Background Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a virus that causes COVID-19, which has become a worldwide pandemic. However, until now, there is no vaccine or specific drug to prevent or treat COVID-19. Objectives To find out the effective treatment as an antiviral agent for COVID-19, to determine the correlation between sociodemography with clinical outcomes and duration of treatment, and to determine the relationship between comorbidities with clinical outcomes and duration of treatment for COVID-19 patients. Methods A prospective cohort study was conducted in this study. This study included only confirmed COVID-19 patients who were admitted to the hospital during April-May 2020. Convenience sampling was used to select 103 patients, but only 72 patients were suitable for inclusion. Results The survival analysis for COVID-19 patients using the Kaplan Meier method showed that patients receiving Oseltamivir + Hydroxychloroquine had an average survival rate of about 83% after undergoing treatment of about ten days. Gender (p = 0.450) and age (p = 0.226) did not have a significant correlation with the duration of treatment for COVID-19 patients. Gender (p = 0.174) and age (p = 0.065) also did not have a significant correlation with clinical outcome of COVID-19 patients. Comorbidities showed a significant correlation with duration of treatment (p = 0.002) and clinical outcome (p = 0.014) of COVID-19 patients. Conclusion The most effective antiviral agent in this study based on treatment duration was the combination of Oseltamivir + Hydroxychloroquine. The higher the patient’s average treatment duration is, the lower the average survival rate for COVID-19 patients.

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Background and aim Coronavirus Disease 2019 (COVID-19) has become a worldwide pandemic and is a threat to global health. Patients who experienced cytokine storms tend to have a high mortality rate. However, to date, no study has investigated the impact of cytokine storms. Materials and methods This retrospective cohort study included only COVID-19 positive patients hospitalized in a Private Hospital in West Jakarta between March and September 2020. All patients were not vaccinated during this period and treatment was based on the guidelines by the Ministry of Health Indonesia. A convenience sampling method was used and all patients who met the inclusion criteria were enrolled. Results The clinical outcome of COVID-19 patients following medical therapy was either cured (85.7%) or died (14.3%), with 14.3% patients reported to have cytokine storm, from which 23.1% led to fatalities. A plasma immunoglobulin (Gammaraas®) and/or tocilizumab (interleukin-6 receptor antagonist; Actemra®) injection was utilised to treat the cytokine storm while remdesivir and oseltamivir were administered to ameliorate COVID-19. Most (61.5%) patients who experienced the cytokine storm were male; mean age 60 years. Interestingly, all patients who experienced the cytokine storm had hypertension or/ and diabetes complication (100%). Fever, cough and shortness of breath were also the common symptoms (100.0%). Almost all (92.3%) patients with cytokine storm had to be treated in the intensive care unit (ICU). Most (76.9%) patients who had cytokine storm received hydroxychloroquine and all had antibiotics [1) azithromycin + levofloxacin or 2) meropenam for critically ill patients] and vitamins such as vitamins C and B-complex as well as mineral. Unfortunately, from this group, 23.1% patients died while the remaining 70% of patients recovered. A significant (p<0.05) correlation was established between cytokine storms and age, the presence of comorbidity, diabetes, hypertension, fever, shortness of breath, having oxygen saturation (SPO2) less than 93%, cold, fatigue, ward of admission, the severity of COVID-19 disease, duration of treatment as well as the use of remdesivir, Actemra® and Gammaraas®. Most patients recovered after receiving a combination treatment (oseltamivir + remdesivir + Antibiotics + Vitamin/Mineral) for approximately 11 days with a 90% survival rate. On the contrary, patients who received oseltamivir + hydroxychloroquine + Gammaraas® + antibiotics +Vitamin/Mineral, had a 83% survival rate after being admitted to the hospital for about ten days. Conclusion Factors influencing the development of a cytokine storm include age, duration of treatment, comorbidity, symptoms, type of admission ward and severity of infection. Most patients (76.92%) with cytokine storm who received Gammaraas®/Actemra®, survived although they were in the severe and critical levels (87.17%). Overall, based on the treatment duration and survival rate, the most effective therapy was a combination of oseltamivir + favipiravir + hydroxychloroquine + antibiotics + vitamins/minerals.

Background: Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a virus that causes COVID-19, which has become a worldwide pandemic. However, until now, there is no vaccine or specific drug to prevent or treat COVID-19. Objectives: To find out the effective treatment as an antiviral agent for COVID-19, to determine the correlation between sociodemography with clinical outcomes and duration of treatment, and to determine the relationship between comorbidities with clinical outcomes and duration of treatment for COVID-19 patients. Methods: A prospective cohort study was conducted in this study. This study included only confirmed COVID-19 patients who were admitted to the hospital during April-May 2020. Convenience sampling was used to select 103 patients, but only 72 patients were suitable for inclusion. Results: The survival analysis for COVID-19 patients using the Kaplan Meier method showed that patients receiving Oseltamivir + Hydroxychloroquine had an average survival rate of about 83% after undergoing treatment for about ten days. Gender (p = 0.450) and age (p = 0.226) did not have a significant correlation with the duration of treatment for COVID-19 patients. Gender (p = 0.174) and age (p = 0.065) also did not have a significant correlation with clinical outcome of COVID-19 patients. Comorbidities showed a significant correlation with duration of treatment (p = 0.002) and clinical outcome (p = 0.014) of COVID-19 patients. Conclusion: The most effective antiviral agent in this study based on treatment duration was the combination of Oseltamivir + Hydroxychloroquine.The higher the patient's average treatment duration, the lower the average survival rate for COVID-19 patients.

Purpose: To identify the use patterns of complementary and alternative medicine (CAM) and its impact on medication adherence among patients with stroke.Method: A systematic search through Science Direct, Google Scholar, and PubMed was performed to identify potential studies up to June 2021.The primary outcome was CAM use, and the secondary outcome was medication adherence among patients with stroke. Articles included in the review met the following criteria: 1) patients with stroke ≥18 years old on prescribed medications, and 2) medication adherence reported status. Meta-analyses were conducted to estimate the pooled prevalence of complementary and alternative medicine and adherence in stroke patients using a random-effects model.Results: A total of 1,330 studies were screened, of which 22 were included in the final analysis. The type of studies included were cross-sectional surveys, cohort studies, retrospective studies and prospective survey. The pooled prevalence of CAM usage was at 38% (29–48% CI) and medication non-adherence among stroke patients was at 29% (20–48% CI). The most common reason for inadequate stroke therapy and higher dependence on CAM was the patients’ lack of knowledge and the regimen complexity of the medication. Other factors for medication non-adherence were forgetfulness, side effects, cost, and lack of doctor-patient communication.Conclusion: A low prevalence of CAM usage and non-adherence to medications was observed among patients with stroke. Studies investigating the association between CAM usage and medication adherence among patients with stroke are scarce and future researches are needed to explore the influence of CAM use on stroke medication adherence.

Objective: To Evaluate intensively patients taking Sinovac-CoronaVac vaccine for the side effects and effectiveness in preventing COVID infection. Methods: This is a prospective crossectional study using convenience sampling for all Indonesian populations who received full dose of Sinovac-CoronaVac vaccine. Results: The efficacy and safety of the Sinovac-CoronaVac vaccine is 96.8%. factors that influence efficacy and safety are side effects with Age, BMI and Gender with p-value<0.05. Conclusion: There is correlation between side effects of Sinovac-CoronaVac with Age, BMI and Gender for safety and efficacy.

Objective of the review was to evaluate the correlation between treatment profile and survival analysis among Acute Respiratory Distress Syndrome (ARDS) covid-19 patients. Journals were searched from Google scholar, Elsevier and Pubmed with references from 2018 to 2021. Hydroxychloroquine and favipiravir has a good outcome in treating severe to critical illness patients. Ivermectin has a better output on treating mild to moderate symptoms covid-19 but further study is required to know the outcome from treating severe to critical illness. Oseltamivir only works on mild cases of covid-19, early-onset therapy on patient covid-19 can reduce the time of fever. An antibacterial is applied on the covid-19 patients with pneumonia and for cytokine storm patients required tocilizumab on therapy. Severe to critical cases of covid-19 can be given corticosteroid. Lopinavir/ritonavir and ribavirin have a poor antiviral activity against SARS-CoV-2. In conclusion, for severe to critical illness required hydroxychloroquine or favipiravir as antiviral agent plus antibacterial agent, if cytokine storm is developed tocilizumab can be given. For mild to moderate symptoms can be given oseltamivir or ivermectin, if there is a sign of bacterial infection (pneumonia) an antibacterial agent can be given.

Objective: To evaluate the potential side effects and efficacy also to find the risk factors that contributed to the side effects of both vaccines in Indonesia. Methods: This is a prospective cross-sectional study was conducted in October-December 2021; informations collection was carried out by using a standardized questionnaire and disseminated through social media. All full-dosed AstraZeneca and Moderna vaccine participants above 18 y old were included. Results: Among 406 participants, 73.4% were female, 87.2% were in the group of 18-30 y, 80 % were Java race, and 52.6% of them had asthma. In this study, the number of participants between AstraZeneca and Moderna was almost the same (50.5% and 49.5%). The most common side effects experienced after first of AstraZeneca and Moderna vaccine were fever (65.8% and 45.3%) respectively, sore arm (77.5% and 63.6%) respectively, headache (52.7% and 40.8%) respectively, and drowsiness (64.4% and 53.7%) respectively. After the second dose were fever (26.8% and 55.2) respectively, nausea (4.8% and 18%) respectively, diarrhea (0.5% and 5%) respectively, headache (27.3 and 44.8%) respectively and allergic reaction or skin rash (1% and 6%) respectively. After the first and second dose, participants with the AstraZeneca vaccine were most likely to get infected by COVID-19 (6.3% and 4.3%), respectively. Conclusion: Both AstraZeneca and Moderna vaccines' most common side effects were mild-moderate such as fever, sore arm, headache, drowsiness, and nausea. Several risk factors contributed to the side effects, such as younger age (median: 22), and female participants, and non-overweight BMI (median: 21.8).