Post COVID-19 Syndrome Monitoring in Confirmed COVID-19 Patients with Telemedicine at Cipto Mangunkusumo Hospital.

BACKGROUND: The incidence of post-covid-19 syndrome is quite high and requires further monitoring after the patient is discharged from treatment. So we need a proper monitoring method and description of the Covid-19 syndrome in Indonesia.  Methods: This retrospective cohort study with total sampling method uses data from medical records and telemedicine observations of confirmed COVID-19 patients who received treatment in the Kiara room at Cipto Mangunkusumo. The data were then analyzed using chi-squared and multinomial logistic regression techniques. RESULTS: A total of 133 samples were used, including 44.4% male and 55.6% female, with an average age Standard Deviation (SD) of 40.36 (17.94). The severity levels of Covid-19 were mild (66.9%). The most common post-Covid-19 symptom manifestations was cough expressed at the first follow-up (first week after recovery) and second follow-up (the fourth week after recovery). Furthermore, the significant relationship between severity levels and post-Covid-19 symptomatic syndrome outcomes is the critical headache or vertigo symptoms with an RR of 8.70 (95% CI, 1.10-68.69,). In comparison, the telemedicine quality assessment was declared good, as shown by 98.7% of an examined sample. CONCLUSION: The most manifestation shown in the first and fourth week of follow-up is cough. Other symptoms tend to decrease in the second follow-up. The severity level associated with post-Covid-19 manifestations are severe-critical with headache or vertigo as a risk factor and mild with symptoms of headache or vertigo as a preventative. Meanwhile, the quality of telemedicine services was recognized as good by the majority of the sample.

Prognostic Scoring System for Mortality of Hospitalized COVID-19 Patients in Resource-Limited Settings: A Multicenter Study from COVID-19 Referral Hospitals.

BACKGROUND: Many studies identified the risk factors and prognostic factors related to in-hospital COVID-19 mortality using sophisticated laboratory tests. Cost and the availability of supporting blood tests may be problematic in resource-limited settings. This multicenter cohort study was conducted to assess the factors associated with mortality of COVID-19 patients aged 18 years and older, based on history taking, physical examination, and simple blood tests to be used in resource-limited settings. METHODS: The study was conducted between July 2020 and January 2021 in five COVID-19 referral hospitals in Indonesia. Among 1048 confirmed cases of COVID-19, 160 (15%) died during hospitalization. RESULTS: Multivariate analysis showed eight predictors of in-hospital mortality, namely increased age, chronic kidney disease, chronic obstructive pulmonary disease, fatigue, dyspnea, altered mental status, neutrophil-lymphocyte ratio (NLR) ≥ 5.8, and severe-critical condition. This scoring system had an Area-under-the-curve (AUC) of 84.7%. With cut-off score of 6, the sensitivity was 76.3% and the specificity was 78.2%. CONCLUSION: The result of this practical prognostic scoring system may be a guide to decision making of physicians and help in the education of family members related to the possible outcome.