Background The incidence of COVID-19 is still rapidly increasing, but little is known about the prevalence and characteristics of fatal cases in children in Indonesia. This study aims to describe the characteristics of pediatric COVID-19 cases with fatal outcomes in Indonesia's tertiary referral hospital. Methods This is a cross-sectional study with data collected from the medical records of COVID-19 patients admitted to Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia, from March to October 2020. Results During the study period, 490 patients were admitted and diagnosed with suspected and probable COVID-19. Of these patients, 50 (10.2%) were confirmed to have COVID-19, of which 20 (40%) patients with positive tests for SARS-CoV-2 had a fatal outcome. The fatality was higher in patients ≥10 years old, categorized with severe disease upon admission, with PaO 2 /FiO 2 ratios of ≤300 mmHg and chronic underlying diseases. The most common clinical manifestations were generalized symptoms, while acute respiratory distress syndrome (8/20) and septic shock (7/20) were the two most common causes of death. Increased procalcitonin, D-dimer, lactate dehydrogenase, and presepsin levels were found in all fatal COVID-19 cases. One patient met the criteria of multisystem inflammatory syndrome in children (MIS-C). Conclusion Our work highlights the high mortality rate in pediatric patients positive for the COVID-19 test. Further studies are needed to understand better the role of SARS-CoV-2 in elaborating the mechanisms leading to death in children with comorbidities.

Background Dengue hemorrhagic fever (DHF) can lead to highmorbidity and mortality. Its clinical features vary from time to time.Many studies were performed to determine the risk factors of se-vere dengue infection.Objective To find out clinical features and risk factors for predict-ing the likelihood of shock in DHF.Methods A retrospective cohort study was conducted in all con-firmed DHF children who were hospitalized at the Department ofChild Health, Cipto Mangunkusumo Hospital within the period ofJanuary 1, 2003 until June 30, 2004. Risk factors for developmentof shock were analyzed using chi-square test and multiple logisticregressions with a level of significance of <0.05.Results A total of 101 patients, consisted of 47 males and 54females were enrolled in this study. Mean age was 6.5 (SD 3.6)years, ranged from 5 months to 15 years. About 31.7% patientshad grade III DHF, 30.7% grade II, and 26.7% grade IV (including1 patient with encephalopathy). Shock was more frequent amongpatients aged between 6-10 years, female, under-nourished, bodytemperature <38°C, hematocrit level 46-50 vol%, and platelet count<20 000/ml. During year 2003-2004, there was increased numberof patients who developed shock. Based on univariate analysis,hepatomegaly, high hematocrit value, and thrombocytopenia wereconsidered significantly different. Among those variables analyzedwith multiple logistic regression method, only hepatomegaly andthrombocytopenia were identified as predictors of shock.Conclusion There was an alteration on clinical features of DHFin our hospital in 2003-2004 period compared to the previous years.Hepatomegaly and platelet count <50 000/ml are independent riskfactors of shock among DHF patients

Latar belakang. Skor PELOD-2 digunakan untuk mengetahui disfungsi organ pada anak dengan sakit kritis. Hasil skor PELOD-2 tidak selalu berbanding lurus dengan luaran perawatan anak sakit kritis sehingga tidak selalu dapat digunakan sebagai prediktor luaran dan mortalitas anak yang dirawat di PICU.Tujuan. Mengetahui profil dan luaran pasien sakit kritis yang dirawat berdasar skor PELOD-2.Metode. Penelitian dilakukan secara retrospektif dengan mengambil data rekam medis pasien rawat di ruang intensif anak RSUPN Cipto Mangukusumo, sejak Januari sampai Desember 2018. Pengambilan subjek secara total sampling, penilaian dilakukan pada 24 jam pertama perawatan. Hasil. Diperoleh 477 subjek yang memenuhi kriteria. Subjek sebagian besar berjenis kelamin laki-laki (56,4%), berusia <1 tahun (27,9%), dengan bedah sebagai diagnosis awal terbanyak (65%). Sebagian besar pasien memiliki penyakit kronik (70,4%). Angka mortalitas penelitian ini adalah 10,7%. Mayoritas subjek memiliki lama rawat <7 hari (75,5%). Subjek dengan lama rawat >14 hari memiliki median skor PELOD-2 tiga kali lipat dari subjek dengan lama rawat <7 hari. Titik potong luaran mortalitas skor PELOD-2 pada penelitian ini adalah >5, memiliki spesifisitas 84,5% dan sensitifitas 84,3% dengan nilai AUC skor PELOD-2 dari kurva ROC sebesar 93,4% (IK 95% 90,6–96,2).Kesimpulan. Skor PELOD-2 dapat digunakan untuk memprediksi disfungsi organ yang mengancam kehidupan pada anak tanpa imunosupresi dan semakin tinggi skor PELOD-2 akan diikuti dengan peningkatan lama rawat dan mortalitas.

Latar belakang: prevalensi anemia defisiensi besi masih tinggi terutama pada bayi. Deteksidini terhadap anemia pada bayi terutama bayi dengan risiko tinggi sangat diperlukanuntuk mencapai tumbuh kembang optimal.Tujuan: untuk mengetahui prevalensi anemia defisiensi besi.Bahan dan cara metode: studi deskriptif belah lintang dilakukan di empat Puskesmasdi Jakarta Timur. Populasi sampel adalah bayi umur 4-12 bulan yang tinggal di wilayahKecamatan Matraman dan sekitarnya pada bulan Maret 2004. Sampling diambil denganmetode convenient, pengumpulan data dengan pengisian kuesioner oleh ibu bayi secaraterpimpin. Pengukuran di lakukan pada panjang badan, berat badan, lingkar kepalabayi. Pemeriksaan kadar hemoglobin menggunakan Hemocue®, sedangkan serum feritindiperiksa di laboratorium SEAMEO-TROPMED FKUI.Hasil: sampel terdiri dari 55 bayi, 63,6% laki-laki, 58,2% berumur 8-12 bulan, dan87,3% berasal dari keluarga dengan pendapatan per kapita per bulan rendah. Sebagianbesar berstatus gizi kurang (60%), 96,4% lahir cukup bulan, 3,6% bayi lahir denganberat badan rendah pemberian ASI ekslusif 94,5%. Diantara 55 bayi 38,2% mengalamianemia dan 71,4% bayi anemia tersebut menderita anemia defisiensi besi. Prevalensianemia defisiensi besi lebih besar pada bayi 8-12 bulan daripada bayi yang lebih muda,yaitu 73,3%.Kesimpulan: tidak didapatkan hubungan bermakna antara anemia defisiensi pada bayidengan jenis kelamin, umur, tingkat pendapatan orang tua, usia gestasi, berat lahir,pemberian ASI ekslusif, susu formula yang difortifikasi besi, dan makanan pendampingASI, serta infeksi yang diderita bayi.