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"Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) merupakan coronavirus baru, pertama kali terdeteksi di Wuhan, Cina. Tingginya jumlah kasus dan cepatnya proses infeksi membutuhkan deteksi cepat dan akurat untuk menegakan diagnosis COVID-19. Studi bertujuan memperoleh sensitivitas dan spesifisitas uji serologi IgG SARS-CoV-2 Architect dibandingkan dan RT-PCR pada pasien COVID19. Studi ini menggunakan pendekatan potong lintang uji diagnostik, dengan menggunakan 128 pasien yang diperoleh di RSUP Persahabatan. Studi ini berlangsung sejak bulan April sampai Juli 2021 di RSUP Persahabatan. Sampel berupa swab nasofaring diambil dari pasien untuk diperiksa dengan uji RT PCR dan darah untuk uji serologi menggunakan Architect ® i2000SR Abbott. Hasil uji sensivitas Architect sebesar 27.37% (18.72%-37,48%) dan spesifisitas 63.64% (45,12% - 79,60%). NPV 23,33% dan PPV 68,42%. Kesimpulan: Secara keseluruhan uji serologi SARS-CoV-2 IgG Architech memiliki sensitivitas dan spesifisitas yang rendah dibanding dengan RTPCR. Architect dapat digunakan untuk screening, dapat digunakan pada fase akut, hasil negatif perlu dikonfirmasi dengan RT-PCR. Tidak ada hubungan antara Ct-value RTPCR dengan derajat keparahan COVID-19, dan terdapat hubungan antara titer Architect dengan derajat keparahan COVID-19. Tidak ada hubungan onset COVID-19 dengan hasil pemeriksaan RT-PCR dan Architect

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Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a new coronavirus, which was first detected in Wuhan, China. The high number of cases and the rapid process of infection require fast and accurate detection to establish the diagnosis of COVID-19. The study aimed to obtain the sensitivity and specificity of the SARS-CoV2 Architect IgG serological test compared to RT-PCR in COVID-19 patients. This study used a cross-sectional approach to diagnostic testing, using 128 patients obtained from Persahabatan Hospital. This study took place from April 2021 to July 2021 at the Persahabatan Hospital. Nasopharyngeal swab samples were taken for RT-PCR and blood was drawn for serological testing using the Architect® i2000SR from Abbott. The sensitivity of Architect test was 27.37% (18.72–37.48%), specificity was 63.64% (45.12–79.60%), whereas NPV was 23.33% and PPV was 68.42%. Conclusion: Architech's SARS-CoV-2 IgG serological test has low sensitivity and specificity compared to RT-PCR. Architect can be used for screening, can be used in the acute phase, negative results need to be confirmed by RT-PCR. There is no relationship between the Ct-value RT-PCR and the severity of COVID-19, and there is a relationship between Architect titers and the severity of COVID-19. There is no relationship between the onset of COVID-19 and the results of the RT-PCR and Architect examinations."

"Pada bulan Desember, 2019, serangkaian kasus pneumonia dengan penyebab yang tidak diketahui muncul di China. Analisis data menunjukkan adanya coronavirus baru, yang diberi nama SARS-CoV-2. Beradasarkan WHO dan CDC pemeriksaan yang digunakan untuk mendeteksi SARS-CoV-2 adalah metode molekular RT-PCR, salah satu kit yang digunakan adalah BioCoV-19 RT-PCR. Penelitian ini bertujuan membandingkan uji RT-PCR kit BioCoV-19 RT-PCR dengan N1N2 CDC sebagai standar dalam mendeteksi SARS-CoV-2, serta melakukan uji deteksi minimal untuk mengetahui sensitivitas analitik dari kit BioCoV-19 RT-PCR, menguji reaksi silang terhadap mikroba saluran nafas lain, dan menilai secara deskriptif karakteristik subjek penelitian. Perbandingan uji kit BioCoV-19 RT-PCR dengan N1N2 CDC mendapatkan nilai sensitivitas, spesifisitas, nilai duga positif (NDP) dan nilai duga negative (NDN). Hasil pada penelitian ini menunjukkan bahwa sensitivitas dan spesifisitas BioCoV-19 RT-PCR Kit secara umum adalah 97,50% dan 100%, dengan Nilai Duga Positif (NDP) 100% dan Nilai Duga Negatif (NDN) 96,49%. Hasil uji minimal deteksi untuk primer-probe N1N2 CDC dan BioCoV-19 RT-PCR Kit setelah dilakukan dilusi bertingat sebanyak enam kali pengenceran yakni 3,5 kopi/reaksi (rerata nilai Ct 35,21). Uji reaksi silang tidak terdeteksi adanya reaksi silang dari 12 bakteri, tujuh virus dan tiga jamur. Karakteristik subjek penelitian lebih banyak pada laki-laki sebanyak (61,5%), untuk usia lebih banyak pada usia berkisar 20-40 tahun (56,29%), gejala klinis pasien saat datang lebih banyak gejala ringan.

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In December, 2019, a series of pneumonia cases of unknown cause appeared in China. Analysis of the data indicated the presence of a new coronavirus, which was named SARS-CoV-2. Based on WHO and the CDC, the tests used to detect SARS-CoV-2 are the molecular RT-PCR method, one of the kits used is BioCoV-19 RT-PCR. This study aims to compare the RT-PCR test of the BioCoV-19 RT-PCR kit with the CDC's N1N2 as a standard in detecting SARS-CoV-2, as well as to conduct a minimal detection test to determine the analytical sensitivity of the BioCoV-19 RT-PCR kit, to test cross reactions against other respiratory tract microbes, and descriptively assessed the characteristics of the research subjects. Comparison of the BioCoV-19 RT-PCR test kit with N1N2 CDC obtained sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). The results of this study showed that the sensitivity and specificity of the BioCoV-19 RT-PCR Kit in general were 97.50% and 100%, with a positive predictive value (PPV) of 100% and a negative predictive value (NPV) of 96.49%. The minimum test results for detection of the N1N2 CDC primer-probe and the BioCoV-19 RT-PCR Kit were carried out after six dilutions of 3.5 copies/reaction (mean Ct value 35.21). The cross-reaction test did not detect any positives of 12 bacteria, seven viruses and three fungi. The characteristics of the study subjects were more male (61.5%), for ages ranging from 20-40 years (56.29%), the clinical symptoms of the patients when they arrived were more mild symptoms."

"Latar Belakang: Coronavirus disease 2019 (COVID-2019) disebabkan oleh severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) dan menjadi tantangan karena menyebar luas secara cepat. Jumlah virus SARS-CoV-2 ditemukan tinggi pada awal infeksi di rongga mulut dan saluran pernapasan bagian atas. Tindakan bedah di rongga mulut memiliki potensi tinggi untuk transmisi SARS-CoV-2. American Dental Association (ADA) dan Centers for Disease Control and Prevention (CDC) merekomendasikan berkumur hidrogen peroksida 1,5% atau iodin povidon 0,2% sebelum tindakan medis. Mengurangi jumlah virus di saluran pernapasan bagian atas pada awal infeksi menurunkan keparahan perkembangan penyakit dan risiko transmisi. Nilai cycle threshold (CT) dari hasil pemeriksaan real time reverse transcription polymerase chain reaction (RT-PCR) merepresentasikan secara semikuantitatif viral load. Tujuan Penelitian: Menganalisis pengaruh berkumur iodin povidon 1% dan hidrogen peroksida 3% terhadap nilai CT RT-PCR SARS-CoV-2. Metode Penelitian: 45 subjek penelitian diambil dari pasien Rumah Sakit Umum Pusat Persahabatan yang terinfeksi SARS-CoV-2 sesuai kriteria inklusi dan ekslusi. Subjek penelitian dibagi ke dalam kelompok iodin povidon 1%, kelompok hidrogen peroksida 3%, dan kelompok kontrol. Subjek penelitian berkumur 30 detik di rongga mulut dan 30 detik di tenggorokan belakang dengan 15 ml sebanyak 3 kali sehari selama 5 hari. Analisis nilai CT dilakukan melalui pemeriksaan RT-PCR pada hari ke-1, hari ke-3, dan hari ke-5 setelah berkumur. Hasil: Didapatkan perbedaan bermakna pada hasil uji Friedman dan tampak peningkatan nilai CT RT-PCR mulai dari awal, hari ke-1, hari ke-3, dan hari ke- 5 pada keseluruhan kelompok dan masing-masing kelompok perlakuan. Hasil uji Post- Hoc dengan Wilcoxon menunjukkan perbedaan bermakna pada keseluruhan kelompok hari nilai CT RT-PCR dari keseluruhan kelompok dan kelompok iodin povidon 1%. Perbedaan bermakna sebagian besar kelompok hari nilai CT RT-PCR ditemukan dari hasil uji Post-Hoc dengan Wilcoxon pada kelompok hidrogen peroksida 3% dan kelompok kontrol, kecuali antara hari ke-1 dengan hari ke-3 dan antara hari ke-3 dengan hari ke-5 pada kelompok hidrogen peroksida 3% dan antara hari ke-3 dengan hari ke-5 pada kelompok kontrol. Peningkatan tertinggi nilai CT RT-PCR awal hingga hari ke-1 ditemukan pada kelompok hidrogen peroksida 3%, sedangkan antara hari ke-1 hingga ke-3 dan hari ke-3 hingga hari ke-5 ditemukan pada kelompok iodin povidon 1%. Usia dan jenis kelamin ditemukan tidak memiliki hubungan yang bermakna terhadap perubahan nilai CT RT-PCR. Kesimpulan: Berkumur iodin povidon 1% dan hidrogen peroksida 3% berpengaruh terhadap peningkatan nilai CT RT-PCR SARS-CoV-2. Peningkatan tertinggi nilai CT RT-PCR awal hingga hari ke-1 ditemukan pada kelompok hidrogen peroksida 3%, sedangkan antara hari ke-1 hingga ke-3 dan hari ke-3 hingga hari ke-5 ditemukan pada kelompok iodin povidon 1%.

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Background: Coronavirus disease 2019 (COVID-2019) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and poses a challenge because it can spread rapidly. The number of SARS-CoV-2 was found to be high at the beginning of infection in the oral cavity and upper respiratory tract. Surgery in the oral cavity poses high transmission risk of SARS-CoV-2. The American Dental Association (ADA) and the Centers for Disease Control and Prevention (CDC) recommend the use of mouthrinse either 1.5% hydrogen peroxide or 0.2% povidone iodine before commencing any surgical treatment. Reducing the viral load in the upper respiratory tract at the early of infection may decrease the severity of disease progression and the risk of transmission. The cycle threshold (CT) value from the real time reverse transcription polymerase chain reaction (RT-PCR) examination semi-quantitatively represents the viral load.

Objective: To analyze the effect of mouthrinsing and gargling with 1% povidone iodine and 3% hydrogen peroxide on the CT value of SARS-CoV-2.

Methods: 45 subjects were patients recruited from Persahabatan General Hospital infected with SARS-CoV-2 according to the inclusion and exclusion criteria. The subjects were divided into 1% povidone iodine group, the 3% hydrogen peroxide group, and the control group. The subjects were instructed to rinse their mouths for 30 seconds and gargle for 30 seconds at the back of the throat with 15 mL of the mouthrinse 3 times a day for 5 days. Analysis of CT values were carried out using RT-PCR on day 1, day 3 and day 5 after mouthrinsing and gargling.

Results: Significant differences were found in the results of the Friedman test, and the CT value demonstrated increases from the initial, day 1, day 3 and day 5 in the whole group and each group. The results of the Post-Hoc test with Wilcoxon showed significant differences in the whole day group of the CT value of the whole group and the 1% povidone iodine group. Significant differences in most of the day group were found from the results of the Post-Hoc test with Wilcoxon in the 3% hydrogen peroxide group and the control group, except between day 1 and day 3 and between day 3 and day 5 in the 3% hydrogen peroxide group and between day 3 and day 5 in the control group. The highest increase in the initial CT value until day 1 was found in the 3% hydrogen peroxide group, while the increase between days 1 to 3 and day 3 to day 5 was found in the 1% povidone iodine group. Age and gender showed no significant correlation with changes in CT values.

Conclusion: Mouthrinsing and gargling with 1% povidone iodine and 3% hydrogen peroxide were found to increase the CT value of SARS-CoV-2. The highest increase in the initial CT value until day 1 was found in the 3% hydrogen peroxide group, while between days 1 to 3 and day 3 to day 5 was found in the 1% povidone iodine group."

"[ABSTRAKLatar belakang: Metode PCR rutin untuk mendeteksi mutasi pada thalassemia α seperti PCR multi kompleks dan restriction fragment length polymorphism (RFLP) membutuhkan proses yang lama dan reagen yang banyak serta biaya yang besar. Saat ini telah dikembangkan metode baru yaitu tes strip (α-globin strip assay), yang dapat mendeteksi 21 macam mutasi gen globin -α secara simultan dalam satu paket reaksi dan hanya membutuhkan DNA dalam jumlah sedikit.Tujuan : Mengetahui nilai sensitivitas dan spesifisitas metode α-globin strip assay dalam mendeteksi mutasi thalassemia-α.Metode penelitian: Penelitian merupakan uji diagnostik yang dilakukan dengan metode belah lintang yang membandingkan pemeriksaan α -globin strip assay dan PCR rutin dalam mendeteksi mutasi gen pada thalassemia α. Pada tahap I disertakan 17 pasien yang berobat ke pusat thalassemia di RSCM dan Lembaga Biomolekular Eijkman Jakarta pada bulan Oktober 2014 sampai Maret 2015, kemudian tahap II disertakan 18 anggota keluarga inti subjek pada tahap I. Pada semua subjek dilakukan pemeriksaan hematologi termasuk indeks eritrosit, morfologi darah tepi, analisis Hb, PCR rutin dan α -globin strip assay.Hasil penelitian dan pembahasan: Ditemukan tujuh jenis mutasi yang terdiri dari: 1) delesi 1 gen 3,7kb; 2) non delesi Cd59; 3) non delesi HbCS; 4) delesi 2 gen SEA; 5) mutasi campuran 3,7kb/Cd59 ; 6) mutasi campuran Cd59/HbCS; 7) mutasi campuran SEA/HbCS. Metode α-globin strip assay memiliki nilai sensitivitas dan spesifisitas sebesar 100%.Kesimpulan : Metode α-globin strip assay akurat mendeteksi mutasi thalassemia-α dengan tingkat sensitivitas dan spesifisitas sebesar 100%.

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ABSTRACTBackground : Routine PCR methods in detecting mutations that occur in α thalassemia such as multi-complex single tube PCR and PCR restriction fragment length polymorphism (RFLP) require a lengthy process and utilize large amount of reagents and are costly. α-globin strip assay is a new method in detecting α thalassemia related mutations that is able to detect 21 types of globin-α mutations simultaneously in a single reaction and requires only small amount of DNA. Objective: To determine the sensitivity and specificity of α-globin strip assay compared to routine PCR in detecting α thalassemia associated mutations.Methods: A cross sectional diagnostic study was performed comparing α-globin strip assay and routine PCR in detecting mutations related to α thalassemia. Phase I of the study includes 17 patients treated for α thalassemia at RSCM and Biomolecular Eijkman Institute between October 2014 and March 2015, phase II includes 18 close relatives of patients recruited in phase I. All subjects underwent hematological examination including erythrocyte indices, peripheral blood morphology, Hb analysis, routine PCR and α ?globin strip assay.Results: Seven kind of mutations were identified including 1) deletion of one gene 3,7 kb; 2) non-deletion of CD59; 3) non deletion of HbCS; 4) deletion of two genes SEA; 5) mixed mutation of 3,7kb/CD59; 6) mixed mutation of CD59/HbCS; 7) mixed mutation of SEA/HbCS. α-globin strip assay has sensitivity and specificity of 100%.Conclusion: α ?globin strip assay accurately detect mutations in α thalassemia with 100% sensitivity and specificity., Background : Routine PCR methods in detecting mutations that occur in α thalassemia such as multi-complex single tube PCR and PCR restriction fragment length polymorphism (RFLP) require a lengthy process and utilize large amount of reagents and are costly. α-globin strip assay is a new method in detecting α thalassemia related mutations that is able to detect 21 types of globin-α mutations simultaneously in a single reaction and requires only small amount of DNA. Objective: To determine the sensitivity and specificity of α-globin strip assay compared to routine PCR in detecting α thalassemia associated mutations.Methods: A cross sectional diagnostic study was performed comparing α-globin strip assay and routine PCR in detecting mutations related to α thalassemia. Phase I of the study includes 17 patients treated for α thalassemia at RSCM and Biomolecular Eijkman Institute between October 2014 and March 2015, phase II includes 18 close relatives of patients recruited in phase I. All subjects underwent hematological examination including erythrocyte indices, peripheral blood morphology, Hb analysis, routine PCR and α –globin strip assay.Results: Seven kind of mutations were identified including 1) deletion of one gene 3,7 kb; 2) non-deletion of CD59; 3) non deletion of HbCS; 4) deletion of two genes SEA; 5) mixed mutation of 3,7kb/CD59; 6) mixed mutation of CD59/HbCS; 7) mixed mutation of SEA/HbCS. α-globin strip assay has sensitivity and specificity of 100%.Conclusion: α –globin strip assay accurately detect mutations in α thalassemia with 100% sensitivity and specificity.]"

"Latar Belakang. Penyakit COVID-19 yang disebabkan oleh SARS-CoV-2 dengan cepat menyebar dan menjadi Pandemi serta menimbukan kerugian yang sangat besar pada masyarakat di seluruh dunia. Deteksi virus yang cepat dan akurat memegang peranan penting untuk mengendalikan penyebaran di masyarakat dan membantu pasien untuk menghindari perkembangan penyakit lebih lanjut. Saat ini real-time Reverse Transcriptase Polymerase Chain Reaction (real-time RT-PCR) merupakan reference standard diagnostic test dalam mendeteksi SARS-CoV-2 di seluruh dunia. Real-time Reverse Transcriptase Loop Mediated Isothermal Amplification (RT-LAMP) merupakan metode amplifikasi asam nukleat isotermal yang memiliki sensitivitas dan spesifisitas tinggi dan waktu pengerjaan yang jauh lebih cepat dibandingkan real-time RT-PCR. Tujuan. Penelitian bertujuan untukiDetectTM SARS-CoV-2 Detection KitSARS-CoV-2.Metode. Penelitian ini merupakan uji kesesuaian dengan studi potong lintang dan menggunakan metode pengumpulan sampel secara consecutive sampling. Subjek penelitian yaitu spesimen swab nasofaring dan orofaring dalam VTM (N=80) yang dianalisis di Laboratorium Mikrobiologi Klinik Fakultas Kedokteran Universitas Indonesia. iDetectTM SARS-CoV-2 Detection Kit menggunakan uji kesesuaian Kappa aplikasi SPSS versi 25.Hasil. Dari 72 sampel valid yang diperiksa dengan real-time RT-LAMP iDetectTM SARS- CoV-2 Detection Kit dan real-time RT-PCR, 24 sampel terdeteksi positif oleh real-time RT-PCR dan hanya tiga sampel yang terdeteksi positif oleh real-time RT-LAMP. Tiga sampel yang terdeteksi positif oleh real-time RT-LAMP termasuk ke dalam sampel - sampel yang terdeteksi positif oleh real-time RT-PCR. Secara statistik, uji reliabilitas / uji kesesuaian dari penelitian kedua alat diagnostik ini menunjukkan nilai Kappa yang sangat rendah, yaitu 0,16. Uji kesesuaian Kappa kedua alat ini menunjukkan bahwa hasil pemeriksaan alat real-time RT-LAMP iDetectTM SARS-CoV-2 Detection Kit tidak sesuai dengan alat real-time RT-PCR dalam mendeteksi SARS-CoV-2. Kesimpulan. Real-time RT-LAMP iDetectTM SARS-CoV-2 Detection Kit tidak sesuai dengan alat real-time RT-PCR dan tidak dapat digunakan sebagai alat diagnostik dalam mendeteksi SARS-CoV-2.

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Introduction. COVID-19 caused by SARS-CoV-2 quickly spread and became Global Pandemic and caused enormous losses to people around the world. Rapid and accurate virus detection plays an important role in controlling spread in the community and helping patients to avoid further disease progression. Currently, real-time Reverse Transcriptase Polymerase Chain Reaction (real-time RT-PCR) is determined as the reference standard diagnostic test for detecting SARS-CoV-2 worldwide. Real-time Reverse Transcriptase Loop Mediated Isothermal Amplification (RT-LAMP) is an isothermal nucleic acid amplification method that has high sensitivity and specificity and provide faster result than real-time RT-PCR. Aim. The research aims to compare real-time RT-LAMP iDetectTM SARS-CoV-2 Detection Kit and real-time RT-PCR in detecting SARS-CoV-2. Method. This research is a comparison test with a cross-sectional study and uses a consecutive sampling method to collect samples. The research subjects were nasopharyngeal and oropharynx swab specimens in VTM (N=80) which were analyzed at the Clinical Microbiology Laboratory, Faculty of Medicine, Universitas Indonesia. The data obtained from the real-time RT-LAMP iDetectTM SARS-CoV-2 Detection Kit and real-time RT-PCR test results were analyzed using Kappa test SPSS version 25.

Results. Of the 72 valid samples examined by the real-time RT-LAMP iDetectTM SARS- CoV-2 Detection Kit and real-time RT-PCR, 24 samples were detected positive by real- time RT-PCR and only three samples were detected positive by real-time RT-LAMP. Three samples that were detected positive by the real-time RT-LAMP were included in the samples that were detected positive by the real-time RT-PCR. Statistically, the comparison test of the research of these two diagnostic tools showed a very low Kappa value, which was 0.16. The Kappa suitability test of these two tools showed that the real- time RT-LAMP iDetectTM SARS-CoV-2 Detection Kit were not compatible with the real- time RT-PCR in detecting SARS-CoV-2. Summary. Real-time RT-LAMP iDetectTM SARS-CoV-2 Detection Kit is not compatible with real-time RT-PCR and cannot be used as a diagnostic tool in detecting SARS-CoV-2."

"Latar Belakang: Reseptor ACE2 tidak hanya terdapat pada paru-paru, tetapi juga pada saluran pencernaan yang memungkinkan terjadinya infeksi SARS-COV-2 pada enterosit, menimbulkan manifestasi klinis gastrointestinal, dan terdeteksinya RNA virus pada pemeriksaan swab anal. Studi lain di seluruh dunia menunjukkan hasil yang berbeda-beda serta belum didapatkan penelitian serupa di Indonesia. Tujuan: Penelitian ini bertujuan untuk mengetahui luaran klinis infeksi COVID- 19 pada pasien yang dilakukan swab anal, mendapatkan hubungan hasil pemeriksaan PCR SARS-CoV-2 swab anal dengan manifestasi klinis gastrointestinal dan derajat keparahan pada pasien COVID-19 di Indonesia. Metode: Merupakan cabang penelitian dari penelitian utama yang berjudul “Nilai RT-PCR Swab Anal untuk Diagnosis COVID-19 pada Orang Dewasa di Indonesia”. Penelitian ini merupakan studi analitik dengan desain potong lintang. Sampel penelitian merupakan pasien COVID-19 yang menjalani rawat inap di RSUPN dr. Cipto Mangunkusumo (RSCM), RS Mitra Keluarga Depok, RS Mitra Keluarga Kelapa Gading, dan RS Ciputra selama periode April 2020 sampai dengan Januari 2021. Dikumpulkan data demografi, manifestasi klinis, derajat keparahan, dan hasil swab anal PCR SARS-CoV-2.Hasil: 136 subjek penelitian dengan swab nasofaring positif dianalisis. 52 pasien (38,2%) dengan swab anal PCR SARS-CoV-2 positif dan 84 pasien (61,8%) dengan swab anal negatif. Manifestasi klinis saluran cerna tersering, yaitu: mual-muntah 69 pasien (50,7%), nafsu makan menurun sebanyak 62 pasien (45,6%), dan nyeri perut sebanyak 31 pasien (22,8). Terdapat 114 pasien (83,8%) tergolong dalam derajat ringan-sedang dan 22 pasien (16,2%) tergolong dalam berat-kritis. Terdapat hubungan yang bermakna secara proporsi statistik antara variabel hasil pemeriksaan PCR SARS-CoV-2 swab anal dengan manifestasi klinis gastrointestinal berupa keluhan diare atau mual-muntah (nilai p 0,031). Tidak terdapat hubungan yang bermakna secara proporsi statistik antara variabel hasil pemeriksaan PCR SARS-CoV-2 swab anal dengan derajat keparahan (nilai p 0,844).Simpulan: Terdapat hubungan antara hasil pemeriksaan PCR SARS-CoV-2 swab anal dengan manifestasi klinis gastrointestinal berupa keluhan diare atau mual- muntah dan tidak terdapat hubungan antara variabel hasil pemeriksaan PCR SARS- CoV-2 swab anal dengan derajat keparahan infeksi COVID-19.

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Background: ACE2 receptor is not only found in the lungs, but also in the digestive tract, which allows the occurrence of enterocyte infection, gastrointestinal clinical manifestations, and detection of viral RNA on anal swab PCR. Studies around the world show various results, yet there has been no similar study to be found in Indonesia.

Objective: This study aims to determine the clinical outcome of COVID-19 patients with gastrointestinal manifestations who were tested by anal swab, the relationship between anal swab PCR for SARS-CoV-2 test result with gastrointestinal clinical manifestations as well as the severity of COVID-19 patients in Indonesia.

Methods: This research is a branch of study titled. The Value of Anal Swab RT- PCR for COVID-19 Diagnosis in Adult Indonesian Patients. This is an analytical study with cross-sectional design. Samples were obtained from hospitalized COVID-19 patients at RSUPN dr. Cipto Mangunkusumo (RSCM), Mitra Keluarga Hospital Depok, Mitra Keluarga Kelapa Gading Hospital, and Ciputra Hospital from April 2020 to January 2021. Demographic data, clinical manifestations, severity, and SARS-CoV-2 PCR anal swab were collected.

Results: 136 subjects with positive nasopharyngeal swab were analyzed. Result showed that 52 patients (38.2%) had positive anal swabs PCR SARS-CoV-2 and 84 patients (61.8%) had negative anal swabs. Common gastrointestinal clinical manifestations were: nausea and vomiting in 69 patients (50.7%), anorexia in 62 patients (45.6%), and abdominal pain in 31 patients (22.8). There were 114 patients (83,8%) classified as mild-moderate and 22 patients (16,2%) as severe-critical. There was a statistically significant relationship between anal swab PCR for SARS- CoV-2 test result with gastrointestinal clinical manifestations (diarrhea or nausea- vomiting) (p value 0.031). There was no statistically significant relationship found between anal swab PCR for SARS-CoV-2 test result with the severity of COVID- 19 infection (p value 0.844).

Conclusions: There is a relationship between anal swab PCR SARS-CoV-2 test result with gastrointestinal clinical manifestations (diarrhea or nausea-vomiting) and there is no relationship between anal swab PCR SARS-CoV-2 test result with severity of COVID-19 infection."

"Latar Belakang: Pandemi COVID-19 yang saat ini sedang terjadi meningkatkan kesadaran akan risiko penularan di ruang operasi dari virus Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Dokter spesialis bedah mulut dan maksilofasial pada khususnya merupakan profesi yang rentan terhadap transmisi SARS-CoV-2 hal tersebut disebabkan karena ruang lingkup pekerjaan yang erat kaitannya dengan reservoir SARS-CoV-2 yaitu rongga mulut dan orofaring. American Dental Association (ADA), Centers for Disease Control and Prevention (CDC) dan petunjuk klinis Kementrian Kesehatan Republik Indonesia menganjurkan berkumur dengan iodin povidon sebelum tindakan kedokteran gigi. Nilai cycle threshold (CT) dari hasil pemeriksaan real time reverse transcription polymerase chain reaction (RT-PCR) merepresentasikan secara semikuantitatif viral load. Tujuan Penelitian: Menganalisis pengaruh berkumur iodin povidon 1% dan iodin povidon 0.5% terhadap nilai CT RT-PCR SARS-CoV-2 dan nilai saturasi oksigen. Metode Penelitian: 42 subjek penelitian diambil dari pasien Rumah Sakit Umum Pusat Persahabatan yang terinfeksi SARS-CoV-2 sesuai kriteria inklusi dan ekslusi. Subjek penelitian dibagi ke dalam kelompok iodin povidon 1%, kelompok iodin povidon 0.5%, dan kelompok kontrol. Subjek penelitian berkumur 30 detik di rongga mulut dan 30 detik di tenggorokan belakang dengan 15 ml sebanyak 3 kali sehari selama 5 hari. Analisis nilai CT dilakukan melalui pemeriksaan RT-PCR pada hari ke-1, hari ke-3, dan hari ke-5 setelah berkumur. Hasil: perbedaan bermakna didapatkan pada hasil uji Friedman dan tampak peningkatan nilai CT RT-PCR mulai dari awal, hari ke-1, hari ke-3, dan hari ke- 5 pada keseluruhan kelompok dan masing-masing kelompok perlakuan. Hasil uji Post- Hoc dengan Wilcoxon menunjukkan perbedaan bermakna pada keseluruhan kelompok hari nilai CT RT-PCR dari keseluruhan kelompok dan kelompok iodin povidon 1%. Perbedaan bermakna sebagian besar kelompok hari nilai CT RT-PCR ditemukan dari hasil uji Post-Hoc dengan Wilcoxon pada kelompok iodin povidon 0.5% dan kelompok iodin povidon 1%. Peningkatan tertinggi nilai CT RT-PCR awal hingga hari ke-1 ditemukan pada kelompok iodin povidon 0.5% sedangkan antara hari ke-1 hingga ke-3 dan hari ke-3 hingga hari ke-5 ditemukan pada kelompok iodin povidon 1%. Usia dan jenis kelamin ditemukan tidak memiliki hubungan yang bermakna terhadap perubahan nilai CT RT-PCR.Peningkatan nilai CT RT-PCR tidak menyebabkan pengaruh terhadap nilai saturasi oksigen. Kesimpulan: Berkumur iodin povidon 1% dan iodin povidon 0.5% berpengaruh terhadap peningkatan nilai CT RT-PCR SARS-CoV-2 dan berkumur dengan iodin povidon 1% atau iodin povidon 0.5% dapat mempertahankan saturasi oksigen dalam rentang normal 96%-99%.

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Background: The current COVID-19 pandemic is raising awareness of the risk of transmission in the operating room from the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Oral and maxillofacial surgeons in particular are professions that are vulnerable to the transmission of SARS-CoV-2, this is because the scope of work is closely related to the SARS-CoV-2 reservoir, namely the oral cavity and oropharynx. The American Dental Association (ADA) and the Centers for Disease Control and Prevention (CDC) and the clinical guidelines of the Ministry of Health Republic of Indonesia recommend gargling with iodine povidon before commencing any surgical treatment. The cycle threshold (CT) value from the real time reverse transcription polymerase chain reaction (RT-PCR) examination semi-quantitatively represents the viral load. Low blood oxygen levels or hypoxia can be defined as a measurable oxygen saturation below 94% in patients without lung disease.

Objective: To analyze the effect of mouthrinsing and gargling with iodine povidone 1% and iodine povidone 0.5% on the CT value of SARS-CoV-2.

Methods: 42 subjects were patients recruited from Persahabatan General Hospital infected with SARS-CoV-2 according to the inclusion and exclusion criteria. The subjects were divided into iodine povidone 1% group, iodine povidone 0.5% group, and the control group. The subjects were instructed to rinse their mouths for 30 seconds and gargle for 30 seconds at the back of the throat with 15 mL of the mouthrinse 3 times a day for 5 days. Analysis of CT values were carried out using RT-PCR on day 1, day 3 and day 5 after mouthrinsing and gargling.

Results: Significant differences were found in the results of the Friedman test, and the CT value demonstrated increases from the initial, day 1, day 3 and day 5 in the whole group and each group. The results of the Post-Hoc test with Wilcoxon showed significant differences in the whole day group of the CT value of the whole group and the iodine povidone 1% group. Significant differences in most of the day group were found from the results of the Post-Hoc test with Wilcoxon in the iodine povidone 0.5% group and the iodine povidone 1%, except between day 1 and day 3 and between day 3 and day 5 in the iodine povidone 0.5% group and between day 3 and day 5 in the control group. The highest increase in the initial CT value until day 1 was found in the iodine povidone 1%. Age and gender showed no significant correlation with changes in CT values. The increasing of CT value of RT-PCR did not cause any effect on oxgen saturation values, the saturation values remain normal.

Conclusion: Mouthrinsing and gargling with iodine povidone 1% and iodine povidone 0.5% had an effect on increasing the CT value of RT-PCR SARS-CoV-2 and also could maintain oxygen saturation in the normal range between 96-99%."

"Latar Belakang: Melihat potensi tingginya jumlah virus didalam rongga mulut, dengan bukti bahwa SARS-CoV-2 ditemukan pada reseptor ACE2, perlu upaya untuk mencegah penularan dari pasien ke praktisi melalui saliva yang terkontaminasi. Virus ini menyebar lebih cepat karena SARS-CoV-2 bereplikasi disaluran pernapasan bagian atas dengan melepaskan patogen yang berpindah dari satu orang ke orang lain saat bersin dan batuk melalui penyebaran pernapasan. Diperkirakan waktu penularan bisa terjadi sebelum gejala muncul (sekitar 2,5 hari lebih awal dari munculnya gejala). Berkumur dengan hidrogen peroksida dapat menghilangkan lapisan permukaan epitel pada mukosa mulut yang diketahui terdapat reseptor ACE2 tempat terikatnya SARS- CoV-2 dan dapat menginaktivasi virus tersebut. Pedoman sementara American Dental Association (ADA) menyarankan penggunaan 1,5% Hidrogen peroksida sebagai pilihan untuk pembilasan mulut preoperatif sebagai obat kumur antiseptik. Nilai cycle threshold yang diperoleh RT – PCR bersifat semi-kuantitatif dan mampu membedakan antara viral load tinggi dan rendah. Tujuan Penelitian: Mengevaluasi perbedaan pengaruh penggunaan obat kumur diantara berkumur hidrogen peroksida 1,5% dan hidrogen peroksida 3% terhadap nilai cycle threshold RT-PCR pada pasien COVID - 19. Metode Penelitian: 42 subjek penelitian diambil dari pasien RSUP Persahabatan yang terinfeksi SARS-CoV-2 sesuai dengan kriteria inklusi dan ekslusi. Setelah dilakukan informed consent, subjek penelitian dibagi menjadi 3 kelompok, yaitu kelompok hidrogen peroksida 1,5%, kelompok hidrogen peroksida 3% dan kelompok kontrol. Subjek penelitian berkumur 30 detik di rongga mulut dan 30 detik di tenggorokan belakang dengan 15 ml sebanyak 3 kali sehari selama 5 hari. Analisis menggunakan nilai cycle threshold pada pemeriksaan RT-PCR pada hari ke-1, hari ke-3 dan hari ke-5 setelah berkumur. Hasil: Terdapat perbedaan bermakna pada hasil uji Friedman dan peningkatan nilai cycle threshold RT-PCR dari awal, hari ke-1, hari ke-3 dan hari ke-5 di keseluruhan kelompok dan masing – masing kelompok perlakuan. Peningkatan tertinggi nilai cycle threshold RT-PCR awal hingga hari ke-1 ditemukan pada kelompok hidrogen peroksida 3%, kemudian antara hari ke-1 hingga ke-3 dan hari ke-3 hingga hari ke-5 ditemukan pada kelompok hidrogen peroksida 1,5%. Kesimpulan: Berkumur hidrogen peroksida 1,5% dan hidrogen peroksida 3% berpengaruh terhadap peningkatan nilai cycle threshold RT-PCR SARS-CoV-2. Kedua konsentrasi hidrogen peroksida 1,5% dan hidrogen peroksida 3% memberikan pengaruh positif dalam menurunkan jumlah virus di rongga mulut, sehingga pilihan penggunaan konsentrasi hidrogen peroksida yang lebih kecil bisa menjadi pilihan untuk digunakan untuk berkumur.

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Background: Given the potential high number of viruses in the oral cavity, with evidence that SARS-CoV-2 is found at the ACE2 receptor, efforts are needed to prevent transmission from patient to practitioner through contaminated saliva. This virus spreads faster because SARS-CoV-2 replicates in the upper respiratory tract by releasing pathogens that are passed from one person to another when sneezing and coughing through respiratory spread. It is estimated that the time of transmission can occur before symptoms appear (about 2.5 days earlier than the onset of symptoms). Mouth rinse and gargling with hydrogen peroxide can remove the epithelial surface layer on the oral mucosa which is known to have ACE2 receptors where SARS-CoV-2 binds and can inactivate the virus. Interim guidelines of the American Dental Association (ADA) recommend the use of 1.5% hydrogen peroxide as an option for preoperative oral rinse as an antiseptic mouth rinse. The cycle threshold value obtained by RT-PCR is semi-quantitative and able to distinguish between high and low viral loads.

Objective: To evaluate the difference in the effect of using mouth rinse between 1.5% hydrogen peroxide and 3% hydrogen peroxide mouth rinse and gargling on the RT-PCR cycle threshold value in COVID-19 patients.

Methods: 42 subjects were patients recruited from Persahabatan General Hospital infected with SARS-CoV-2 according to the inclusion and exclusion criteria. Following informed consent procedure, the research subjects were divided into 3 groups, namely the 1.5% hydrogen peroxide group, the 3% hydrogen peroxide group and the control group. The subjects were instructed to rinse their mouths for 30 seconds and gargle for 30 seconds at the back of the throat with 15 ml of the mouth rinse 3 times a day for 5 days. Analysis of cycle threshold values was carried out using RT-PCR on day 1, day 3 and day 5 after mouth rinse and gargling.

Results: There were significant differences in the results of the Friedman test and an increase in the RT-PCR cycle threshold value starting from the beginning, day 1, day 3 and day 5 in the whole group and each treatment group. The highest increase RT-PCR cycle threshold value at day 1 was found in the 3% hydrogen peroxide group, while the increase between day 1 to 3 and day 3 to day 5 was found in the 1.5% hydrogen peroxide group.

Conclusion: Mouth rinse and gargling with 1.5% hydrogen peroxide and 3% hydrogen peroxide has an effect on increasing the cycle threshold value of the SARS-CoV-2 RT-PCR. Both 1.5% and 3% hydrogen peroxide concentration have a positive effect in reducing the number of viruses in the oral cavity, so the choice of using a lower hydrogen peroxide concentration can be an option to use for mouth rinse and gargling."

"Latar Belakang. SARS-CoV-2 sebagai penyebab COVID-19 pertama kali terdeteksi pada sampel klaster pasien di Provinsi Hubei, China pada Desember 2019. Pada mulanya klaster pasien tersebut memiliki gejala seperti demam, batuk, sesak nafas, dan gejala lainnya yang tidak spesifik. Alat uji Rapid Antigen Test (RAT) dapat dijadikan alternatif untuk diagnosis klinis COVID-19. Tujuan. Penelitian ini bertujuan untuk mendapatkan rekomendasi mengenai alternatif spesimen dan metode deteksi SARS-CoV-2. Metode. Desain penelitian ini merupakan uji diagnostik studi potong lintang dengan pengumpulan spesimen secara consecutive sampling. Subjek penelitian yaitu pasien yang memiliki kontak dengan kasus infeksi SARS-CoV-2 yang terkonfirmasi dengan atau tanpa gejala klinis COVID-19 di Fasilitas Pelayanan Kesehatan (Fasyankes) dan Laboratorium Mikrobiologi Klinik (LMK) FKUI dengan jumlah sampel 221. Analisis data dengan tabulasi silang dan perhitungan sensitivitas, spesifisitas, PPV, dan NPV. Hasil. Deteksi antigen menggunakan spesimen nasal memiliki nilai sensitivitas 32,35%, spesifisitas 99,35%, PPV 95,65%, NPV 76,77%, akurasi 78,73%. Tingkat positifitas pada spesimen nasofaring 34,84%, spesimen orofaring 30,32%, dan nasal 30,77%. Kesimpulan. Hasil uji rRT-PCR pada beberapa jenis spesimen menunjukkan bahwa spesimen nasal dan orofaring dapat dijadikan pilihan selain spesimen nasofaring. Penggunaan kit deteksi antigen dapat dilakukan untuk pelacakan kontak COVID-19 atau untuk diagnosis, terutama untuk daerah yang memiliki keterbatasan akses diagnosis menggunakan rRT-PCR.

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Introduction. The SARS-CoV-2 as the cause of COVID-19 was first detected in a cluster sample of patients in Hubei Province, China in December 2019. The first patient had symptoms such as fever, cough, shortness of breath, and other non-specific symptoms. Rapid Antigen Test can be used as an alternative for diagnosis of COVID-19. Aim. This study aims to obtain recommendations alternative specimens and detection methods for SARS-CoV-2. Method. The design of this study is a cross-sectional diagnostic test with consecutive sampling. The research subjects were patients who had contact with confirmed cases of SARS-CoV-2 infection with or without clinical symptoms of COVID-19 at Health Service Facilities (Fasyankes) and Laboratorium Mikrobiologi Klinik (LMK) FKUI with a total sample of 221. Data analysis using cross tabulation to calculate the sensitivity, specificity, PPV, and NPV. Results. The positivity rate for nasopharyngeal specimens was 34.84%, oropharyngeal specimens 30.32%, and nasal specimens 30.77%. Antigen detection using nasal specimens has sensitivity 32.35%, specificity 99.35%, PPV 95.65%, NPV 76.77%, accuracy 78.73%. Conclusion. The results of the rRT-PCR test on several types of specimens indicate that nasal and oropharynx specimens can be used as an alternative to nasopharyngeal specimens. The use of antigen detection kits can be carried out for COVID-19 contact tracing or for diagnosis, especially for areas that have limited access to diagnosis using rRT-PCR."

"Pandemi Coronavirus Disease 2019 (COVID-19) merupakan pandemi disebabkan oleh virus SARS-CoV-2. Indonesia diketahui sebagai salah satu negara dengan tingkat infeksi COVID-19 paling tinggi di dunia. Deteksi cepat secara Real Time Reverse Transcription Polymerase Chain Reaction (rRT-PCR) merupakan salah satu langkah yang diperlukan untuk menekan laju penyebaran COVID-19. Kit deteksi BioCore 2019-nCoV Real Time PCR Kit adalah salah satu kit dignosis COVID-19 produksi BioCore. Ltd., Korea Selatan. Kit diagnosis BioCore telah beredar di Indonesia dan perlu diuji keakuratan diagnosis yang dihasilkan untuk menghindari hasil negatif palsu. Pengujian dilakukan menggunakan protokol Penjaminan Mutu Eksternal (PME) Kementerian Kesehatan Indonesia dengan melibatkan 30 sampel uji dan membandingkan hasil uji terhadap kit gold standard CDC dengan gen target N1, N2, dan HRP. Alur kerja penelitian dimulai dari proses pengambilan sampel, ekstraksi RNA, persiapan mastermix, adisi template RNA, dan amplifikasi template dengan metode rRT-PCR. Hasil penelitian menunjukkan adanya amplifikasi pada kontrol yang digunakan, sehingga proses diagnosis dapat dilakukan. Nilai Ct IC kit Biocore dan IC CDC menunjukkan perbedaan signifikan (P 0,05; CI=95%). Gen target SARS-CoV-2 tidak terdeteksi pada kit Biocore dengan nilai Ct>35, serta didapatkan nilai sensitivitas dan spesifisitas analitik kit Biocore berturut-turut sebesar 75% dan 100%. Hasil uji Kit Biocore terhadap pasien terinfeksi COVID-19 di Indonesia tidak memenuhi standar kit diagnosis yang ditetapkan oleh WHO, yaitu memiliki sensitivitas analitik sebesar 95%. Peninjauan ulang primer pada kit Biocore perlu dilakukan untuk memperbaiki mutu kit dalam deteksi awal virus SARS-CoV-2 di Indonesia.

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The Coronavirus Disease 2019 (COVID-19) pandemic is a pandemic caused by the SARS-CoV-2 virus. Indonesia is known as one of the countries with the highest COVID-19 infection rate in the world. Real Time Reverse Transcription Polymerase Chain Reaction (rRT-PCR) detection is one of the steps needed to accelerate the spread of COVID-19. The BioCore 2019-nCoV Real Time PCR Kit is one of the COVID-19 diagnosis kits produced by BioCore. Ltd., South Korea. The BioCore diagnostic kit has been circulating in Indonesia and needs to be tested for the accuracy of the resulting diagnosis to avoid false negative results. The test was carried out using the External Quality Assurance (PME) protocol of the Indonesian Ministry of Health involving 30 test samples and test results against the CDC gold standard kit with target genes N1, N2, and HRP. The research workflow starts from the sampling process, RNA extraction, mastermix preparation, RNA template addition, and template amplification using the rRT-PCR method. The results showed that there was amplification of the controls used, so that the diagnosis process could be carried out. The Ct values ​​of the Biocore IC kit and the CDC IC showed a significant difference (P 0.05; CI=95%). The SARS-CoV-2 target gene was not detected in the Biocore kit with a Ct value>35, ​​and the sensitivity and analytical specificity of the Biocore kit were 75% and 100%, respectively. The results of the Biocore Kit test on patients infected with COVID-19 in Indonesia do not meet the diagnostic kit standard set by WHO, which has an analytical sensitivity of 95%. Primary review on the Biocore kit needs to be done to improve the quality of the kit in early detection of the SARS-CoV-2 virus in Indonesia."