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"World Health Organization (WHO) mendeklarasikan corona virus disease 19 (COVID-19) sebagai pandemi. Penyakit Ginjal kronis (PGK) muncul sebagai faktor risiko paling umum COVID-19 dengan manifestasi klinis yang parah dan mengkhawatirkan. Penyakit Ginjal kronis (PGK) dikaitkan dengan peningkatan tingkat rawat inap pasien dengan COVID-19, dan tingkat kematian tampaknya 14 - 16 kali lebih tinggi daripada populasi umum. RS UI merupakan rumah sakit rujukan COVID-19 di Kota Depok. Studi kasus kontrol dilakukan dengan memanfaatkan data rekam medis pasien COVID-19 terkonfirmasi yang dirawat inap di RS UI periode September 2020 – Agustus 2022 dengan jumlah sampel pada kelompok kasus 121 responden dan kelompok kontrol 242 responden. Hasil penelitian ini menunjukkan ada hubungan dan bermakna secara statistik antara Penyakit Ginjal Kronis dengan kematian pasien COVID-19 (OR 6,67; 95% CI 3,48–12,77; pvalue <0,001). Demikian, secara statistik hubungan antara Penyakit Ginjal Kronis dengan kematian pasien COVID-19 setelah dikontrol variabel kovariat yaitu : hipertensi, ARDS, ruang perawatan, obesitas dan umur. Jadi, pasien COVID-19 dengan Penyakit Ginjal Kronis memiliki resiko 3,65 kali lebih besar secara bermakna untuk meninggal dibanding pasien COVID19 tanpa Penyakit Ginjal kronis.

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The World Health Organization (WHO) declared the corona virus disease 19 (COVID-19) a pandemic. Chronic Kidney Disease (CKD) is emerging as the most common risk factor for COVID-19 with severe clinical manifestations and deficiencies. Chronic Kidney Disease (CKD) is associated with increased hospitalization rates of patients with COVID-19, and death rates are roughly 14 – 16 times higher than the general population. UI Hospital is a COVID-19 referral hospital in Depok City. A case-control study was carried out by utilizing the medical record data of confirmed COVID-19 patients who were hospitalized at UI Hospital for the period September 2020 – August 2022 with a sample size of 121 respondents in the case group and 242 respondents in the control group. The results of this study showed that there was a statistically significant relationship between Chronic Kidney Disease and the death of COVID-19 patients (OR 6.67; 95% CI 3.48–12.77; pvalue <0.001). Thus, statistically the relationship between Chronic Kidney Disease and the death of COVID-19 patients after controlling for covariate variables, namely: hypertension, ARDS, treatment room, obesity and age. So, COVID19 patients with Chronic Kidney Disease have a significantly greater risk of dying 3.65 times than COVID-19 patients without Chronic Kidney Disease."

"Penelitian mengenai pengaruh remdesivir terhadap perubahan nilai cycle threshold (Ct) atau viral load masih sedikit, memiliki hasil yang berbeda-beda, dan belum pernah dilakukan pada subjek dari Indonesia. Penelitian ini bertujuan untuk mengevaluasi pengaruh remdesivir terhadap perubahan nilai Ct dan keamanannya pada pasien COVID-19 derajat berat. Penelitian dilakukan secara retrospektif dengan desain kohort studi. Subjek penelitian terdiri dari kelompok remdesivir (n=80) dan non remdesivir (n=80). Pengamatan yang dilakukan adalah perubahan nilai Ct sebelum dan sesudah penggunaan antivirus pada gen ORF1ab, E, dan N, kebutuhan oksigenasi, mortalitas, kejadian yang tidak dikehendaki (KTD) dan analisis kausalitas KTD dengan Algoritma Naranjo. Hasil yang ditemukan menunjukkan remdesivir mempengaruhi peningkatan nilai Ct pada pasien COVID-19 derajat berat daripada kelompok non remdesivir, dengan peningkatan pada gen ORF1ab adalah 97,5% vs 83,8% (p=0,005), peningkatan pada gen E adalah 95% vs 81,2% (p=0,013), dan peningkatan gen N adalah 97,5% vs 82,5% (p=0,003). Hasil analisis multivariat, remdesivir mempengaruhi peningkatan gen ORF1ab 7,6 kali (95% CI: 1,600-36,449), gen E 5,1 kali (95% CI: 1,528-17,071), dan gen N 8,9 kali (95% CI: 1,864-42,265). Kebutuhan oksigenasi dan mortalitas kelompok remdesivir menunjukkan persentase yang lebih rendah daripada kelompok non remdesivir (15% vs 22,5%; p=0,311; dan 63,8% vs 70%; p=0,502). KTD lebih banyak terjadi pada kelompok remdesivir daripada kelompok non remdesivir (58,8%, vs 53,8%; p=0,633). Kejadian yang signifikan dan memiliki proporsi yang tinggi pada kelompok remdesivir adalah peningkatan ALT (p=0,037). Hasil penelitian ini dapat disimpulkan bahwa remdesivir mempengaruhi peningkatan nilai Ct, namun menunjukkan terjadinya gangguan fungsi hati yang bermanifestasi pada peningkatan nilai ALT.

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Studies on the effect of remdesivir on changes in the cycle threshold (Ct) values or viral load are still limited with varied results, even have never been conducted on subjects from Indonesia. This study aims to evaluate the effect of remdesivir on changes in Ct values and its safety in severe COVID-19 patients. The study was conducted retrospectively with a study cohort design. Research subjects consisted of remdesivir group (n=80) and non-remdesivir group (n=80). Observations focused on changes in the Ct values before and after antiviral use in the ORF1ab, E, and, N genes, oxygenation requirements, mortality, adverse events (AE), and AE causality analysis using the Naranjo Algorithm. The results showed that remdesivir affected the increase in Ct values in severe COVID-19 patients than the non-remdesivir group, with an increase in the ORF1ab gene was 97.5% vs. 83.8% (p = 0.005), an increase in the E gene was 95% vs 81.2% (p = 0.013), and an increase in the N gene was 97.5% vs 82.5% (p=0.003). The results of multivariate analysis showed that remdesivir increased the ORF1ab gene 7.6 times (95% CI: 1.600-36.449), the E gene 5.1 times (95% CI: 1.528-17.071), and the N gene 8.9 times (95% CI: 1.864-42.265). Oxygenation requirements and mortality in the remdesivir group showed lower percentages than the non-remdesivir group (15% vs 22.5%; p=0.311; and 63.8% vs 70%; p=0.502). AE in the remdesivir group was higher than in the non-remdesivir group (58.8%, vs. 53.8%; p=0.633). A significant event and a high proportion in the remdesivir group was an increase in ALT (p=0.037). The results of this study can be concluded that remdesivir affects the increase in Ct values, but shows the occurrence of impaired liver function which manifests in the increase in ALT values. "

"Infeksi Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pada derajat berat dan kritis dapat menyebabkan kejadian sindrom badai sitokin, dimana jika tidak ditangani secara tepat dapat menyebabkan kegagalan multiorgan. Tocilizumab merupakan antagonis reseptor IL-6 yang telah disetujui dan disarankan sebagai pengobatan untuk menurunkan mortalitas yang disebabkan oleh kejadian sindrom badai sitokin. Penelitian ini bertujuan untuk menganalisis efektivitas dan kejadian peningkatan enzim transaminase pada pasien terkonfirmasi COVID-19 di Rumah Sakit Universitas Indonesia dengan terapi tocilizumab. Penelitian ini dilakukan secara observasional retrospektif dengan desain cross-sectional di Rumah Sakit Universitas Indonesia tahun 2020-2021 dengan teknik total sampling. Pada penelitian ini sejumlah 68 pasien memenuhi kriteria inklusi dan eksklusi, sebagian besar pasien yang menerima terapi tocilizumab adalah laki-laki (58.8%), bergolongan darah B dan O (masing-masing 33.8%), memiliki komorbid hipertensi (47.1%), dan menerima terapi remdesivir (69.1%). Sebanyak 47 dari 68 pasien (69.12%) mengalami kejadian peningkatan enzim transaminase setelah pemberian tocilizumab. Pasien yang menerima terapi tocilizumab lebih banyak mengalami perburukan (55.9%) berdasarkan WHO Clinical Progression Scale tetapi lebih banyak yang mengalami perbaikan (66.2%) berdasarkan nilai CRP. Karakteristik pasien yang berpengaruh terhadap keberhasilan terapi tocilizumab adalah komorbid obesitas (OR: 1.745, 95% CI: 1.196-2.546; P = 0.015) berdasarkan WHO Clinical Progression Scale, golongan darah AB (OR: 3.647, 95% CI: 2.433-5.468; P = 0.001) dan O (OR: 5.333, 95% CI: 1.385-10.541; P = 0.014), serta terapi remdesivir (OR: 3.208, 95% CI: 1.091-9.434; P = 0.050) berdasarkan nilai CRP, serta terapi komorbid diabetes mellitus (OR: 0.208, 95% CI: 0.071-0.610; P = 0.005) berdasarkan Length of Stay (LOS).

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Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection in severe and critical state can cause the occurrence of cytokine storm syndrome, if this condition not treated properly it can cause multi-organ failure. Tocilizumab is an IL-6 receptor antagonist that has been approved and suggested as a treatment to reduce mortality caused by the occurrence of cytokine storm syndrome. This study aims to analyze the effectiveness and incidence of elevated transaminase enzymes in COVID-19 patients at Universitas Indonesia Hospital receiving tocilizumab therapy. This research was conducted retrospectively observational with cross-sectional design at Universitas Indonesia Hospital in 2020-2021 using total sampling. In this study a total of 68 patients met the inclusion and exclusion criteria, the majority of patients who received tocilizumab therapy were male (58.8%), blood group B and O (33.8% each), had comorbid hypertension (47.1%), and receiving remdesivir therapy (69.1%). 47 of 68 patients (69.12%) experienced elevated transaminase enzymes after tocilizumab administration. Patients who received tocilizumab therapy experienced more worsening (55.9%) based on the WHO Clinical Progression Scale but more experienced improvements (66.2%) based on CRP values. Patient characteristics that influence the effectiveness of tocilizumab therapy are comorbidities, obesity (OR: 1.745, 95% CI: 1.196-2.546; P = 0.015) based on WHO Clinical Progression Scale, blood type AB (OR: 3.647, 95% CI: 2.433-5.468; P = 0.001) and O (OR: 5.333, 95% CI: 1.385-10.541; P = 0.014), remdesivir therapy (OR: 3.208, 95% CI: 1.091-9.434; P = 0.050) based on CRP level, and diabetes mellitus (OR: 0.208, 95% CI: 0.071-0.610; P = 0.005) based on Length of Stay (LOS)."