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Putri Aisyah
"Latar Belakang: The Coronavirus disease 2019 (COVID-19) merupakan infeksi oleh severe acute respiratory syndrome Coronavirus 2 (SARS-COV-2) yang menjadi perhatian internasional pada Januari 2020. Manifestasi kasus ringan terjadi sekitar 81%, kasus berat sebanyak 14%. Mortalitas akibat pneumonia COVID-19 meningkat secara global akibat transmisi cepat dan gejala awal yang atipikal. Usia ≥ 60 tahun, jenis kelamin laki-laki dan komorbiditas merupakan faktor risiko untuk menjadi berat dan kematian sehingga dibutuhkan kontrol ketat pada pasien berisiko.
Metode Penelitian: Penelitian ini merupakan penelitian retrospektif dengan studi potong lintang. Sampel penelitian merupakan pasien yang datang ke IGD dan terkonfirmasi pneumonia COVID-19 yang masuk dalam kriteria inklusi. Sampel pada penelitian ini adalah sebanyak 299 pasien.
Hasil Penelitian: Pada penelitian ini didapatkan subjek penelitian adalah 299 dari 336 pasien yang masuk dalam kriteria inklusi. Jenis kelamin laki-laki sebanyak 162 orang (54,18%), nilai IMT obesitas I (29,77%) dan diikuti IMT normal (28,76%), paling banyak tidak memiliki komorbid dengan derajat pneumonia berat (60,2%) dan luaran pasien sebanyak 69,2% adalah hidup. Komorbid terbanyak yaitu hipertensi (30,77%), Diabetes mellitus (24%) dan kardiovaskular (14%). Usia median hidup pasien pneumonia COVID-19 di RS Persahabatan adalah 52 th (20-84) dan median usia meninggal adalah 59 th (28-92). Terdapat hubungan bermakna antara derajat klinis, HT, IMT dan DM terhadap luaran pasien pneumonia COVID-19 di RS Persahabatan.
Kesimpulan: Usia median hidup pasien pneumonia COVID-19 di RS Persahabatan adalah 52 th (20-84) dan median usia meninggal adalah 59 th (28-92). Terdapat hubungan bermakna antara derajat klinis, HT, IMT dan DM terhadap luaran pasien pneumonia COVID-19 di RS Persahabatan.

Background: The Coronavirus disease 2019 (COVID-19) is an infection by severe acute respiratory syndrome Coronavirus 2 (SARS-COV-2) which became international attention in January 2020. The manifestation of mild cases occurred about 81%, severe cases as much as 14%. Mortality of COVID-19 pneumonia increasing globally due to rapid transmission and atypical symptoms. Age of 60 years, male gender and comorbidities are risk factors for severe and death so that strict control is needed.
Methods: This study is retrospective cross-sectional study, which samples were patients who came to emergency room and confirmed of COVID-19. The samples are 299 patients who included of inclusion criteria.
Results: The sample of this study were 299 patients out of 336 patients who were include in inclusion criteria. Male (54.18%) are the most common, Obesity class I was the most common (29.77%) followed by normal BMI (28,76%) and didn’t have comorbid with severe (60.2%) and outcome are survived (69.2%). Hypertension (30,77%) is the most comorbid, followed by diabetes melitus (24%) and cardiovascular (14%). The median age of survivor is 52 (20-84) years old and median age of non survivor is 59 (28-92) years. There was relationship between severe pneumonia to respiratory rate and peripheral oxygen saturation. Gender, number of comorbidities and BMI were not related to the outcome. There is a relationship between the severity of pneumonia, obesity, diabetes and hypertension to the outcome.
Conclusion: The median age of survivor is 52 (20-84) years old and median age of non survivor is 59 (28-92) years. There was relationship between severe pneumonia to respiratory rate and peripheral oxygen saturation. Gender, number of comorbidities and BMI were not related to the outcome. There is a relationship between the severity of pneumonia, obesity, diabetes and hypertension to the outcome.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
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UI - Tugas Akhir  Universitas Indonesia Library
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Harahap, Nofria Rizki Amalia
"Pandemi Coronavirus disease-19 (COVID-19) telah secara drastis mempengaruhi kesehatan global. Salah satu komplikasi COVID-19 yang berbahaya adalah pneumonia. Berbagai jenis antibiotik telah digunakan untuk pencegahan dan pengobatan pneumonia pada pasien COVID-19. Pemberian antibiotik yang tidak sesuai dapat memicu resistensi antibiotik sehingga berdampak pada peningkatan mortalitas pasien. Penelitian ini bertujuan untuk menganalisis pengaruh kesesuaian pemberian antibiotik berdasarkan diagram alir Gyssen terhadap luaran klinis pasien terkonfirmasi COVID-19 dengan pneumonia. Penelitian ini merupakan penelitian cross-sectional. Sampel penelitian adalah 72 pasien rawat inap yang mendapat diagnosis COVID-19 terkonfimasi dan pneumonia di RSUP Fatmawati Jakarta pada periode Maret hingga Desember 2020 yang memenuhi kriteria inklusi. Pasien terkonfirmasi COVID-19 dengan pneumonia memiliki rerata usia 53,13 ± 12,61 tahun. Pasien dengan derajat penyakit COVID-19 berat atau kritis (66,7%) lebih banyak dibandingkan non-berat (33,3%). Jumlah pasien meninggal yang dilaporkan dalam penelitian ini adalah 36 (50%). Berdasarkan evaluasi antibiotik menggunakan diagram alir Gyssen diperoleh hasil sejumlah 11 dari 72 (15,3%) pasien menggunakan regimen antibiotik yang tidak sesuai. Karakteristik ketidaksesuaian antibiotik, meliputi: ketidaktepatan pemilihan antibiotik (2,8%) dan durasi antibiotik (12,5%). Kesesuaian pemberian antibiotik berdasarkan diagram alir Gyssen tidak berpengaruh secara bermakna terhadap luaran klinis pasien terkonfirmasi COVID-19 dan pneumonia.

The COVID-19 pandemic affected global health drastically. COVID-19 becomes more dangerous if pneumonia attacks COVID-19 patients as a complication. Numerous types of antibiotics were used for the prevention and treatment of pneumonia in COVID-19 patients. Inappropriate administration of antibiotics caused antibiotic resistance and influenced patient mortality. This research aims to analyze the effect of appropriate antibiotics administration according to Gyssen flowchart on clinical outcomes of confirmed COVID-19 patients with pneumonia. This research was conducted using a cross-sectional design. A total of 72 COVID-19 confirmed inpatients with pneumonia diagnosis from March to December 2020 at Fatmawati Hospital Jakarta whose met inclusion criteria were included in our study. The mean age of all patients was 53.13 ± 12.61 years. The percentage of critical or severe ill patients (66.7%) was higher than those who were having noncritical diseases (33.3%). 36 (50%) death were reported in our patient population. 11/72 (15.3%) antibiotic regimens were found to be inappropriate. Characteristics of inappropriate antibiotics included: incorrect choice (2.8%) and duration of antibiotics (12.5%). We conclude that appropriate administration of antibiotics based on the gyssen flowchart was not significantly associated with the clinical outcomes of confirmed COVID-19 with pneumonia patients."
Depok: Fakultas Farmasi Universitas Indonesia, 2022
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UI - Tesis Membership  Universitas Indonesia Library
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Mila Charonika
"Pneumonia merupakan penyebab utama morbiditas dan mortalitas pada usia dewasa, yang disebabkan oleh agen infeksius seperti bakteri, mycoplasma, dan virus, termasuk Coronavirus Disease-19 (Covid-19) yang saat ini menjadi pandemic. Klinis pasien dengan pneumonia akibat infeksi Covid-19 adalah demam, batuk, kesulitan bernapas, dan keluhan sesak memberat. Salah satu masalah keperawatan yang adalah ketidakefektifan bersihan jalan napas dikarenakan akumulasi sekret berlebih sebagai akibat reaksi inflami jaringan paru, yang ditandai dengan batuk, keluhan susah mengeluarkan dahak, terdengar ronchii, hingga timbulnya sesak napas. Tujuan penulisan Karya Ilmiah Akhir Ners ini adalah untuk menganalisis asuhan keperawatan pada pasien pneumonia terkonfirmasi positif Covid-19, dengan penerapan fisioterapi dada dan batuk efektif sebagai upaya meningkatkan bersihan jalan napas. Setelah dilakukan tindakan keperawatan secara reguler dan kontinyu yaitu 2kali dalam sehari (pagi pukul 06.00 dan sore pukul 16.00) maka terjadi perbaikan kondisi dan masalah teratasi di hari ke III rawat inap dibuktikan dengan frekuensi napas 20x.menit, irama napas reguler, kedalaman napas normal, suara napas vesikuler, tidak terdapat keluhan sesak, dan pasien mampu melakukan batuk efektif dengan baik dan benar. Hal ini menunjukkan bahwa Fisioterapi Dada dan Batuk Efektif dapat diberikan pada pasien Covid-19 dan menjadi intervensi mandiri bagi perawat isolasi kepada pasien sesuai indikasi.

Pneumonia is the main cause of morbidity and mortality in adulthood, caused by infectious agents such as bacteria, mycoplasma, and viruses, including Coronavirus Disease-19 (Covid-19) which is currently becoming a pandemic. Clinical signs of patients with pneumonia due to Covid-19 infection are fever, cough, difficulty breathing,and severe shortness of breath. One of the nursing problems is the ineffective airway clearance caused by accumulation of excess secretions as the result of the reaction of lung tissue inflami, which is characterized by coughing, difficulty in expelling phlegm, sound of ronchii, to the onset of shortness of breath. This paper aims to analyze nursing care in patients with pneumonia confirmed positive for Covid-19, with the application of chest physiotherapy and effective-cough as the nursing intervention for improving the airway clearance. After regular and continuous nursing intervention, which 2 times a day (morning at 6:00 a.m. and 4:00 p.m. in the afternoon), there was an improvement in the conditionThe problems resolved in the third day of hospitalization evidenced by the frequency of breath 20x.minutes, regular breathing rhythm, normal breathing depth, vesicular breath sounds, no complaints of shortness of breath, and the patient is able to cough effectively properly and correctly. This shows that chest physiotherapy and effective-cough can be given to Covid-19 patients and become an independent intervention for isolation nurses to patients as indicated."
Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2020
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UI - Tugas Akhir  Universitas Indonesia Library
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Radius Kusuma
"Latar belakang: Kasus COVID-19 anak lebih jarang ditemukan daripada dewasa. Meskipun demikian, pada dasarnya anak tetap dapat terinfeksi SARS-CoV-2 dan turut berperan dalam transmisi penyakit. Pemeriksaan reverse transcription polymerase chain reaction (RT-PCR) merupakan baku emas untuk mendiagnosis COVID-19 namun memerlukan waktu relatif lama untuk memperoleh hasil. Radiografi toraks memiliki potensi menjadi modalitas diagnostik COVID-19 di masa pandemi. Sampai saat ini, belum ada penelitian terhadap penggunaan kategori gambaran radiografi toraks untuk menunjang diagnosis COVID-19 pada pasien anak.
Metode: Penelitian ini dilaksanakan dengan desain potong lintang menggunakan data sekunder berupa hasil pemeriksaan radiografi toraks dan hasil RT-PCR terhadap 88 pasien anak di RSUPN Cipto Mangunkusumo mulai dari periode April 2020 hingga Oktober 2021, yang terdiri dari 22 pasien pneumonia COVID-19 dan 66 pasien pneumonia bukan COVID-19.
Hasil: Analisis kappa Cohen untuk menilai kesesuaian antara kategori radiografi toraks (tipikal dan non-tipikal) dan hasil RT-PCR (pneumonia COVID-19 dan pneumonia bukan COVID-19) menunjukkan hasil nilai kappa ialah 0,22 (p = 0,033) yang mengindikasikan tingkat kesesuaian lemah namun bermakna.
Simpulan: Tidak terdapat gambaran radiografi toraks yang khas pada anak dengan pneumonia COVID-19. Tidak terdapat kesesuaian yang baik antara kategori radiografi toraks dan hasil RT-PCR pada anak dengan pneumonia COVID-19.

Background: COVID-19 pneumonia is rare in children. However, children may still be infected and transmit disease. RT-PCR is the gold standard in diagnosing COVID-19, although results may be delayed. Chest radiograph may have role in diagnosing COVID- 19. To dates, literature in chest radiograph categorization in diagnosing COVID-19 in children has yet to be found.
Method: This study used secondary data of chest radiographs and RT-PCR result from 88 children in RSUPN Cipto Mangunkusumo from April 2020 to October 2021.
Result: Kappa Cohen analysis of agreement between chest radiographic category and RT-PCR result showed kappa score of 0,22 (p = 0,033), indicating a weak agreement yet statistically significant.
Conclusion: There is no pathognomonic chest radiograph findings of COVID-19 pneumonia in children. Agreement between chest radiographic category and RT-PCR testing in paediatric COVID-19 pneumonia is poor.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2021
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UI - Tugas Akhir  Universitas Indonesia Library
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Buti Ariani Ar Nur
"Latar Belakang: Coronavirus disease 2019 (COVID-19) adalah penyakit yang sedang menjadi pandemi di dunia saat ini. Kasus COVID-19 semakin meningkat di seluruh dunia, hingga September 2022 tercatat kasus COVID-19 telah menyebar ke 233 negara dengan total kasus terkonfirmasi lebih dari 600.000.000 dan kasus kematian lebih dari 6.500.000. Coronavirus disease 2019 dapat berkembang menjadi kondisi yang berat dan kritis. Terapi sel punca mesenkimal (SPM) sedang dikembangkan sebagai tambahan tata laksana COVID-19 berat melalui potensi imunomodulator. Skor sequential organ failure assessment (SOFA) adalah sistem penilaian yang dapat digunakan untuk mengetahui derajat keparahan penyakit dan memprediksi mortalitas pasien COVID-19. Sampai saat ini, belum terdapat sistem penilaian yang digunakan sebagai parameter untuk mengetahui efikasi pemberian terapi sel punca mesenkimal tali pusat (SPM-TP). Penelitian ini bertujuan untuk mengetahui perbedaan skor SOFA pada pasien pneumonia COVID-19 yang mendapatkan terapi SPM-TP dan plasebo di RSUP Persahabatan.
Metode: Desain penelitian ini adalah kohort retrospektif menggunakan data rekam medik pasien, dilakukan di RSUP Persahabatan Juli 2021-September 2022, dengan teknik total sampling. Subjek penelitian adalah pasien pneumonia COVID-19 derajat sedang, berat dan kritis yang mendapat terapi SPM-TP atau plasebo di RSUP Persahabatan bulan Juni 2020-Juli 2021 yang memenuhi kriteria penelitian.
Hasil: Didapatkan 29 subjek penelitian yang terdiri dari 13 subjek kelompok perlakuan dan 16 subjek kelompok kontrol. Kedua kelompok memiliki karakteristik dasar yang sama. Perbedaan skor SOFA pada kedua kelompok tidak bermakna secara statistik. Namun, terdapat tren penurunan skor SOFA pada kelompok perlakuan. Perbedaan nilai C-reactive protein (CRP), prokalsitonin (Pct) dan rasio neutrofil limfosit (NLR) pada kedua kelompok tidak bermakna secara statistik. Namun, terdapat penurunan ketiga nilai tersebut pada kelompok perlakuan. Perbedaan lama rawat, pemakaian kanula hidung arus tinggi (KHAT) dan ventilasi mekanis pada kedua kelompok tidak bermakna secara statistik. Proporsi mortalitas lebih rendah pada kelompok perlakuan dibandingkan dengan kelompok kontrol walaupun tidak bermakna secara statistik.
Kesimpulan: Tidak terdapat perbedaan bermakna skor SOFA, nilai CRP, nilai Pct, nilai NLR, lama perawatan, lama pemakaian KHAT atau ventilasi mekanis serta mortalitas pada kedua kelompok. Tetapi secara keseluruhan kelompok perlakuan mengalami perbaikan klinis dan laboratorium dibandingkan dengan kelompok kontrol.

Background: Coronavirus disease 2019 (COVID-19) is a disease that is currently a pandemic in the world. Coronavirus disease 2019 are increasing worldwide, as of September 2022, COVID-19 cases have spread to 233 countries with a total of more than 600,000,000 confirmed cases and more than 6,500,000 deaths. Coronavirus disease 2019 can develop into a severe and critical condition. Mesenchymal stem cell (MSC) therapy is being developed as an adjunct to the management of severe COVID-19 through its immunomodulatory potential. The sequential organ failure assessment (SOFA) score is a scoring system that can be used to determine the severity of disease and predict mortality in COVID-19 patients. Until now, there is no scoring system that is used as a parameter to determine the efficacy of umbilical cord mesenchymal stem cell (UC-MSC) therapy. This study aims to determine the difference in SOFA scores in COVID-19 pneumonia patients who received UC-MSC therapy and placebo at Persahabatan Hospital.
Methods: The design of this study was a retrospective cohort using patient medical record data, conducted at Persahabatan Hospital July 2021-September 2022, with a total sampling technique. The subjects were patients with moderate, severe and critical COVID-19 pneumonia who received UC-MSC or placebo therapy at Persahabatan Hospital in June 2020-July 2021 who met the inclusion criteria.
Results: There were 29 subjects consisting of 13 treatment group and 16 control group. Both groups have the same basic characteristics. The difference in SOFA scores in the two groups was not statistically significant. However, there was a downward trend in SOFA scores in the treatment group. The difference in the value of C-reactive protein (CRP), procalcitonin (Pct) and neutrophil lymphocyte ratio (NLR) in the both group was not statistically significant. However, there was a decrease values ​​in the treatment group. Differences in length of stay, use of high flow nasal cannula (HFNC) and mechanical ventilation in the two groups were not statistically significant. The proportion of mortality was lower in the treatment group compared to the control group although not statistically significant.
Conclusion: There were no significant differences in SOFA, CRP, Pct, NLR, length of stay, length of use of HFNC or mechanical ventilation and mortality in the two groups. However, the treatment group experienced clinical and laboratory improvement compared to the control group.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
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UI - Tugas Akhir  Universitas Indonesia Library
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Hendra Wahyuni MS
"Latar Belakang: Kejadian pandemi penyakit Coronavirus disease 2019 (COVID-19) telah menyebar ke berbagai belahan dunia dengan peningkatan angka pasien terkonfirmasi dan meninggal. Cedera miokard akut merupakan salah satu manifestasi klinis yang sering timbul pada pasien terkonfirmasi COVID-19 yang mengakibatkan meningkatnya risiko morbiditas dan mortalitas. Meskipun demikian, kejadian cedera miokard akut pada pasien COVID-19 belum banyak didokumentasikan. Penelitian ini bertujuan mengetahui kejadian cedera miokard akut pada pasien COVID-19 serta faktor-faktor yang mempengaruhinya.
Metode: Penelitian ini merupakan penelitian potong lintang dengan menggunakan data rekam medis pasien COVID-19 yang dirawat di RSUP Persahabatan, Jakarta, selama periode Juni-Desember 2020. Prevalens cedera miokard akut dinilai dengan menggunakan kadar pemeriksaan high sensitivity Troponin I (hsTrop-I). Penelitian ini juga menentukan hubungan antara faktor demografi, riwayat penyakit komorbid kardiovaskular, derajat penyakit, penanda respon inflamasi serta faktor koagulasi dengan kejadian cedera miokard akut pada pasien terkonfirmasi COVID-19.
Hasil: Dari total 340 sampel yang diikutkan dalam penelitian ini didapatkan sebanyak 62 (18,2%) sampel mengalami cedera miokard akut, mayoritas berusia diatas 40 tahun (93,5%). Cedera miokard akut lebih dominan terjadi pada sampel dengan riwayat komorbid (90,3%) dan derajat penyakit berat-kritis (87,1%). Prokalsitonin dan d-Dimer secara konsisten menunjukkan hubungan yang bermakna pada uji bivariat dan multivariat dengan kejadian cedera miokard akut.
Kesimpulan: Prevalens cedera miokard akut pada pasien COVID-19 di RS Persahabatan sebesar 18,2%. Cedera miokard akut berhubungan dengan kadar prokalsitonin, d-Dimer dan komorbid kardiovaskular.

Background: The pandemic of Coronavirus disease 2019 (COVID-19) has spread worldwide with the growing number of confirmed patients and deaths. Acute myocardial injury is one of the most common clinical manifestations in COVID-19 patients, results in higher risk of morbidity and mortality. However, the prevalence of acute myocardial injury in COVID-19 patients is not well documented. This study aimed to assess the prevalence of acute myocardial injury in COVID-19 patients.
Methods: This is a cross-sectional study utilizing medical record on COVID-19 patients admitted to Persahabatan hospital, Jakarta, within the period of June to December 2020. The prevalence of acute myocardial injury was assessed through high sensitivity Troponin I (hsTrop-I) levels examination. The association of demographic factors, cardiovascular disease comorbidities, disease severity, levels of inflammatory biomarkers and coagulation factor with acute myocardial injury were also determined.
Results: From a total of 340 patients enrolled in the study, 62 (18.2%) samples experienced acute myocardial injury, in which majority (93.5%) aged >40 years. The prevalence of acute myocardial injury was more dominant in patients with the history of comorbidities (90.3%) and severe-critically ill COVID-19 patients (37.1%). Procalcitonin and d-Dimer levels consistently showed significant association with acute myocardial injury from bivariate and multivariate analysis.
Conclusion: The prevalence of acute myocardial injury in COVID-19 patients in Persahabatan Hospital was 18,2%. Acute myocardial injury was significantly associated with procalcitonin levels, d-Dimer levels and cardiovascular comorbidities.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
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UI - Tugas Akhir  Universitas Indonesia Library
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Adetya Rahma Dinni
"Latar Belakang: Coronavirus disease 2019 (COVID-19) memiliki berbagai spektrum gejala klinis salah satunya sesak napas. Sesak napas disertai hipoksia merupakan prediktor penurunan kapasitas fungsional. Uji jalan 6 menit dapat mengidentifikasi sesak napas dan hipoksia pasca-uji latih pada pasien COVID-19 saat perawatan dan pascarawat. Penelitian ini bertujuan untuk mengetahui derajat sesak pada pasien COVID-19 yang dirawat dan pascarawat Metode: Penelitian ini merupakan penelitian kohort prospektif yang dilakukan pada Bangsal COVID-19 dan poli paru RSUP Persahabatan dari Agustus 2021 – Juni 2022. Subjek penelitian adalah pasien COVID-19 derajat ringan atau sedang yang dirawat di Bangsal COVID-19 yang memenuhi kriteria penelitian. Subjek penelitian akan dilakukan uji jalan 6 menit, penilaian skala Borg, saturasi oksigen, skor RALE dan arus puncak ekspirasi saat perawatan dan akan di evaluasi pada 1 bulan dan 3 bulan pascarawat. Hasil: Pada penelitian ini didapatkan 40 subjek penelitian. Nilai rerata uji jalan 6 menit pasien COVID-19 yang dirawat 279,9 m (SB ± 75,4), 1 bulan pascarawat 332 m ((SB ± 63,7) dan 3 bulan pascarawat 394,52 m (SB ± 58). Median saturasi oksigen pasien COVID-19 yang dirawat 97%, 1 bulan pascarawat 97,5% dan 3 bulan pascarawat 98%. Nilai median skala Borg pasien COVID-19 yang dirawat 2, 1 bulan pascarawat 1, 3 bulan pascarawat 1. Arus puncak ekspirasi pasien COVID-19 250 L/menit, 1 bulan pascarawat 310 L/menit dan 3 bulam pascarawat 370 L/menit. Median skor RALE pasien COVID-19 yang dirawat 3, 1 bulan pascarawat 2,5 dan 3 bulan pascarawat 1,5. Terdapat korelasi bermakna skala Borg dengan uji jalan 6 menit, saturasi oksigen dengan uji jalan 6 menit dan uji jalan 6 menit dengan skor RALE, terdapat korelasi bermakna arus puncak ekspirasi dengan skala Borg pada pasien COVID-19 yang dirawat dan 1 bulan pascarawat, terdapat korelasi bermakna saturasi oksigen dengan skala Borg pada pasien COVID-19 yang dirawat dan 1 bulan pascarawat Kesimpulan: Terdapat perbaikan derajat sesak yang ditunjukkan dari hasil uji jalan 6 menit, skala Borg, saturasi oksigen, skor RALE dan arus puncak ekspirasi pada pasien COVID-19 ringan dan sedang yang dirawat dibandingkan 1 bulan pascarawat dan 3 bulan pascarawat.

Background: Coronavirus disease 2019 (COVID-19) has various clinical symptoms, one of which is shortness of breath. Exertional dyspnea is a predictor of decreased functional capacity. The 6-minute walk test can identify exertional dyspnea and hypoxia in COVID-19 patients during hospitalization and post-hospitalization. This study aims to determine the degree of shortness of breath in hospitalized and post-hospitalized COVID-19 patients. Methods: A prospective cohort study was conducted in the COVID-19 isolation ward and pulmonology clinic National Respiratory Center Persahabatan Hospital from August 2021 – June 2022. The study subjects were mild or moderate COVID-19 patients admitted to the COVID-19 isolation ward who met the research criteria. Patients underwent a 6-minute walk test, assessment of Borg scale, oxygen saturation, RALE score, and peak expiratory flow rate and will be evaluated at a month and three months post-hospitalization. Results: There were 40 subjects participating in this study. The mean of the 6-minute walk test of COVID-19 patients was 279.9 m (SD ± 75.4), one-month post-hospitalized was 332 m (SD ± 63.7) and three months post-hospitalized was 394.52 m (SD±58) Median oxygen saturation of COVID-19 patients was 97%, one-month post-hospitalized was 97.5% and three months post-hospitalized was 98%. Median Borg scale of COVID-19 patients was 2, 1-month post-hospitalized was 1, 3 months post-hospitalized was 1. The median peak expiratory flow rate of COVID-19 patients was 250 L/min, one-month post-hospitalized was 310 L/min and three months post-hospitalized was 370 L/min. Median RALE scores for COVID-19 patients was 3, 1-month post-hospitalized was 2,5 and 3 months post-hospitalized was 1,5. There was a significant correlation between Borg scale and 6-minute walk test, oxygen saturation with the 6-minute walk test and the 6-minute walk test with RALE score. There was a significant correlation between peak expiratory flow and the Borg scale in hospitalized and one-month post-hospitalized COVID-19 patients. There was a significant correlation between oxygen saturation with the Borg scale in COVID-19 patients and one-month post-hospitalized COVID-19 patients. Conclusion: There was an improvement in the degree of dyspnea in mild and moderate COVID-19 patients as indicated by 6-minute walk test distance, Borg scale, oxygen saturation, RALE score and peak expiratory flow rate compared to a-month and three-months post-hospitalized."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
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UI - Tugas Akhir  Universitas Indonesia Library
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Hamka Rauf
"Pendahuluan: Pemeriksaan baku emas swab nasoorofaring dengan metode Reverse transcriptase polymerase chain reaction (RT-PCR) merupakan prosedur diagnostik yang dilakukan pada pasien dengan suspek COVID-19. Metode lain yang digunakan yaitu dengan pemeriksaan serologi yang mulai terbentuk dalam beberapa hari hingga minggu.
Tujuan: Untuk mengetahui hubungan antara hasil swab nasoorofaring dan uji serologi terhadap luaran pasien COVID-19 dalam evaluasi masa rawat 14 hari
Metode: Analisis observasional kohort retrospektif terhadap pasien COVID-19 yang dirawat di RS Rujukan Respirasi Nasional Persahabatan, Jakarta, Indonesia secara total sampling diperoleh dari bulan Maret 2020 sampai Mei 2020. Kami meninjau rekam medis 132 pasien dengan diagnosis probable case dan confirmed case COVID-19 yang memenuhi kriteria inklusi.
Hasil: Sebanyak 132 pasien yang termasuk dalam penelitian ini, didominasi oleh laki-laki sebanyak 51,5% dengan usia rerata 50,23 tahun. Derajat pneumonia berturut-turut yaitu derajat ringan, sedang, dan berat (17,4%, 57,6%, dan 25,0%). Proporsi pasien dengan komorbid sebanyak 71,2%. Proporsi penggunaan alat bantu napas terbanyak yaitu penggunaan kanula hidung (69,7%) diikuti berturut-turut oleh Ventilator, non rebreathing mask dan high flow nasal cannule (13,6%, 9,1% dan 7,6%).. Proporsi kematian sebesar 18,3%, dengan proporsi kematian pada confirmed case sebanyak 21,3% dan probable case sebanyak 19,3%. Tingkat kematian pada confirmed case berkorelasi terhadap jenis kelamin laki-laki (p =0,009), derajat pneumonia berat (p=0,000), penggunaan alat bantu napas bukan kanula hidung (p=0,000) dan komorbid (p=0,021). Tingkat kematian pada probable case berkorelasi dengan derajat pneumonia berat (p=0,000), penggunaan alat bantu napas bukan kanula hidung (p=0,000).
Kesimpulan: Kombinasi penggunaan swab nasoorofaring dan hasil uji serologi dapat memprediksi luaran pasien COVID-19 dalam evaluasi masa rawat 14 hari. Derajat pneumonia berat dan penggunaan alat bantu napas bukan kanula hidung merupakan prediktor buruk terhadap luaran pasien COVID-19.

Introduction: Reverse transcriptase polymerase chain reaction (RT-PCR) to detect SARS- CoV-2 is a gold standard method in a patient with suspected COVID-19 and achievable by means of nasopharyngeal and oropharyngeal swab. Serological test is another method to detect the antibody which is produced in a several days or week.
Aims: To determine the association between nasooropharyngeal swab and serological test to predict the mortality of COVID-19 patient after 14-days admission.
Methods: We performed an observational retrospective cohort analysis of COVID-19 patients treated at National Respiratory Referral Hospital Persahabatan Jakarta, Indonesia. Subjects by means of total sampling were COVID-19 patients between March to May 2020. We reviewed the medical records of 132 patients categorized as probable and confirmed cases whom met the inclusion criteria. Their 14-days course of the treatment were observed.
Results: We included 132 patients, which dominated by males (51.5%) with mean age of
50.23 years old. Cases were mild pneumonia, moderate pneumonia, and severe pneumonia (17.4%, 57.6%, and 25.0%, respectively). Most patients presented with comorbidities (71,2%). Most patients required oxygen supplementation by nasal cannula (69.7%), followed by mechanical ventilator, non-rebreathing mask, and high flow nasal cannula (13.6%, 9.1%, and 7.6%, respectively). Patient deaths were 18.3%, including 21.3% among confirmed cases and 19.3% among probable cases. Mortality among confirmed case were correlated with male sex (p=0.009), severe pneumonia (p=0.000), supplemental oxygen delivery requiring device other than nasal cannula (p=0.000), and comorbidities (p=0.021). Mortality among probable cases were correlated with severe pneumonia (p=0.000), and supplemental oxygen delivery requiring device other than nasal cannula (p=0.000).
Conclusions: Combination of nasooropharyngeal swab and serological test results predicted the 14-days outcomes of COVID-19 patients. Severe pneumonia and supplemental oxygen delivery requiring device other than nasal cannula were predictors of poor COVID-19 outcomes as observed from our study.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2020
T57651
UI - Tesis Membership  Universitas Indonesia Library
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Muhammad Bimo Adi Wicaksono
"Latar Belakang: Pada tanggal 12 Maret 2020, World Health Organization (WHO) mengumumkan penyakit Coronavirus Disease 2019 (COVID-19) sebagai pandemi yang disebabkan oleh virus Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Infeksi virus dapat menyebabkan kolonisasi organ yang terinfeksi akibat penurunan respon imun oleh patogen akibat penurunan respons imun serta masuknya bakteri patogen melalui akses yang diperantarai oleh mikroorganisme oportunis. Hingga saat ini telah banyak studi yang membahas COVID-19 dari aspek epidemiologi dan karakteristik klinis namun informasi terkait infeksi sekunder akibat bakteri pada COVID-19 masih terbatas.
Metode Penelitian: Penelitian ini menggunakan desain studi potong lintang dengan dengan menelusuri data rekam medis pasien yang memiliki riwayat perawatan pneumonia COVID-19 di ruang isolasi Pinere RSUP Persahabatan sejak 1 Januari 2021 - 31 Desember 2021. Total sampel pada penelitian ini adalah sebanyak 111 pasien.
Hasil Penelitian: Total pasien pneumonia COVID-19 yang dirawat di ruang isolasi Pinere selama tahun 2021 yaitu sebanyak 718 pasien. Pasien yang memenuhi kriteria inklusi dan eksklusi adalah sebanyak 111 pasien. Karakteristik pasien pneumonia COVID-19 didominasi oleh jenis kelamin laki-laki, median usia 53 tahun, lama rawat 11 hari, status gizi obesitas, belum divaksin, derajat keparahan sedang, penggunaan antivirus remdesivir, antibiotik levofloksasin, azitromisin dan kortikosteroid. Terdapat pertumbuhan bakteri pada 41,5% hasil biakan yang terdiri dari gram negatif (38,8%) dan gram positif (2,7%). Klebsiella pneumoniae merupakan bakteri gram positif terbanyak yang tumbuh, sedangkan Enterococcus faecalis merupakan satu-satunya gram positif yang tumbuh. Tidak terdapat hubungan antara hasil biakan patogen saluran napas terhadap luaran pasien pneumonia COVID-19 (nilai p=0,738). Derajat keparahan tidak berhubungan dengan hasil biakan, tetapi berhubungan dengan luaran pasien pneumonia COVID-19.
Kesimpulan: Tidak terdapat hubungan antara hasil biakan patogen saluran napas terhadap luaran pasien pneumonia COVID-19.

Background: World Health Organization (WHO) declared Coronavirus Disease 2019 (COVID-19) as a pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) virus on March 12, 2020. Viral infections can cause colonization of infected organs due to decreased immune response and entry of pathogenic bacteria through access mediated by opportunistic microorganism. Until now, there have been many studies discussing COVID-19 from the aspect of epidemiology and clinical characteristics, but information regarding secondary infections caused by bacteria in COVID-19 is still limited.
Methods: The design of this study is cross-sectional by tracing the medical record data of patients who had a history of treatment for COVID-19 pneumonia in the Pinere isolation ward of Persahabatan General Hospital from January 1st 2021 to December 31st 2021. The total sample in this study was 111 patients.
Result: The total number of COVID-19 patients treated in the Pinere isolation room during 2021 is 718 patients. Patients who met the inclusion and exclusion criteria were 111 patients. The characteristics of COVID-19 patients were dominated by male, median age 53 years, length of stay 11 days obesity, not yet vaccinated, moderate severity, use of antiviral remdesivir, antibiotics levofloxacin, azithromycin and corticosteroid. There was bacterial growth in 41,5% of culture results consisting of gram negative (38,8%) and gram positive (2,7%). Klebsiella pneumoniae is the most gram positive bacteria that grows, while Enterococcus faecalis is the only gram positive that grows. There was no relationship between the results of respiratory tract cultures and the outcomes of COVID-19 patients (p value = 0.738). The severity of COVID-19 is not associated to culture results, but is associated to the patient’s outcome.
Conclusion: There was no relationship between the results of respiratory tract cultures and the outcomes of COVID-19 patients.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
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Dara Puspita Dewi
"Covid-19 telah mewabah ke hampir seluruh negara di dunia selama lebih dari satu tahun. Case Fatality Rate (CFR) dan Recovery Rate (RR) penyakit digunakan untuk menilai tingkat keparahan, risiko pada populasi dan mengevaluasi mutu fasilitas pelayanan kesehatan. Status gizi dapat memperburuk prognosis penyakit, ketahanan hidup, dan memperpanjang lama rawat inap. Obesitas menyebabkan morbiditas yang lebih tinggi saat perawatan di rumah sakit seperti kegagalan sistem pernafasan, pemindahan tempat rawat ke ICU dan meningkatkan tingkat kematian. Penelitian ini bertujuan untuk mengetahui kesintasan pasien dewasa yang dirawat di rumah sakit berdasarkan status gizi. Penelitian menggunakan desain studi kohort retrospektif menggunakan data rekam medis pasien rawat inap terkonfirmasi Covid-19 tahun 2021 di RS Universitas Indonesia dan dianalisis menggunakan Cox Proportional Hazard Model. Hasil menunjukkan perbedaan probabilitas kesintasan antara pasien dewasa terkonfirmasi Covid-19 yang dirawat di RS Universitas Indonesia dengan status gizi normoweight, underweight dan obesitas (15,41% vs 71,11% vs 7,43%). Pasien dengan underweight meningkatkan risiko kematian sebesar 1,19 kali dibandingkan pasien dengan normoweight (95% CI 0,471-3,049) setelah dikontrol dengan usia, tingkat keparahan, dan ARDS. Sedangkan pasien dengan overweight/obesitas meningkatkan risiko kematian sebesar 1,03 kali dibandingkan pasien dengan normoweight (95% CI 0,714-1,487).

Covid-19 has plagued almost all countries in the world for more than a year. Case Fatality Rate (CFR) and Recovery Rate (RR) of disease are used to assess the severity, risk to the population, and evaluate the quality of health care facilities. Nutritional status can worsen disease prognosis, survival, and prolong hospitalization. Obesity causes higher morbidity during hospitalization such as respiratory system failure, and increased mortality rates. This study aims to determine the survival of adult patients who are hospitalized based on nutritional status. The study used a retrospective cohort study design using medical record data of confirmed Covid-19 inpatients in 2021 at the University of Indonesia Hospital and analyzed using the Cox Proportional Hazard Model. The results showed a difference in the probability of survival between adult patients with confirmed Covid-19 who were admitted with normoweight, underweight and obese nutritional status (15.41% vs 71.11% vs 7.43%). Underweight patients increased the risk of death by 1.19 times compared to normoweight patients (95% CI 0.471-3.049) after controlling for age, severity, and ARDS. Meanwhile, overweight/obese patients increased the risk of death by 1.03 times compared to normoweight patients (95% CI 0.714-1.487)."
Depok: Fakultas Kesehatan Masyarakat Universitas Indonesia, 2022
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UI - Tesis Membership  Universitas Indonesia Library
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