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"[ABSTRAKLatar Belakang: Major adverse cardiac events (MACE) merupakan komplikasi serius pada pasien pasca sindrom koroner akut (SKA) sehingga perlu suatu metode yang andal dalam memprediksi kejadiannya. Heart rate variability (HRV) yang menggambarkan ketidakseimbangan sistem otonom pasca SKA dan dapat dilakukan dengan cara yang lebih cepat, mudah, dan praktis berpotensi dapat digunakan sebagai alat stratifikasi risiko MACE.Tujuan: Mengetahui kemampuan HRV awal perawatan yang diukur melalui metode pulse photoplethysmograph (PPG) dalam memprediksi MACE pada pasien pasca SKA yang dirawat di intensive cardiac care unit (ICCU).Metode: Studi ini adalah studi kohort prospektif dengan subjek pasien SKA yang menjalani perawatan di ICCU. Pemeriksaan HRV dilakukan dengan metode PPG dalam 48 jam pasca diagnosis SKA dan adanya MACE dideteksi selama perawatan di ICCU. Komplikasi yang digolongkan sebagai MACE adalah kematian, aritmia fatal, gagal jantung, syok kardiogenik, re-infark, dan komplikasi mekanik. Kemampuan HRV dalam memprediksi MACE dinyatakan melalui AUC (+IK95%) dan untuk parameter yang memiliki kemampuan prediksi baik akan dihitung nilai prediksi positif (PPV) dan nilai prediksi negatif (NPV) beserta IK95% parameter tersebut.Hasil: Sebanyak 75 subjek SKA menjalani pengukuran HRV < 48 jam pasca diagnosis dan sebanyak 18,7% di antaranya mengalami MACE. Parameter LF dengan AUC 0,697 (0,543-0,850) dan rasio LF/HF dengan AUC 0,851 (0,741-0,962) memiliki kemampuan diskriminasi MACE yang paling baik. Parameter LF pada titik potong 89,673 memiliki PPV dan NPV sebesar 13% dan 71%, sedangkan rasio LF/HF pada titik potong 1,718 sebesar 6% dan 50%.Kesimpulan: Variabel LF dan rasio LF/HF merupakan parameter HRV yang dinilai memiliki kemampuan diskriminasi cukup baik terhadap MACE. Kedua variabel tersebut memiliki nilai prediksi negatif sehingga dapat digunakan untuk menyingkirkan kemungkinan terjadinya MACE pada mereka dengan nilai LF > 89,673 dan rasio LF/HR > 1,718.

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ABSTRACTIntroduction: Major adverse cardiac events (MACE) are serious complications needed to be predicted rapidly and accurately in acute coronary syndrome (ACS) patients. Heart rate variability (HRV), reflecting autonomic system imbalance post ACS, is currently available in quick, easy, and practical method. This parameter has potential to be used in MACE risk stratification.Aim: To find the ability of HRV measurement with pulse photoplethysmograph (PPG) method in predicting MACE in post ACS patients hospitalized in intensive cardiac care unit (ICCU).Method: This study is a prospective study using ACS patients in ICCU as its subjects. Measurement of HRV by means of PPG is conducted within 48 hours post diagnosis and the incidence of MACE is identified during ICCU stay. Events classified as MACE are including death, lethal arrhytmia, heart failure, cardiogenic shock, re-infarction, and other mechanical complications. The ability of HRV in predicting MACE was listed as AUC (+95%CI) and for specific HRV parameters which had adequate capability, positive predictive value (PPV) and negative predictive value (NPV) would be calculated.Result: HRV measurements were done in 75 ACS subjects < 48 h post-diagnosis. Among the subjects, 18,7% suffered from MACE. Measurement of LF with AUC 0,697 (0,543-0,850) and LF/HF ratio with AUC 0,851 (0,741-0,962) had the best discrimination values. The former variable had PPV and NPV of 13% and 71% in the cutoff point of 89,673, while the latter had the number of 6% and 50% in the cutoff point of 1,718, respectively.Conclusion: LF and LF/HF ratio are the only HRV variables having adequate MACE discrimination. Both variables have better NPV so that they can be applied in reducing MACE risk in patients with LF > 89,673 and LF/HF ratio > 1,718.;Introduction: Major adverse cardiac events (MACE) are serious complications needed to be predicted rapidly and accurately in acute coronary syndrome (ACS) patients. Heart rate variability (HRV), reflecting autonomic system imbalance post ACS, is currently available in quick, easy, and practical method. This parameter has potential to be used in MACE risk stratification.Aim: To find the ability of HRV measurement with pulse photoplethysmograph (PPG) method in predicting MACE in post ACS patients hospitalized in intensive cardiac care unit (ICCU).Method: This study is a prospective study using ACS patients in ICCU as its subjects. Measurement of HRV by means of PPG is conducted within 48 hours post diagnosis and the incidence of MACE is identified during ICCU stay. Events classified as MACE are including death, lethal arrhytmia, heart failure, cardiogenic shock, re-infarction, and other mechanical complications. The ability of HRV in predicting MACE was listed as AUC (+95%CI) and for specific HRV parameters which had adequate capability, positive predictive value (PPV) and negative predictive value (NPV) would be calculated.Result: HRV measurements were done in 75 ACS subjects < 48 h post-diagnosis. Among the subjects, 18,7% suffered from MACE. Measurement of LF with AUC 0,697 (0,543-0,850) and LF/HF ratio with AUC 0,851 (0,741-0,962) had the best discrimination values. The former variable had PPV and NPV of 13% and 71% in the cutoff point of 89,673, while the latter had the number of 6% and 50% in the cutoff point of 1,718, respectively.Conclusion: LF and LF/HF ratio are the only HRV variables having adequate MACE discrimination. Both variables have better NPV so that they can be applied in reducing MACE risk in patients with LF > 89,673 and LF/HF ratio > 1,718., Introduction: Major adverse cardiac events (MACE) are serious complications needed to be predicted rapidly and accurately in acute coronary syndrome (ACS) patients. Heart rate variability (HRV), reflecting autonomic system imbalance post ACS, is currently available in quick, easy, and practical method. This parameter has potential to be used in MACE risk stratification.Aim: To find the ability of HRV measurement with pulse photoplethysmograph (PPG) method in predicting MACE in post ACS patients hospitalized in intensive cardiac care unit (ICCU).Method: This study is a prospective study using ACS patients in ICCU as its subjects. Measurement of HRV by means of PPG is conducted within 48 hours post diagnosis and the incidence of MACE is identified during ICCU stay. Events classified as MACE are including death, lethal arrhytmia, heart failure, cardiogenic shock, re-infarction, and other mechanical complications. The ability of HRV in predicting MACE was listed as AUC (+95%CI) and for specific HRV parameters which had adequate capability, positive predictive value (PPV) and negative predictive value (NPV) would be calculated.Result: HRV measurements were done in 75 ACS subjects < 48 h post-diagnosis. Among the subjects, 18,7% suffered from MACE. Measurement of LF with AUC 0,697 (0,543-0,850) and LF/HF ratio with AUC 0,851 (0,741-0,962) had the best discrimination values. The former variable had PPV and NPV of 13% and 71% in the cutoff point of 89,673, while the latter had the number of 6% and 50% in the cutoff point of 1,718, respectively.Conclusion: LF and LF/HF ratio are the only HRV variables having adequate MACE discrimination. Both variables have better NPV so that they can be applied in reducing MACE risk in patients with LF > 89,673 and LF/HF ratio > 1,718.]"

"Latar Belakang: Angka harapan hidup yang meningkat menyebabkan peningkatan populasi usia lanjut termasuk populasi usia lanjut dengan penyakit jantung koroner. Frailty sering ditemukan pada pasien usia lanjut dengan penyakit kardiovaskular dan keberadaan frailty sangat mempengaruhi prognosis penyakit jantung koroner pada pasien usia lanjut termasuk luaran terhadap intervensi revaskularisasi. Percutaneous Coronary Intervention (PCI) adalah salah satu metode revaskularisasi dan belum banyak penelitian yang dilakukan terkait pengaruh frailty terhadap luaran pasien usia lanjut yang menjalani PCI elektif. Tujuan: Penelitian ini dilakukan untuk mendapatkan proporsi frailty, insidensi Major Adverse Cardiovascular Events (MACE) 30 hari dan mengkaji peran frailty terhadap prognosis pasien usia lanjut dengan penyakit jantung koroner yang menjalani PCI elektif. Metode: Secara prospektif dilakukan penilaian terhadap kondisi frailty pasien usia lanjut dengan penyakit jantung koroner yang menjalani PCI elektif di RS Cipto Mangunkusumo dengan menggunakan kriteria Frailty Phenotipe. Pasien kemudian di follow-up selama 30 hari setelah tindakan PCI elektif untuk melihat apakah MACE terjadi atau tidak. Hasil: Terdapat 100 pasien usia lanjut dengan penyakit jantung koroner yang menjalani PCI elektif dari bulan September 2014 - Juni 2015. Usia rata-rata pasien adalah 66.95 tahun (SD = 4.875) dengan pasien terbanyak adalah laki-laki (69%). Sebanyak 61% pasien termasuk ke dalam kelompok frail. MACE terjadi pada 8.19% pasien pada kelompok frail dan 5.12% pada kelompok non-frail. Hubungan frailty terhadap MACE dapat dilihat dari hasil crude Hazard Ratio (HR) 1.6 (IK 95% 0.31-8.24). Pada penelitian ini, kesintasan 30 hari 95% pada kelompok frail, sementara pada kelompok non-frail kesintasan 30 hari adalah sebesar 98%. Kesimpulan: Terdapat peningkatan risiko 1.6 kali untuk terjadinya MACE 30 hari pada subyek usia lanjut frail yang menjalani PCI elektif namun belum bermakna secara statistik.

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Background: The increase in life expectancy caused the increase in elderly population including the population of elderly with Coronary Artery Disease. Frailty is commonly found in elderly patients with cardiovascular disease and frailty had a major influence in determining the prognosis of cardiovascular disease in elderly including the outcome of revascularization intervention. PCI (Percutaneous Coronary Intervention) is one method of revascularization. However, frailty research on the effect on the outcome of elderly patients with coronary artery disease undergoing PCI is still limited.

Aim: To get the proportion of frailty and 30 days Major Adverse Cardiovascular Events (MACE) incidence, and to review impact of frailty in elderly patients with coronary heart disease who underwent elective PCI.

Method: The frailty condition of the elderly patients with coronary artery disease that underwent elective PCI in Cipto Mangunkusumo Hospital was assessed with the Frailty Phenotype criteria. After the patients underwent the elective PCI, they were followed for 30 days to see whether MACE occurred or not.

Result: There are 100 elderly patients with coronary artery disease that underwent elective PCI from September, 2014 until June, 2015. The mean age of patients is 66.95 ± 4.875 years and 69% of the patients were males. Frail was present in 61% of the patients. MACE were occurred in 8.19% of frail patients and 5.12% were occurred in non-frail patients. The correlation between frailty and MACE could be seen in the result of crude HR 1.6 (CI 95% 0.31-8.24). In this research, the 30 days survival rate is 95% in frail patients and 98% in non-frail patients.

Conclusion: There is a 1.6 fold increased risk of 30 days MACE in elderly frail patients that underwent elective PCI but it is not statistically significant."

"Latar Belakang : Implantasi pacu jantung permanen telah menjadi prosedur umum saat ini. Tujuan tindakan pemasangan pacu jantung permanen tidak lagi hanya sebatas morbiditas dan mortalitas, tetapi juga kualitas hidup. Dalam menilai kualitas hidup dibutuhkan kuesioner yang dapat merubah sesuatu yang kualitatif menjadi data kuantitatif. Kuesioner kualitas hidup yang ada saat ini belum ada yang berbahasa Indonesia. Untuk dapat digunakan dalam menilai kualitas hidup di Indonesia perlu adaptasi bahasa dan budaya. Selain itu, kuesioner terjemahan tersebut harus memiliki validitas dan reliabilitas yang baik. Metode : Studi ini adalah studi cross sectional yang terbagi dalam 2 tahap. Tahap awal berupa adaptasi bahasa dan budaya untuk dapat menghasilkan kuesioner SF-36 dan Aquarel berbahasa Indonesia. Tahap akhir berupa uji validitas dan reliabilitas kuesioner SF-36 dan Kuesioner Aquarel. Subjek berjumlah 30 orang pada tahap awal, dan 20 orang pada tahap akhir. Subjek merupakan pasien dengan pacu jantung permanen, yang kemudian akan dilakukan Tes Jalan 6 Menit (6MWT) dan pemeriksaan NT pro-BNP. Validitas SF-36 dinilai berdasarkan nilai korelasi Kuesioner dengan pemeriksaan penunjang, dan validitas Aquarel dinilai berdasarkan nilai korelasi kuesioner Aquarel dengan Kuesioner SF-36, dan korelasi kuesioner dengan pemeriksaan penunjang. Reliabilitas kuesioner dinilai berdasarkan konsistensi internal dan repeatabilitas. Hasil : Kuesioner SF-36 berbahasa Indonesia memiliki korelasi positif antara 6MWT dengan domain PF (Physical Functioning) (r= 0,363; p=0,001), dan memiliki korelasi negatif antara NT Pro-BNP dengan domain GH (General Health) (r= 0,269; p = 0,020) dan MH (Mental Health) (r= -0,271; p = 0,019). Kuesioner Aquarel berbahasa Indonesia memiliki korelasi positif antara 6MWT dengan domain dyspneu (r=0,228; p=0,048), dan memiliki korelasi negatif antara NT proBNP dengan Domain Chest Discomfort (r = -0.231; p = 0.043) dan Dyspneu (r = 0.268; p = 0.020). Kedua kuesioner SF-36 berbahasa Indonesia (Cronbach α = 0.789) dan Aquarel berbahasa Indonesia (Cronbach α = 0.728) memiliki reliabilitas dan repeatabilitas yang baik. Kesimpulan : Pada proses adaptasi bahasa dan budaya tidak terdapat modifikasi yang berarti pada kedua kuesioner dan dapat diterima baik oleh pasien. Kuesioner SF-36 berbahasa Indonesia dan Kuesioner Aquarel berbahasa Indonesia bersifat valid dan reliable.

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acemaker implantation has became common procedure in the last decades. The goal of our therapy was no longer about morbidity and mortality, but quality of life. In assessing the quality of life, we need a questionnaire that can change qualitative value to quantitative value. There is no quality of life questionnaires in Bahasa Indonesia, therefore we need language and cultural adaptation before we can use it in Indonesia. Moreover the translation questionnaire must has good validity and good reliability. We choose SF-36 as generic health related quality of life (HRQoL), as it is the most popular HRQoL questionnaire. Specifically for pacemaker patients, we choose Aquarel Questionnaire. Methods : This cross sectional study was divided into 2 steps. The first step was language and cultural adaptation to create SF-36 and Aquarel questionnaire in Bahasa Indonesia. The final step was validation and reliability test of the translated questionnaire. The subjects were 30 people for the first step , and 20 people for the final step. All the subject were patient with permanent pacemaker. We also conduct two diagnostic tests (6 Minutes Walk Test (6MWT) and NT pro-BNP). SF-36 validity was assessed by its correlation with diagnostic tests, and Aquarel validity was assessed by its correlation with SF-36 and with The diagnostic tests. Both questionnaire reliability assessed by its Internal consistency and repeatability. Results : Our indonesian version of SF-36 shows positive correlation between 6MWT and PF (Physical Functioning) ( r = 0.363 ; p = 0.001) and negative correlation between NT Pro-BNP value with GH (General Health) (r = -0.269; p = 0.020) and MH (Mental Health) (r = -0.271; p = 0.019). Our Indonesian version of Aquarel shows positive correlation between 6MWT with Dyspneu domain ( r = 0.228 ; p = 0.048 ) and shows negative correlation between NT Pro-BNP with Chest Discomfort (r = -0.231; p = 0.043) and Dyspneu (r = -0.268; p = 0.020). Both the Indonesian SF-36 (Cronbach ? = 0.789) and the Indonesian Aquarel (Cronbach ? = 0.728) shows good reliability and repeatability. Conclusions : We succed doing language and cultural adaptation of SF-36 and Aquarel questionnaire. Both Indonesian version questionnaire are valid and reliable ."

"Latar Belakang: Reaktivasi CMV pasca transplantasi ginjal 3 bulan pertama 40-80% dan 20-50% menjadi penyakit CMV. Pencegahan pasca transplantasi dapat dilakukan dengan terapi preemptive saat terjadi reaktivasi CMV yang ditandai dengan DNA CMV >500 kopi/mL. Di Indonesia belum ada pemeriksaan DNA CMV, sebaliknya pemeriksaan IgG CMV tersedia di seluruh daerah, mudah dan murah. Tujuan: Untuk mengetahui insidens reaktivasi CMV pada resipien seropositif 3 bulan pertama pasca transplantasi ginjal, mengetahui korelasi antara DNA CMV dengan peningkatan titer IgG CMV, dan cutoff point titer IgG CMV saat reaktivasi. Metode: Penelitian ini kohort prospektif 3 bulan. Uji korelasi DNA CMV dengan peningkatan IgG CMV menggunakan uji korelasi Spearman’s rho. Penentuan cutoff point terbaik IgG CMV menggunakan kurva ROC dengan menilai AUC. Hasil: Jumlah subyek penelitian 23 resipien seropositif CMV. Reaktivasi pertama pada minggu ke-4 pasca transplantasi (2 orang), diikuti minggu ke-6 (4 orang) dan ke-10 (3 orang), sehingga keseluruhan 9 orang (39%). Dua (22,2%) orang meninggal karena penyakit CMV, dan 7 (77,8%) orang tanpa tanda/keluhan klinis CMV dengan kreatinin serum 1,19 (SB 0,29) mg/dL serta eGFR 69,99 (SB 19,92) mL/menit/1,73 m2. Korelasi positif antara DNA CMV dengan IgG CMV ditemukan bermakna mulai minggu ke-8 (r=0,70 p <0,001), minggu ke-10 (r=0,83 p <0,001) dan minggu ke-12 (r=0,72 p <0,001), dengan peningkatan minimal 2 kali. Cutoff point titer IgG CMV terbaik pada minggu ke-10, yaitu 401,4 AU/dL (sensitivitas 88,9 %, spesifisitas 92,9%), Pada minggu ke-8 dan ke-12 juga diperoleh AUC yang baik untuk ditetapkan nilai cutoff point titer IgG CMV, yaitu berturut-turut 502,7 AU/dL (sensitivitas 83,3 %, spesifisitas 94,1%) dan 679,35 AU/dL (sensitivitas 81,9 %, spesifisitas 90,8%). Kesimpulan: Insidens reaktivasi pada resipien seropositif pasca transplantasi ginjal 3 bulan pertama adalah 39%. Terdapat korelasi positif yang bermakna antara DNA CMV kuantitatif dengan peningkatan minimal 2 kali titer IgG CMV pada resipien seropositif mulai pada minggu ke-8 pasca transplantasi ginjal; dengan cutoff point terbaik titer IgG CMV pada minggu ke-10.

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Background: Reactivation of CMV in the first 3 month after kidney transplantation reached 40-80%, and 20-50% developed to CMV disease. CMV reactivation in seropositive recipients are prevented by pre-emptive therapy, when CMV DNA >500 copy/mL. Indonesia hasn’t performed CMV DNA real-time routinely, however do measuring CMV antibody-IgG because it is simple, cheap and available.

Objective: to determine the incidence of CMV reactivation in seropositive recipients, identify correlation between quantitative CMV DNA with increasing CMV antibody-IgG titre, and determine CMV antibody-IgG cutoff point when reactivation.

Methods: prospective cohort study for 3 months. Using Spearman‘s rho test to correlate CMV DNA and CMV antibody-IgG, and using ROC curve to identify AUC to decide the best cutoff point of CMV antibody-IgG.

Results: All of subject is 23 seropositive recipients. The first reactivation on 4th week after transplantation (2 persons), followed on 6th week (4 persons) and on 10th week (3 persons), so the total is 9 recipients (39%). Two (22,2%) recipients died due to sepsis, and 7 (77,8%) recipients is healthy without signs/symptoms of CMV infection. Their serum creatinin is 1,19 (SB 0,29) mg/dL and eGFR 69,99 (SB 19,92) mL/menit/1,73 m2. There was positive correlation between CMV DNA with CMV antibody-IgG on the 8th week (r=0,70 p <0,001), on the10th week (r=0,83 p <0,001) and on the 12th week (r=0,72 p <0,001), with double increasing of antibody IgG titre. The best of antibody IgG cutoff point was on the 10th week (401,4 AU/dL, sensitivity 88,9 %, specifity 92,9%). On 8th and 12th week was found a good antibody IgG cutoff point titre too, respectively 502,7 AU/dL (sensitivity 83,3 %, specifity 94,1%) and 679,35 AU/dL (sensitivity 81,9 %, specifity 90,8%).

Conclusion: Incidence of reactivation in seropositive recipients after kidney transplantation was 39%. There was positive correlation between quantitative CMV DNA with double increasing of CMV antibody-IgG titre started from 8th week after transplantation. The best cutoff point was on 10th week."

"Latar Belakang : Angka kejadian depresi tinggi pada individu yang menderita penyakit kronik, termasuk asma bronkial, dengan prevalensi depresi hampir 50% pada pasien yang berobat di pelayanan tertier klinik asma. Tumor Necrosis Factor-Alpha (TNF-α) telah diketahui sebagai sitokin pro-inflamasi yang berperan penting dalam mekanisme patogenesis sejumlah penyakit inflamasi kronik, termasuk asma bronkial dan depresi. Belum ada data penelitian mengenai hal tersebut di Indonesia. Tujuan : Mengetahui korelasi depresi dengan kadar TNF-α pada penderita asma bronkial tidak terkontrol. Metode : Penelitian ini merupakan studi cross sectional dilakukan pada 40 pasien asma bronkial tidak terkontrol di poliklinik alergi imunologi klinik unit rawat jalan RSUP Moh Hoesin Palembang selama kurun waktu mulai bulan Juni 2014 sampai dengan Agustus 2014. Asma bronkial tidak terkontrol dinilai mempergunakan kuisioner Asthma Control Test (ACT), sedangkan gejala depresi dinilai dengan kuisioner Beck Depression Inventory (BDI), dan dikonfirmasi diagnosis depresi dengan kriteria dari Diagnostic and Statistical Manual for Psychiatry-IV Text Revision (DSM-IV TR) / International Code Diagnose 10 (ICD-10). Kadar TNF-α serum diukur dengan metode kuantitatif enzyme-linked immunosorbent assay (ELISA). Hasil : Nilai median skor depresi dan kadar TNF-α serum pada penelitian ini adalah 16 (10 – 45) dan 4,09 (1,29 – 19,57) pg/mL. Tidak didapatkan korelasi bermakna antara depresi dan kadar TNF-α (r = -0,265, p = 0,098). Kesimpulan : Tidak didapatkan korelasi yang bermakna antara depresi dengan kadar TNF-α pada penderita asma bronkial tidak terkontrol.

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Background : Depression occurs at high rates in people with chronic diseases, including bronchial asthma, with the prevalence of depression approaching 50% in patients treated in tertiary care asthma clinic. Tumor necrosis factor alpha (TNF-α) is known to play a critical role in the pathogenic mechanism of a number of chronic inflammatory disease, including bronchial asthma and depression. There has not been any research data on the subject in Indonesia.

Aim : The objective of this study was to investigate the correlation between depression and TNF-α level in uncontrolled bronchial asthma.

Method : This study was a cross sectional study conducted in 40 patients with uncontrolled bronchial asthma at the allergy immunology clinic outpatient of Dr Moh Hoesin Hospital Palembang, during June 2014 until August 2014. Uncontrolled bronchial asthma assessed using the Asthma Control Test (ACT) questionnaire, whereas depressive symptoms assessed by Beck Depression Inventory (BDI) questionnaire, and confirmed the diagnose of depression by the criteria of the Diagnostic and Statistical Manual for Psychiatry-IV Text Revision (DSM-IV TR) / International Code Diagnose 10 (ICD-10). Serum levels of TNF-α was measured by the method of quantitative enzyme-linked immunosorbent assay ( ELISA ).

Result : The median value of the score of depression and serum TNF- α level in this study were 16 (10 - 45) and 4.09 (1.29 - 19.57) pg/mL. There was no significant correlation between depression and TNF-α level (r = -0.265, p = 0.098).

Conclusion : There was no significant correlation between depression and TNF-α level in uncontrolled bronchial asthma."

"Latar Belakang: COVID-19 dapat menimbulkan konsekuensi kesehatan jangka panjang yang serius, yang disebut Post-COVID-19 Syndrome (SPC). Saat ini, bukti dan pemahaman yang tersedia tentang manajemen SPC masih terbatas. Oleh karena salah satu gejala SPC dikaitkan dengan gejala psikis, maka psikoterapi dipercaya memiliki peran dalam penatalaksanaan SPC. Tujuan: Mengetahui efektivitas psikoterapi suportif pada pasien SPC di RSUPN dr. Cipto Mangunkusumo. Metode: Penelitian ini merupakan penelitian klinis acak tersamar tunggal menggunakan kontrol sebelum-setelah intervensi. Peserta secara acak dibagi menjadi dua kelompok: kelompok psikoterapi yang terdiri dari 40 peserta dan kelompok edukasi yang terdiri dari 37 peserta. Setiap kelompok diberikan psikoterapi atau edukasi berbasis internet tiga kali seminggu dalam bentuk kelompok yang terdiri dari 6-8 peserta. Kuesioner Symptom Checklist-90 digunakan untuk mengevaluasi gejala psikis dan somatik. Variabilitas Denyut Jantung (VDJ) dan Rasio Limfosit Neutrofil (RNL) juga dinilai. Analisis data dilakukan dengan menggunakan uji Mann-Whitney atau uji T tidak berpasangan. Hasil: Perbaikan skor SCL-90 ditemukan sebesar 17,51 (SD 30,52) pada kelompok psikoterapi dan 19,79 (SD 35,11) pada kelompok edukasi (p = 0,771). Baik psikoterapi maupun edukasi meningkatkan RNL sebanyak 0,03 (IQR -0,17 – 0,27) pada kelompok psikoterapi dan 0,085 (IQR -0,385 – 0,41) pada kelompok edukasi (p = 0,534). Baik psikoterapi maupun edukasi juga menurunkan VDJ sebesar 3,83 (RIK -7,245 – 5,605) pada kelompok psikoterapi dan 0,705 (RIK -6,49 – 4,462) pada kelompok edukasi (p = 0,827). Simpulan: Baik psikoterapi suportif kelompok dan edukasi berbasis internet memperbaiki secara bermakna gejala psikis dan somatik pasien SPC, meskipun tidak didapatkan perbedaan bermakna antara kelompok psikoterapi dan edukasi. Baik psikoterapi suportif kelompok dan edukasi berbasis internet tidak memperbaiki RNL dan VDJ. Saran dilakukan penelitian lebih lanjut dengan melakukan penambahan frekuensi sesi psikoterapi kelompok berbasis internet kepada pasien SPC dan dilaksanakan pada pagi hari untuk mencapai hasil yang lebih optimal.

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Background: COVID-19 can have serious long term health consequences, which is called Post-COVID-19 Syndrome (PCS). Currently, the available evidence and understanding of PCS management is limited. Because one of the symptoms of PCS is associated to psychological symptoms, psychotherapy is believed to have a role in the management of PCS. Objective: To identify the effectiveness of supportive psychotherapy in PCS patients at Cipto Mangunkusumo National General Hospital. Methods: This study was a single blind randomized clinical trial using a pre-and post-test with control group study design. Participants were randomly divided into two groups: a psychotherapy group with 40 participants and an education group with 37 participants. Each group was given internet-based psychotherapy or education three times a week in a form of group consisting of 6-8 participants. Symptom Checklist-90 questionnaire was used to evaluate somatic and psychological symptoms. Heart rate variability and neutrophil lymphocyte ratio were also investigated. Data analysis was performed using either the Mann-Whitney test or the independent T test. Results: An improvement in the SCL-90 score was found to be 17.51 (SD 30.52) in the psychotherapy group and 19.79 (SD 35.11) in the education group (p = 0.771). Both psychotherapy and education increased NLR by 0.03 (IQR -0.17 – 0.27) in the psychotherapy group and 0.085 (IQR -0.385 – 0.41) in the education group (p = 0.534). Both psychotherapy and education also decreased HRV by 3.83 (RIK -7.245 – 5.605) in the psychotherapy group and 0.705 (RIK -6.49 – 4.462) in the education group (p = 0.827). Conclusion: Both internet-based group supportive psychotherapy and education improved psychological and somatic symptoms in PCS patients, although there was no significant difference between supportive psychotherapy and education groups. Both internet-based group supportive psychotherapy and education did not improve NLR and HRV. Suggestions for further research regarding adding frequency of internet-based group psychotherapy in PCS patients and held in the morning to achieve more optimal results."