Background: Corona Virus Disease (COVID-19) has become a global pandemic and has spread to more than 200 countries including Indonesia. South Kalimantan is one of the provinces in Indonesia that has a high COVID-19 mortality rate (case fatality rate 4.1%). Information about characteristic of mortality patients with SARS-CoV-2 infection in Indonesia was limited. The objective of this study to describe clinical characteristics of COVID-19-confirmed deaths at Ulin Regional Hospital Banjarmasin, as a referral hospital in South KalimantanMethods: Medical records of 108 hospitalized patients dying with COVID-19 between March until August 2020 were collected. The recorded information included gender, age, onset and severity of disease, comorbidities, symptoms, signs, and laboratory findingsResults: The 108 confirmed cases of COVID-19 deaths were mostly male (73.1%) aged <65 years old (85.2%). About 84% of the cases had at least one comorbidity or more, like hypertension (44.4%), obesity (38%), and diabetes mellitus (32.4%). Common early symptoms were fever (91.7%) and shortness of breath (89.8%). Laboratory findings included lympocytopenia and eosinophilopenia (80.6% and 72.2%), increased neutrophil lymphocyte ratio (NLR; 86.1%), decreased absolute lymphocyte count (ALC; 72.2%), and hyponatremia (55.6%). Elevated C-reactive protein (CRP; 92.6%), lactate dehydrogenase (LDH; 91.7%), serum glutamic oxaloacetic transaminases (SGOT; 82.4%), and creatinine levels (57.4%). The majority of non survivors were severe-critical stage with severe acute respiratory distress syndrome (ARDS).Conclusion: In this depictive study, patients with comorbidities and severe-critical stage are at risk of death. Laboratory abnormalities were common in non survivors. Shortness of breath may indicate poor prognosis of COVID-19.
Corona Virus Disease (COVID-19) is becoming a global pandemic. Indonesia, especially South Kalimantan had recorded increasing cases with a high fatality rate of 3.7%. Information about factors related to outcomes based on clinical and laboratory features in Indonesia is still limited. Identification of the risk is crucial to determine optimal management and reducing mortality. This retrospective study enrolled 455 adults COVID-19 patients, and data were extracted from medical records of Ulin General Hospital Banjarmasin. The latter is COVID-19 referral hospital in South Kalimantan between March-November 2020. Demographic data, comorbidities, and laboratory were all collected. Data were compared between survivors and non-survivors. Fisher’s exact test and chi-square were used to compare categorical variables. The Mann_Whitney U test was used to compare continuous variables. Analysis was continued by multivariate logistic regression then receiver operating characteristic (ROC) curve to determine cut-off value. The multivariate analysis showed that number of comorbidities [odds ratio (OR) 1,339 (95% confidence interval (CI): 1,064-1,685, P = 0,013) was a significant risk factor to the outcome. In laboratory, lactate dehydrogenase (LDH) [OR: 1.001, 95% CI: 1,000-1.002, P = 0.001], Ferritin (OR 1.000, CI: 1,000-1.001, P = 0.013), APTT (OR: 1.045, CI: 1.010-1.082, P = 0.012), and D-dimer (OR: 1.188, CI: 1.064 - 1.327, P = 0.002) were significant predictor factors but only LDH, ferritin, and D- dimer were obtained good AUC 0.731, 0.715, and 0.705, respectively. The cut of the value of LDH was 656.5 U/L, ferritin was 672.18 ng/ml, and D-dimer was 2.28 mg/L. Sensitivity and specificity were 66.7% and 68,0% for LDH, 83,2% and 56,3% for ferritin, and 62,8 and 70,8% for D-dimer. From this research, we revealed that the number of comorbidities was a risk factor for death. Elevated LDH, ferritin, and D-dimer could be good predictive factors for poor outcomes, thereby considering the accelerating management of COVID-19 patients
In Indonesia, the burden of tuberculosis (TB) infection is significant, and there is likely a substantial link between TB and malnutrition. Anemia, which is linked to TB patient outcomes and length of hospital stay, is another issue that might aggravate the disease. This study aims to identify how common undernutrition and anemia are among tuberculosis patients at the Ulin Regional Hospital in Banjarmasin. A cross-sectional observational study was conducted using medical record data from 31 hospitalized tuberculosis patients during the period of September to December 2021. Data of weight, height, body mass index (BMI), Hemoglobin (Hb) and blood albumin level at admission were analyzed. The result shows that tuberculosis cases are mostly found in the male (61.3%) with the age of 20-60 years (83.9%). There were 42% patients with undernutrition (BMI 18.5), 93.5% with anemia and 71% had hypoalbuminemia. Rifampicin resistance was found in 38.7% of all patients with 58.3% being malnourished, 100% had anemia, and 50% had hypoalbuminemia. There was a possible link between tuberculosis and under nutrition. Therefore, screening, early diagnosis, and treatment for under nutrition, anemia, and hypoalbuminemia should be encouraged in patients with tuberculosis, whether susceptible or resistant to rifampicin, to lower the burden of the disease.
The elderly is susceptible to infection due to immunosenescence causing high cases of infection with significant deaths due to Coronavirus Disease 2019 (COVID-19) pandemic. Many studies have examined inflammatory parameters as predictors of the outcome of COVID-19 cases, but there has been no comparison of the values of these parameters between the elderly and adult groups. This study aims to explain the relationship between inflammatory parameter values in the elderly group compared to the adult group with the outcome of confirmed COVID-19 patients treated at Ulin Hospital Banjarmasin. An analytical observational cross-sectional design study with the samples was patients with examined Neutrophil-Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio (PLR), Erythrocyte Sedimentation Rate (ESR), and C-reactive protein (CRP) when admitted to the COVID-19 isolation room at Ulin Banjarmasin Hospital and was divided into elderly and adult groups. A bivariate correlation test was conducted to assess the relationship between each parameter and continued by finding the cut-off value using the Receiver Operating Characteristic (ROC) curve. Odds Ratio (OR) is sought to find out how much the outcome risk prediction is based on the cut-off value. The relative coefficients of NLR, PLR, CRP, and ESR in the elderly group of 1147 subjects were 0.304; 0.119; 0.378; and 0.071. While the cut-off value of NLR, PLR, CRP, and ESR for the elderly group is 6.77; 257.5; 95.65, and 53.4. Outcomes prediction of the confirmed COVID-19 patients in the elderly group from the most significant are CRP, NLR, and PLR. Meanwhile, ESRs are statistically insignificant. The results showed that there are differences in inflammatory parameter values between the elderly and adult groups to predict the outcome of COVID-19 cases.
Background: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has undergone various mutations of Corona Virus Disease 2019 (COVID-19). The World Health Organization (WHO) has designated B.1.617.2 (Delta) and B.1.1.529 (Omicron) as variants of concern (VOC). Since clinical features and epidemiological characteristics of patients infected with SARS-CoV-2 variants remain largely unknown, especially in Indonesia, this study aimed to identify the clinical characteristics of COVID-19 patients from South Kalimantan, Indonesia.Methods: Data from medical records of COVID-19 patients at Ulin General Hospital Banjarmasin from June 2021 to February 2022 were randomly extracted, containing demographic data, comorbidities, and laboratory data, as well as the type of virus. Results: In total, 32 patients were included, 9 were infected with delta, 14 with probable omicrons, and 9 with non-VOC. Patients in the probable Omicron group were significantly older than other groups (median age 64 years old, range 54–73 years; p=0.049), had hypertension as the dominant comorbidity (85.7%; p=0.039), the onset appeared slightly earlier (median 3 days; range 2-3 days, p=0.062), with no anosmia symptom (p=0.006). Critical illness predominated and mostly survived in all variants but was not statistically significant (p=0.590 and 0.726, respectively). The three variants showed similarities in laboratory findings; hence, statistical analysis suggested that the leucocytes differed significantly (p=0.020).Conclusions: Patients with the likely Omicron variant are much older, have hypertension as their main comorbidity, do not have any symptoms of anosmia, and have higher leukocyte counts compared to other variants.
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