan amplifikasi gen 16S rRNA. Kemudian analisis bioinformatika dilakukan untuk memperoleh profil komunitas mikroba pada beberapa varian SARS-CoV-2.Hasil: Ditemukan enam varian SARS-CoV-2 yang dideteksi pada sampel terpilih yang dikoleksi selama bulan Maret-Juni 2021, dengan hasil varian yang mendominasi adalah varian Delta, Alpha, dan Lokal. Pada varian Alpha dan Delta didominasi oleh genus bakteri Streptococcus, Prevotella, dan Veillonella. Pada varian lokal, genus yang mendominasi yaitu Corynebacterium, Staphylococcus, dan Salmonella.Kesimpulan: Komunitas bakteri yang ditemukan pada sampel swab naso/orofaring pasien COVID-19 memiliki tingkat keragaman yang signifikan antar varian SARS-CoV-2. Komunitas bakteri yang ditemukan didominasi oleh genus Prevotella, Streptococcus, Corynebacterium, dan Veillonella. Persentase jumlah bakteri paling banyak yaitu genus Prevotella sebesar 27%. Genus bakteri Prevotella dan Veillonella banyak ditemukan pada varian SARS-COV-2 Alpha dan Delta, yang memiliki potensi meningkatkan inflamasi dan tingkat keparahan pada pasien COVID-19.

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Background: COVID-19 is a disease caused by infection of a SARS-CoV-2 virus that can undergo mutations to form several new variants. These variants could lead to a more rapid transmission, which increases mortality and morbidity in COVID-19 patients. The presence of microbiota in the respiratory tract as part of the immune system provides protection from viral infections and pathogenesis in the human body. However, pathogenesis of different SARS-CoV-2 variants plays a role in inhibiting the homeostasis of the microbial community in the respiratory tract. Therefore, it is necessary to identify the SARS-CoV-2 variants and profile the bacterial community profile in naso/oropharynx using swab samples of COVID-19 patients, to obtain initial data regarding the microbial community profile of COVID-19 patients and potential correlation with the SARS-CoV-2 variants.

Methods: This study used naso/oropharyngeal swab samples from COVID-19 patients. Sample sequencing was performed twice. The first sequencing aims to identify variants of SARS-CoV-2 using Whole Genome Sequencing (WGS) with Oxford Nanopore Technologies (ONT) platform. The second sequencing aims to identify bacterial diversity in the naso/oropharynx of COVID-19 patients using 16S rRNA gene amplification followed by profiling of the microbial community using bioinformatic analysis.

Results: Six variants of SARS-CoV-2 were identified in the selected samples collected during March-June 2021, with the dominant variants being Delta, Alpha, and Local variants. The microbial community of samples belonging to the Alpha and Delta variants was dominated by the bacterial genera Streptococcus, Prevotella, and Veillonella. Meanwhile, in the samples identified as having local variant, the dominant genera were Corynebacterium, Staphylococcus, and Salmonella.

Conclusion: The bacterial diversity in the swab samples naso/oropharyngeal of COVID-19 patients varied significantly among SARS-CoV-2 variants. The bacterial community was dominated by the genera Prevotella, Streptococcus, Corynebacterium, and Veillonella. The highest percentage of genus was Prevotella by 27%. The genera Prevotella and Veillonella were found in the SARS-CoV-2 Alpha and Delta variants, which have the potential to increase inflammation and severity in COVID-19 patients."

"Latar Belakang. Banyak faktor yang memengaruhi derajat berat infeksi dan mortalitas dari infeksi Corona Virus Disease 2019 (COVID-19). COVID-19 menyebabkan kerusakan sel beta pankreas, namun sampai saat ini mekanisme kerusakan ini belum banyak diketahui. Metode untuk menilai fungsi sekresi dari sel beta pankreas adalah Homeostatic Model Assessment- β (HOMA-β) dan C-peptide. Tujuan. Mengetahui hubungan antara HOMA-β dan C-peptide saat admisi dengan luaran buruk pada pasien terkonfirmasi COVID-19 yang dirawat inap. Metode. Penelitian ini merupakan studi kohort retrospektif yang dilakukan di Rumah Sakit Cipto Mangunkusumo (RSCM). Pasien terkonfirmasi COVID-19 (derajat ringan/sedang) berusia > 18 tahun, yang dirawat inap di RSCM Kiara dalam periode waktu September 2020 – Maret 2021, dengan HbA1c <6,5% serta tanpa riwayat diabetes sebelumnya, menjalani pemeriksaan HOMA-β dan C-Peptide. Ditentukan nilai titik potong keduanya untuk kemudian dilihat hubungannya dengan luaran buruk selama perawatan tersebut. Hasil. Dari 232 subyek yang memenuhi kriteria, terdapat 10(4,3%) subyek dengan luaran buruk. Median HOMA-β pada luaran buruk adalah 70,28% (RIK 32,25 – 132,11), sementara itu pada luaran baik adalah 121,6% (RIK 82,39 – 174,23). Median C-peptide pada luaran buruk dan baik berturut-turut adalah 2059 (RIK 1508 – 2762) dan 1647 (RIK 1107 – 2461). Nilai titik potong HOMA-β 80%, dengan AUC 0,702 (IK 95% 0,526-0,879) menunjukkan sensitifitas 60% dan spesifisitas 71,4%. Nilai Hazard Ratio (HR) dari HOMA-β <80 adalah 4,660 (p=0,017). Nilai titik potong C-peptide tidak dapat ditentukan karena AUC 0,555. Kesimpulan. Terdapat hubungan antara nilai HOMA-β saat admisi dengan luaran buruk selama perawatan pada pasien terkonfirmasi COVID-19, namun hubungan C-Peptide tidak didapatkan kemaknaannya dengan luaran buruk selama perawatan. Kata Kunci. COVID-19, C-Peptide, HOMA-β, Luaran buruk.

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Background. Many factors affect the severity of infection and mortality of Corona Virus Disease 2019 (COVID-19) infection. COVID-19 virus linked to pancreatic beta cells damage, yet the mechanism is still unclear. A method to assess the secretory function of pancreatic beta cells is based on Homeostatic Model Assessment- (HOMA-β) and C-peptide. Aim. Determine the relationship between HOMA-β and C-peptide values during admission in hospitalized confirmed COVID-19 patients with poor outcomes. Method. This is a retrospective cohort study conducted at Cipto Mangunkusumo Hospital (RSCM). Patients with confirmed COVID-19 (mild/moderate) who were hospitalized at the RSCM Kiara Hospital during the period September 2020 – March 2021, with HbA1c <6.5%, and without history of diabetes underwent HOMA-β and C-Peptide examination. The cut-off point for both was evaluated, furthermore the relationship with poor outcomes during hospitalization was assessed. Result. From 232 subjects met the inclusion and exclusion criteria, there were 10 (4.3%) subjects with poor outcomes. Median of HOMA-β in poor outcome group was 70.28% (IQR 32.25 – 132.11) while in good outcome group was 121.6% (IQR 82.39 – 174.23). The median of C-peptide on poor and good outcome were 2059 (IQR 1508 – 2762) vs. 1647 (IQR 1107 – 2461), respectively. The HOMA-β cut- off point was 80% showed AUC 0.702 (95% CI 0.526-0.879), with sensitivity 60% and specificity 71.4%. The Hazard Ratio (HR) of HOMA-β value <80% was 4.660 (p=0.017). The C-peptide cut-off point could not be determined because the AUC was 0.555. Conclusion. There is a significant relationship between the HOMA-β during admission and the poor outcome of hospitalized patients with confirmed COVID- 19 yet there is no significant relationship between C-Peptide and poor outcome."

"Pendahuluan. COVID-19 merupakan penyakit infeksi saluran pernapasan yang menular dan saat ini sudah mulai masuk ke Indonesia. Metode surveilans dilakukan dengan membagi pasien menjadi kelompok pasien dalam pengawasan (PDP) dan bukan PDP. Karakteristik tindakan operasi sebagai faktor eskternal, digabungkan dengan faktor internal pasien mungkin dapat berbeda pada masing-masing kelompok, terutama pada pasien pascaoperasi. Penelitian ini bertujuan untuk mendeskripsikan perbedaan karakteristik antara pasien pascaoperasi dengan status PDP dengan bukan PDP.Metode. Sebanyak 120 pasien yang menjalani operasi elektif dan emergensi di RSUPN Dr. Cipto Mangunkusumo dipilih dengan metode consecutive sampling. Data-data tentang faktor eksternal dan faktor internal pasien didapatkan dengan cara melihat catatan pada rekam medis. Data disajikan secara deskriptif dan analitik menggunakan uji perbedaan proporsi chi-square.Hasil. Terdapat perbedaan yang bermakna secara signifikan antara jenis kelamin, status fisik ASA 3, foto toraks praoperasi, dan prosedur operasi level 5 antara kelompok PDP pascaoperasi dengan bukan PDP pascaoperasi (p = 0,014; p = 0,018; p = 0,001; p = 0,019).Simpulan. Perbedaan bermakna yang ditemukan antara pasien PDP dengan bukan PDP pascaoperasi yaitu pada jenis kelamin pasien, status fisik ASA 3, level prosedur operasi level 5, dan foto toraks praoperasi. Perlu dilakukan penelitian lanjutan yang menganalisis hubungan antara faktor internal dan faktor eksternal terhadap penetapan status PDP pascaoperasi.

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Introduction. COVID-19 is a contagious respiratory tract infection and currently emerging in Indonesia. The surveillance method is carried out by dividing patients into under surveillance and not under surveillance for COVID-19. The characteristics of surgery as an external factors, combined with the patient's internal factors, may differ between groups, especially in the postoperative patients. This study aims to describe the differences in characteristics between postoperative patients with under surveillance and not under surveillance for COVID-19 status.

Methods. A total of 120 patients underwent elective and emergency surgery at Cipto Mangunkusumo general hospital were selected by consecutive sampling. Data regarding the patient's external and internal factors were collected using secondary data from the medical records available. Data were presented in a descriptive and analytical manner using the chi-square test.

Results. There were a statistically significant differences between gender, ASA 3 physical status, preoperative lung X-ray, and level 5 surgical procedures between the two groups (p = 0.014; p = 0.018; p = 0.001; p = 0.019).

Conclusions. Statistically significant differences were found between postoperative under surveillance and not under surveillance for COVID-19 patients, namely the patient's gender, ASA 3 physical status, surgical procedure level 5, and preoperative lung X-rays. Further research is needed to analyze the relationship between internal and external factors on the determination of postoperative PDP status."

"Pada akhir tahun 2019 dilaporkan beberapa kasus pneumonia di Wuhan, Cina yang disebabkan oleh Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Penyakit yang ditimbulkan oleh virus ini disebut sebagai coronavirus disease 2019 (COVID-19). Jumlah kasus COVID-19 terus mengalami peningkatan dan penyebarannya terjadi pada seluruh kelompok usia termasuk anak-anak. Pemeriksaan real-time reverse transcription-polymerase chain reaction (rRT-PCR) telah diotorisasi oleh Food and Drug Administration (FDA) dan pada pemeriksaan ini dikenal istilah cycle threshold (Ct). Nilai Ct sering dijadikan acuan dalam menentukan tingkat keparahan penyakit pada anak, akan tetapi masih terdapat kontroversi apakah nilai Ct berhubungan dengan tingkat keparahan penyakit. Penelitian ini bermaksud mencari hubungan bermakna antara nilai Ct khususnya gen ORF1ab dan gen N dengan tingkat keparahan COVID-19 pada anak yang dibagi menjadi tingkat keparahan ringan dan sedang sampai kritis. Didapat 52 responden anak dalam penelitian ini, dengan 24 responden terdeteksi gen ORF1ab dan 49 responden terdeteksi gen N. Rerata nilai Ct gen ORF1ab kelompok ringan (33,5 ± 4,4) lebih tinggi dibandingkan dengan kelompok sedang sampai kritis (31,0 ± 6,0). Median nilai Ct gen N kelompok ringan (34,8 [21,3 – 39,4]) lebih tinggi dibandingkan dengan kelompok sedang sampai kritis (31,7 [19,4 – 38,9]). Tidak didapatkan hubungan bermakna baik antara nilai Ct gen ORF1ab (nilai p = 0,25) maupun gen N (nilai p = 0,159) dengan tingkat keparahan COVID-19 pada anak. Berdasarkan hasil penelitian ini, diperlukan berbagai pertimbangan dalam menginterpretasi nilai Ct.

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At the end of 2019, several cases of pneumonia were reported in Wuhan, China caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The disease caused by this virus is known as Coronavirus Disease 2019 (COVID-19). The number of cases of COVID-19 continues to increase and its spread occurs in all age groups including children. Real-time reverse transcription-polymerase chain reaction (rRT-PCR) has been authorized by the Food and Drug Administration (FDA) and in this method a cycle threshold (Ct) value were obtained. The Ct value is often used as a reference in determining the clinical severity in children, but there is still controversy whether the Ct value is related to the clinical severity. This study intends to find a significant relationship between the Ct values, especially the ORF1ab gene and the N gene, with the COVID-19 clinical severity in children which is divided into mild and moderate to critical severity. There were 52 children in this study, with 24 children have ORF1ab gene detected and 49 children have N gene detected. The mean of ORF1ab gene Ct value in mild group (33.5 ± 4.4) was higher than moderate to critical group (31.0 ± 6.0). The median of N gene Ct value ​​in mild group (34.8 [21.3 – 39.4]) was higher than moderate to critical group (31.7 [19.4 – 38.9]). There was no significant relationship between the Ct value of the ORF1ab gene (p value = 0.25) and the N gene (p value = 0.159) with COVID-19 clinical severity in children. Based on the results of this study, various considerations are needed in interpreting the Ct value."

"Penyakit Coronavirus Disease 2019 (COVID-19) merupakan penyakit infeksi saluran pernafasan akut yang ditandai dengan batuk kering, sesak nafas, demam, dan Acute Respiratory Distress Syndrome (ARDS). Penyakit COVID-19 disebabkan oleh infeksi virus SARS-CoV-2 di saluran pernafasan manusia. Menurut Satuan Tugas COVID-19, kasus terkonfirmasi COVID-19 di Indonesia sampai tanggal 28 Juli 2021 sebanyak 3.287.727 pasien dengan penambahan kasus 47.791 pasien baru per hari. Salah satu langkah memperlambat penyebaran tersebut adalah dengan meningkatkan laju deteksi keberadaan virus SARS-CoV-2 berbasis pendeteksian asam nukleat virus SARS-CoV-2. Satuan tugas COVID-19 Indonesia telah merilis daftar kit komersial yang diizinkan beredar untuk deteksi materi genetik virus SARS-CoV-2 salah satunya adalah kit Seasun U-TOPTM COVID-19 pabrikan dari Seasun Biomaterials. Korea Selatan. Penelitian ini bertujuan untuk mengetahui baku mutu kit Seasun dalam mendeteksi virus SARS-CoV-2 di Indonesia. Pengujian baku mutu kit Seasun dilakukan dengan membandingkan nilai Cycle threshold (Ct) kit Seasun terhadap kit golden standard US CDC serta uji diagnosis kit Seasun menggunakan 20 sampel pasien positif COVID-19 dan 10 sampel pasien negatif COVID-19 berdasarkan protokol Pemantapan Mutu Eksternal (PME) Laboratorium COVID-19 Kementerian Kesehatan Republik Indonesia. Hasil analisis nilai Ct menunjukkan bahwa nilai Ct gen HRP dan gen N dari kit Seasun tidak berbeda signifikan dengan gen N1, gen N2, dan gen HRP dari golden standard US CDC berdasarkan uji ANOVA satu arah (p > 0,05; CI = 95%). Uji diagnosis menunjukkan kit Seasun terdapat hasil negatif palsu pada sampel N00212. Kit Seasun memiliki tingkat sensitivitas analitik sebesar 95% dan spesifisitas analitik sebesar 100%. Kit Seasun memiliki nilai baku mutu berada pada rentang nilai yang disetujui dan direkomendasikan oleh WHO serta dapat digunakan untuk kit deteksi SARS-CoV-2 di Indonesia

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Coronavirus Disease 2019 (COVID-19) is an acute respiratory infectious disease characterized by dry cough, shortness of breath, fever, and Acute Respiratory Distress Syndrome (ARDS). COVID-19 is caused by infection with the SARS-CoV-2 in the human respiratory tract. There were 3.287.727 confirmed cases of COVID-19 in Indonesia on July 28, 2021, with 47.791 new cases per day. The steps to slow the spread is to increase the detection rate of SARS-CoV-2 based on detection of the nucleic acid of the SARS-CoV-2. The Indonesian COVID-19 task force (Satgas COVID-19) has released a list of commercial kits allowed to detect genetic material for the SARS-CoV-2, one of them is the Seasun U-TOPTM COVID-19 kit. This study aims to determine the quality standard of the Seasun kit in detecting SARS-CoV-2 in Indonesia. The Seasun kit quality standard test was carried out by comparing the Cycle threshold (Ct) value of Seasun kit against the United States CDC golden standard kit and the Seasun kit diagnostic test using 20 samples of positive and 10 samples of negative COVID-19 patients based on the External Quality Assurance COVID-19 Laboratory protocol of the Ministry of Health of Republic of Indonesia. The results showed that the Ct values ​​of the HRP gene and the N gene from the Seasun kit were not significantly different from the N1 gene, N2 gene, and the HRP gene from the CDC golden standard based on ANOVA one-way (p > 0,05; CI = 95%). The diagnostic test showed that the Seasun kit had false-negative results in sample N00212 so that the Seasun kit had analytical sensitivity of 95% and analytical specificity of 100%. Seasun kit ​​approved and recommended by WHO to become a SARS-CoV-2 detection kit in Indonesia."

"Vaksinasi dan penggunaan antivirus remdesivir dan favipiravir merupakan strategi yang dapat digunakan untuk menekan pertumbuhan COVID-19. Namun penelitian tentang pengaruh vaksinasi terhadap efektivitas terapi antivirus pada pasien COVID-19 secara klinis masih terbatas. Penelitian ini bertujuan untuk menganalisis pengaruh vaksinasi terhadap efektivitas terapi remdesivir dan favipiravir pada pasien terkonfirmasi COVID-19. Penelitian ini merupakan penelitian observasional dengan desain kohort retrospektif dilakukan di rumah sakit Universitas Indonesia, Depok. Data diambil dari rekam medis RS periode Januari 2021 hingga Agustus 2022. Efektivitas terapi ditentukan dengan menilai kelompok sudah vaksin dan belum vaksin berdasarkan perbaikan kondisi klinis pasien, lama rawat inap, dan kematian pada pasien COVID-19. Hasil analisis menunjukkan bahwa vaksinasi memiliki pengaruh yang signifikan terhadap perbaikan kondisi klinis, lama rawat inap, dan kematian (p < 0,05) pada pasien yang diberi terapi remdesivir dan telah divaksin dibandingkan dengan pasien yang belum divaksin. Pada pasien yang diberi terapi favipiravir vaksinasi tidak menunjukkan pengaruh yang signifikan terhadap perbaikan kondisi klinis, lama rawat inap, dan kematian pada pasien yang telah divaksin dibandingkan dengan pasien yang belum vaksin. Vaksinasi memiliki pengaruh yang baik terhadap efektivitas terapi remdesivir pada pasien COVID-19, yaitu dapat meningkatkan perbaikan kondisi klinis pasien kearah yang lebih baik, mengurangi lama rawat inap dan kematian. Namun tidak memiliki pengaruh yang signifikan terhadap efektivitas terapi favipiravir.

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Vaccination and the use of the antivirals remdesivir and favipiravir are strategies that can be used to suppress the growth of COVID-19. However, clinical research on the effect of vaccination on the effectiveness of antiviral therapy in COVID-19 patients is still limited. This study aims to analyze the effect of vaccination on the effectiveness of remdesivir and favipiravir therapy in patients with confirmed COVID-19. This study was an observational study with a retrospective cohort design conducted at Universitas Indonesia Hospital, Depok. Data were taken from medical records for the period from January 2021 to August 2022. The effectiveness of therapy was determined by assessing the vaccine and non-vaccine groups based on improvement in the patient's clinical condition, length of stay, and mortality in COVID-19 patients. The results of the analysis showed that vaccination had a significant effect on improving clinical condition, length of stay, and mortality (p <0.05) in patients who were given remdesivir therapy and vaccinated compared to patients who not vaccinated. In patients who were given favipiravir, the vaccination did not show a significant effect on improving clinical conditions, length of stay, and death in patients who had been vaccinated compared to patients who not vaccinated. Vaccination has a positive effect on the effectiveness of remdesivir therapy in COVID-19 patients, which can improve the patient's clinical condition, reducing length of stay and mortality. However, it does not have a significant effect on the effectiveness of favipiravir therapy."