Factors related to maternal mortality rate in covid-19 patients - a cross-sectional study from an Indonesian covid-19 referral hospital.

BACKGROUND: The covid-19 pandemic may cause severe clinical manifestations in a vulnerable population, such as pregnant women. Based on Indonesian Obstetrics and Gynecology Association (POGI), the number of maternal deaths due to covid-19 from April 2020 to April 2021 reached 3% and increased to 9% since the delta variant of covid-19 emerged. This research was expected to identify factors that are related to the mortality rate of pregnant women with covid-19. MATERIALS AND METHODS: This was a cross-sectional study using secondary data collected from June 2020 to August 2021. The study was conducted in Universitas Indonesia Hospital, a national covid-19 referral hospital. Patient characteristics, pregnancy profile, comorbidities, laboratory results, chest X-ray examination, treatment options, and the severity of symptoms were evaluated. In addition, bivariate data analysis was carried out using the SPSS device. RESULTS: Out of 114 research subjects, seven patients (6.1%) died, and 107 patients (93.9%) survived. The risk of mortality was significantly (P < 0.05) related to patients' age, duration of hospitalization, gestational age, severity rate of covid-19, the level of hemoglobin, leukocyte count, platelet count, lymphocytes, the levels of D-dimer, C-reactive protein, transaminase enzymes, urea, creatinine, eGFR, sodium, potassium, and procalcitonin. In addition, significant differences (P < 0.05) related to maternal mortality rate were also shown in the presence of comorbidities (type 2 diabetes, congestive heart failure, coronary artery disease/acute coronary syndrome, and urinary tract infection), and the use of steroids and tocilizumab. CONCLUSION: Various factors significantly related to the mortality rate of pregnant women with covid-19. This study may become the basis for a further study with a larger number of subjects, adjustment of assessment and management of covid-19 infected pregnant women, thus hopefully reducing the risk of mortality in pregnant women with covid-19.

Anaphylactic reaction as an etiology of ischemic stroke: A case report.

A 28-year-old man was brought to the emergency room (ER) with a history of decrease of consciousness 30 minutes before admission. In the previous 1 hour, the patient felt bitten or stabbed in the left temple area. Physical examination showed signs of N VII paresis, upper extremity motoric 3/2 (right/left) and lower extremity 3/2 (right/left), positive left extremity hypesthesia. Noncontrast MRI brain examination showed increased DWI signal intensity, suggesting diffusion restriction in bilateral centrum semiovale, bilateral posterior crus internal capsule, and bilateral corpus callosum leading to suspicion of acute-hyperacute ischemia. The therapy given while in the emergency room was IVFD asering, IV dexamethasone 5 mg, IV diphenhydramine 10 mg, oral paracetamol 500 mg, oral aspirin 80 mg, oral clopidogrel 75 mg, and oral atorvastatin 40 mg. We report a case of stroke due to an anaphylactic reaction in an effort to add to the point of view if the same case occurs.

Ischemic stroke in COVID-19 patients: a cross-sectional study from an Indonesian COVID-19 referral hospital.

Background: COVID-19 increases the risk of acute ischemic stroke. The objective of this study is to identify the risk factors, comorbidities, and outcomes in COVID-19 patients with acute ischemic stroke at University of Indonesia Hospital. Results: The clinical condition of COVID-19 patients with ischemic stroke is more severe for patients older than 55 years (p < 0.05), patients at the critical COVID-19 clinical stage, and patients with atrial fibrillation (p < 0.05). The level of C-reactive protein (CRP) more than 60 mg/L correlated with the outcome of the patient as well. Conclusion: The study concluded that, age, COVID-19 clinical degree, and atrial fibrillation significantly affect the outcome in COVID-19 patients with stroke.

Surveillance of Adverse Events Following Immunization (AEFI) after Third Dose Booster Vaccination with mRNA-Based Vaccine in Universitas Indonesia Hospital Health Personnel.

Facing the rising cases of with higher fatalities COVID-19, some countries decided to give the third dose of vaccine as a booster. As of 9 January 2022, 90.31% of health workers in Indonesia have received the third dose vaccine. This study aims to provide an evaluation of adverse events following immunization (AEFI) in a single center in Indonesia to form a basis for ensuring safety for booster administration nationally. A retrospective, cross-sectional study was conducted using an online survey. Demographic data, AEFI complaints, and factors influencing AEFIs were evaluated. In this study, there were a total of 311 subjects were gathered. The most common AEFI symptoms found at onset <24 h to 28 days were pain at the injection site, fever, shoulder pain, and headache. Most of the AEFI severity of <24 h to 28 days post-vaccination was grade 1 (reduced or uninterrupted daily activities). There was a significant correlation between AEFI and several factors, such as the history of drug allergy, exercise after vaccination, age, BMI < 25, history of symptoms after the first and second vaccinations, and history of COVID-19. There was no anaphylactic reaction in this study. Several AEFI should be considered for the third dose of COVID-19 vaccine administration.

Factors Affecting the Self-Isolation Monitoring Program for COVID-19 Patients at the Universitas Indonesia Hospital.

When the outbreak of the COVID-19 delta variant occurred in June 2021, there was a marked increase in Indonesia's number of self-isolated patients. The Universitas Indonesia Hospital provided a One-Stop Service (OSS) to monitor COVID-19 patients on self-isolation. This study was conducted to determine the effectiveness of the self-isolation monitoring performed by hospitals and the factors that determined the outcomes of patients on self-isolation. This study was conducted using a cross-sectional method based on secondary data from electronic medical records. Data analysis was performed by determining the relationship of patient risk factors and characteristics with COVID-19 outcomes. The study found that poorer symptoms, administration of antibiotics, absence of shortness of breath, and normal ALT levels significantly improved the outcome of OSS patients. The study also suggested that during monitoring of patients on COVID-19 self-isolation, chest/thorax radiography is necessary. The self-isolation monitoring program is essential to observe the patient's condition and evaluate the possibility of deteriorating conditions that could lead to admission decisions in the early or middle stages of the program. This will be beneficial during pandemic emergencies.

Evaluation of SARS-CoV-2 Antibody Response Post Third Dose COVID-19 mRNA Vaccination at Universitas Indonesia Hospital.

OBJECTIVE: The longevity of vaccine effectiveness and antibody titer after the Moderna mRNA COVID-19 vaccination booster in healthcare workers in Indonesia is not known. MATERIALS AND METHODS: We performed a prospective observational study of healthcare workers at the Universitas Indonesia Hospital after Moderna mRNA COVID-19 booster vaccination. An Immunology Analyzer with Chemiluminescence Immunoassay (CLIA) test was used to examine Anti SARS-CoV-2 S-RBD levels. Antibody levels were classified into two systems (3 categories, and 2 categories). RESULTS: There were 31 male subjects (75.6%), 33 subjects (80.5%) aged 25-39 years, 17 subjects (41.5%) with overweight BMI, 35 subjects (85.4%) without comorbidities, and 29 subjects without previous history of COVID-19 infection (70.7%) who had antibody titer >1000 AU/ml. There were 27 subjects (65.9%) who had a booster shot ≥6 months after the second vaccination with antibody titer >1000 AU/ml. In this study, there was no significant correlation between antibody titer with factors such as gender, age, BMI, comorbidities, history of COVID-19 infection and time between the 2nd vaccination and booster vaccination. CONCLUSION: There is no significant correlation between antibody titer with factors such as gender, age, BMI, comorbidities, history of COVID-19 infection and time between the 2nd vaccination and booster vaccination.