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"Background: older people contributed to 38.6% of death cases related to COVID-19 in Indonesia. Data regarding clinical profile of hospitalised elderly with COVID-19 in Indonesia were still lacking. Older people are at-risk population in the pandemic, whom we should pay attention to. Methods: this single centre descriptive study utilised complete data of elderly inpatients with COVID-19 in Indonesia’s national general hospital from April to late August 2020. The data consisted of clinical characteristics, symptoms, comorbidities, multimorbidity, and mortality outcome. Results: among elderly patients (n=44), a majority of patients were aged 60-69 years (68%), were male (66%), and had no history of close contact with COVID-19 patient (86%). The most common symptoms were fever, cough and shortness of breath (classic symptoms of COVID-19), whereas the most common chronic diseases were diabetes mellitus, hypertension, and malignancy. Multimorbidity was only found in 14% of patients, all of whom remained alive following SARS-CoV-2 infection. The death rate among elderly inpatients with COVID-19 in this study was 23%, and male older adults contributed to 90% of death cases. Conclusion: male patients dominated both confirmed cases and death cases among elderly with COVID-19. Classic symptoms of COVID-19 were only found in about half of the study patients. Non-survivors had higher percentage of the classic symptoms of COVID-19 than survivors. Atypical COVID-19 presentations are possible in older adults. We postulated that immunosenescence and sex-specific immunoregulatory function play an important role in causing death in this study cohort."

"Latar Belakang: Pandemi COVID-19 telah menjadi ancaman kesehatan global dengan tingginya kasus dan kematian di seluruh dunia. Untuk membantu dokter dan pasien dalam mengambil keputusan terkait perawatan dan tindak lanjut, skor prognosis telah digunakan untuk memprediksi risiko kematian pasien dengan COVID-19. Saat ini terdapat beberapa skor prognostik dan mortalitas yang digunakan untuk COVID-19 yang bervariasi dalam pengaturan, ukuran hasil yang diprediksi dan parameter klinis yang disertakan. Penelitian membandingkan akurasi aplikasi prediksi luaran Clinical Assessment Tool (CAT) COVID dan Coronavirus Clinical Characterisation Consortium (4C) Mortality Score Pada Pasien COVID-19 Terkonfirmasi Pada Perawatan Di Rumah Sakit Universitas Indonesia: Tinjauan Hubungan Status Vaksinasi. Metode: Penelitian ini adalah suatu penelitian observasional dengan metode potong lintang menggunakan data rekam medis pasien COVID-19 di RS Universitas Indonesia Depok. Proses pengumpulan data dimulai sejak Oktober 2023. Pasien dengan status vaksin COVID-19 yang datang ke RSUI dengan keluhan mengarah ke COVID-19 pada periode Januari - Desember 2022 dengan kriteria subjek berusia >18 tahun diambil secara consecutive sampling sebanyak 344 subjek. Hasil: Jumlah subjek pada penelitian ini sebanyak 91. Aplikasi prediksi 4C lebih baik yaitu dengan nilai AUC 73.5% (sensitivitas 78.9% dan spesifisitas 68%) dibandingkan CAT COVID dengan AUC 52.1% (sensitivitas 74% dan spesifisitas 30%). Nilai kesesuaian antara aplikasi CAT COVID dengan aplikasi 4C mortality score dengan uji kappa adalah sebesar 0.094. Bila dinilai dari jumlah subjek, kedua aplikasi prediksi memiliki penilaian prediksi dengan hasil yang sama pada 47 subjek dan terdapat perbedaan prediksi pada 44 subjek. Kesimpulan: Aplikasi prediksi kematian 4C mortality score terjangkau dan mudah untuk digunakan pada fasilitas kesehatan dalam memprediksi kematian sehingga tenaga kesehatan bisa menentukan perawatan dan tindak lanjut untuk pasien serta edukasi mengenai prognosis kepada pasien dan keluarga pasien. Aplikasi 4C mortality score memiliki variabel yang sederhana dengan hasil berupa tingkatan kelompok prediksi risiko kematian ringan, sedang, berat dan sangat berat.

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Background: The corona virus disease 19 (COVID-19) pandemic has become a significant global health threat, with cases and deaths increasing in the worldwide. To assist doctors and patients in making decisions regarding treatment and follow-up, prognosis scores have been used to predict the risk of death in patients with COVID-19. Currently, there are several prognostic and mortality scores used for COVID-19 that vary in setting, predicted outcome measures, and included clinical parameters. Research comparing the accuracy of outcome prediction applications, such as the Clinical Assessment Tool (CAT) COVID, and the Coronavirus Clinical Characterisation Consortium (4C) Mortality Score in Confirmed COVID-19 Patients Under Treatment at Universitas Indonesia Hospital: A Review on Vaccination Status Relationship. Method: This study is an observational research employing a cross-sectional method utilizing medical record data of COVID-19 patients at Universitas Indonesia Hospital in Jakarta. The data collection process commenced in October 2023. Patients with COVID-19 vaccine status presenting to RSUI with complaints suggestive of COVID-19 during the period of January to December 2022, with the criteria of subjects aged > 18 years, were consecutively sampled, totalling 344 subjects. Results: The total number of subjects in this study was 91. The 4C mortality score application performed better, with an accuracy of 73.5% (sensitivity 78.9% and specificity 68%) compared to CAT COVID with an AUC of 52.1% (sensitivity 74% and specificity 30%). The concordance value between CAT COVID application and 4C mortality score application with kappa test was 0.094. When assessed by the number of subjects, both prediction applications had the same prediction outcome in 47 subjects, and there was a difference in prediction in 44 subjects. Conclusion: The 4C mortality score prediction applications are accessible and affordable in healthcare facilities for predicting mortality, allowing healthcare professionals to determine treatment and follow-up for patients as well as provide prognosis education to patients and their families. The 4C mortality score application has simple variables with prediction results in the form of risk group prediction levels low, intermediate, high and very high."

"Transformasi Virus SARS-CoV-2 menghasilkan evolusi virus. Pemahaman mekanisme COVID-19 membantu stratifikasi risiko dan memperkuat manajemen COVID-19. Peningkatan 16 hingga 53% enzim hepar pada pasien dengan infeksi SARS-COV-2 diperlukan telaah terkait dengan SGOT, SGPT dan rasio De ritis. Rangkaian respon inflamasi pada infeksi COVID-19 melibatkan interleukin-6 (IL-6), C-reactive protein (CRP) dan albumin berkorelasi langsung dengan derajat peradangan. Rasio CRP terhadap albumin merupakan indikator baru status inflamasi yang lebih andal dibandingkan CRP atau albumin saja. Luaran buruk pada penelitian jika selama perawatan terdapat perawatan di ruang intensif, penggunaan ventilator mekanik dan atau kematian. Penelitian ini mencoba menganalisis parameter fungsi hepar dan inflamasi pada 48 jam awal perawatan dalam memprediksi luaran buruk pasien dengan COVID-19. Sejumlah 66 data pasien yang terdiri dari 16 data luaran buruk diikutsertakan pada penelitian. Median SGOT,IL-6, CRP, albumin, dan rasio CRP/albumin bermakna dibandingkan kelompok luaran tidak buruk. Titik potong optimal IL-6, CRP dan Rasio CRP/Albumin dalam menentukan luaran buruk sebesar 60,03 pg/ml, 32,5 mg/L dan 10,5. Model prediksi luaran buruk COVID-19 disusun dari parameter komorbid hipertensi, diabetes dan rasio CRP/Albumin

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Transformation SARS-CoV-2 virus resulted in the evolution of the virus. Understanding mechanisms of COVID-19 contributed for risk stratification and strengthening the management COVID-19. Elevated liver enzymes 16 to 53% in patients with SARS-COV-2 infection requires more concern especially SGOT, SGPT and De ritis ratio. The series of inflammatory responses in COVID-19 infection involving interleukin-6 (IL-6), C-reactive protein (CRP) and albumin directly correlates with the degree of inflammation. CRP to albumin ratio is a new indicator of inflammatory status that more reliable than CRP or albumin alone. Poor outcome stated if during treatment there was intensive care unit treatment, use of a mechanical ventilator and/or death. This study tries to analyze whether liver function and inflammation parameters in the initial 48 hours of treatment can be used to predict poor outcomes in patients with COVID-19. A total of 66 patient data consisting of 16 poor outcome data were included in the study. Median SGOT, IL-6, CRP, albumin, and CRP/albumin ratio were significant compared to the non-poor outcome group. The optimal cut points for IL-6, CRP and CRP/Albumin ratio in determining poor outcomes are 60.03 pg/ml, 32.5 mg/L and 10.5. The prediction model for poor outcomes for COVID-19 is compiled from the comorbid parameters of hypertension, diabetes and CRP/Albumin ratio"

"Tujuan penelitian ini adalah untuk menentukan data demografi, faktor risiko, gambaran klinis, infeksi oportunis/ko-infeksi dan perbedaannya pada rumah sakit pemerintah dan swasta. Penelitian retrospektif-deskriptif dilakukan di RSUPN-Dr. Cipto Mangunkusumo (RS pemerintah) dan RS Medistra (RS swasta) di Jakarta. Kriteria inklusi mencakup kasus HIV/AIDS yang dirawat pada tahun 2002-2003, dan hasil serologi HIV positif dengan metode Elisa. Data sekunder didapatkan dari rekam medis. Enam puluh enam subyek diikut-sertakan dalam penelitian (RS pemerintah 30 subyek dan RS swasta 36 subyek), terdiri dari 59 pria (89.4%) dan 7 wanita (10.6%). Tiga puluh tujuh persen subyek didiagnosis HIV dan 62% AIDS. Faktor risiko yang didapat mencakup pengguna narkoba (59.1%), homoseksual (13.6%), heteroseksual (21.1%), transfusi (1.5%) dan perinatal (1.5%). Gejala klinis terutama berupa demam akut (56.2%), penurunan berat badan (39.4%), batuk (38.8%), sesak nafas (27.2%), diare kronik (22.8%), demam berkepanjangan (19.7%), penurunan kesadaran (15.3% dan, anoreksia (15.3%). Perbedaan bermakna antara RS pemerintah dan swasta didapatkan pada keluhan demam dan batuk. Presentasi klinis pasien HIV/AIDS selama perawatan mencakup : pnemonia (56%), oral trush (22.6%), anemia (56.5%), lekopenia (32.3%), limfopenia (55.9%), peningkatan SGOT/SGPT (66.1%), hipoalbuminemia (46.9%), limfadenopati (10.6%), lesi serebral (7.6%), ensefalopati (6.0%), tuberkulosis paru dan efusi pleura (10.6%). Infeksi oportunis dan ko-infeksi mencakup kandidosis (25.8%), hepatitis C kronik (24.2%), hepatitis B dan C kronik (4.5%), tb paru, limfadenitis dan tb milier. Kandidosis dan tb paru lebih sering ditemukan di RS pemerintah. Kesimpulan dari penelitian ini bahwa manifestasi klinis HIV/AIDS berupa pria/wanita usia muda dengan satu atau lebih faktor risiko, mengalami demam, keluhan pernapasan, penurunan berat badan, diare kronik, lemah, oral trush, anemia, lekopenia, limfopenia. Pasien yang dirawat di RS swasta menunjukkan gejala yang lebih bervariasi sedangkan yang dirawat di RS pemerintah menunjukkan kondisi yang lebih berat dan stadium lebih lanjut. (Med J Indones 2004; 13: 232-6)

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The aims of this study is to determine the demographic data, risk factors, clinical presentations, opportunistic/co-infections and its difference between public and private hospitals. A retrospective-descriptive study was conducted in Dr. Cipto Mangunkusumo National General Hospital (public hospital) and Medistra Hospital (private hospital), Jakarta. The inclusion criteria were new HIV/AIDS cases admitted in year 2002-2003 and positive HIV serology (Elisa method). Secondary data were collected form medical record. Sixty-six subjects were enrolled in this study (public hospital 30 subjects and private hospital 36 subjects), consist of 59 male (89.4%) and 7 female (10.6%). Thirty-seven percent subjects were defined as HIV and 62% AIDS. Risk factors obtained include drug user (59.1%), homosexual (13.6%), heterosexual (21.1%), transfusion (1.5%) and maternal-child (perinatal) (1.5%). The clinical symptoms mainly present as acute fever (56.2%), weight loss (39.4%), cough (38.8%), shortness of breath (27.2%), chronic diarrhea (22.8%), prolong fever (19.7%), loss of conciousness (15.3%), anorexia (15.3%). Significant differences between public and private hospitals were seen in fever and cough symptoms. Clinical presentation of HIV/AIDS patients during admission were : pneumonia (56%), oral trush (22.6%), anemia (56.5%), leucopenia (32.3%), lymphopenia (55.9%), elevated AST/ALT (66.1%), hypoalbuminemia (46.9%), limphadenopathy (10.6%), brain space occuping lesion (7.6%), encephalopathy (6.0%), pulmonary tb and pleural effusion (10.6%). The opportunistic and co-infections present were candidiasis (25.8%), chronic hepatitis C (24.2%), chronic hepatitis B and C (4.5%), pulmonary tb, lymphadenitis and miliary tb. Candidiasis and pulmonary tb were frequently found in public hospital. In conclusion from this study that clinical manifestation of HIV/AIDS were young man or woman, with one or more possible risk factor, had fever, respiratory complain, loss of body weight, chronic diarrhea, fatique, oral trush, anemia, leucopenia, lymphopenia. Patients admitted in private hospital had varied complain; and patients that admitted in public hospital had more severe and advance condition. (Med J Indones 2004; 13: 232-6)"

"Tujuan Menunjukkan adanya A. anitratus pada isolat klinik (darah) yang berasal dari pasien rawat di rumah sakit di Jakarta selama periode 2002-2008 dan pola sensitivitas mikroorganisme ini terhadap antibiotika. Metode Penelitian ini merupakan penelitian retrospektif dari semua spesimen darah yang masuk ke laboratorium Mikrobiologi Klinik Fakultas Kedokteran Universitas Indonesia (LMK-FKUI) dari tahun 2002-2008. Kultur dan pemeriksaan kepekaan terhadap antibiotik dilakukan berdasarkan praktek standar di LMK-FKUI dan Clinical Laboratory Standard Institute pada tahun yang bersangkutan. Data dikumpulkan dengan menggunakan program WHO-NET 5.4. Semua mikroorganisme Gram negative yang diisolasi dari spesimen darah ditabulasi juga termasuk dengan uji kepekaan A. anitratus terhadap antibiotik. Selain itu juga dilakukan analisis terhadap asal spesimen atau dari institusi mana spesimen tersebut berasal. Hasil A. anitratus merupakan bakteri Gram negatif yang paling banyak diisolasi selama tujuh tahun sejak 2002 sampai 2008 dari spesimen darah, dan selalu ditemukan setiap tahunnya. Hampir 50% bakteri yang diisolasi terdiri dari bakteri tersebut dan Pseudomonas aeruginosa, dan keduanya adalah bakteri lingkungan. Pemeriksaan kepekaan bakteri A. anitratus terhadap antibiotik menunjukkan adanya resistensi terhadap beberapa antibiotik yang diuji. Evaluasi asal spesimen darah menunjukan sebagai berikut: 88 spesimen (74%) berasal dari Rumah Sakit pemerintah, 18 spesimen (15%) dari Rumah Sakit swasta, 3 spesimen (3%) dari pasien praktek dokter dan 10 spesimen (8%) tidak diketahui asalnya. Kesimpulan Ditemukan A.anitratus setiap tahun sejak 2002 sampai 2008 dari spesimen darah dari pasien rawat inap di beberapa Rumah Sakit di Jakarta. Diperlukan penelitian lebih lanjut untuk mencari faktor resiko bakteremia A. anitratus agar dapat mengurangi kemungkinan terjadinya infeksi rumah sakit. Selain itu sangat dianjurkan untuk melanjutkan sampai tahap genotyping untuk menentukan hubungan antara strain yang ada di Rumah Sakit dengan strain yang diisolasi dari pasien.

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AbstractAim To report the presence of environmental microorganisms, A. anitratus, in blood of hospitalized patients in Jakarta from 2002 to 2008 and their susceptibility to antibiotics. Methods A Retrospective study w as performed on all blood specimens that were received in Clinical Microbiology Laboratory (CML) Faculty of Medicine University of Indonesia during 2002-2008. Culture and antimicrobialsusceptibility examination were carried out according to up to date standard practice in CML and Clinical Laboratory Standard Institute, recpectively. Data was collected by WHONET 5.4 program. All Gram-negative microorganisms that were isolated from blood specimens were tabulated, and so the antibiotics susceptibility of A. anitratus. The origin of the specimens in term of institutions where the specimens came from was also analyzed. Results In a 7 year period up to 2008, A. anitratus was found in blood specimens, and these invironmental bacteria were in fact the most predominant isolated Gram negative microorganisms. Together with another environmental microorganism, Pseudomonas aeruginosa, it composed nearly 50%. Antimicrobial susceptibility test of this microorganism showed some degree of resistance to all tested antibiotics. The origin of those blood specimens which yielded A. anitratus were mainly from government-owned hospitals, that was 88 specimens (74%), followed by private hospitals (18 specimens, 15%), individuals (3 specimens, 3%), and unknown source (10 specimens, 8%). Conclusion Persistent occurrence of A. anitratus in blood specimens of hospitalized patients in hospitals in Jakarta was observed. In the near future, a study to fi nd risk factors for the acquisition of A. anitratus bacteremia is needed to reduce potential hospital associated infection. Moreover, genotyping is advised in order to determine the relationship of hospital and patient derived strains."