Countries worldwide have deployed mass COVID-19 vaccination drives, but there are people who are hesitant to receive the vaccine. Studies assessing the factors associated with COVID-19 vaccination hesitancy are inconclusive. This study aimed to assess the global prevalence of COVID-19 vaccination hesitancy and determine the potential factors associated with such hesitancy. We performed an organized search for relevant articles in PubMed, Scopus, and Web of Science. Extraction of the required information was performed for each study. A single-arm meta-analysis was performed to determine the global prevalence of COVID-19 vaccination hesitancy; the potential factors related to vaccine hesitancy were analyzed using a Z-test. A total of 56 articles were included in our analysis. We found that the global prevalence of COVID-19 vaccination hesitancy was 25%. Being a woman, being a 50-year-old or younger, being single, being unemployed, living in a household with five or more individuals, having an educational attainment lower than an undergraduate degree, having a non-healthcare-related job and considering COVID-19 vaccines to be unsafe were associated with a higher risk of vaccination hesitancy. In contrast, living with children at home, maintaining physical distancing norms, having ever tested for COVID-19, and having a history of influenza vaccination in the past few years were associated with a lower risk of hesitancy to COVID-19 vaccination. Our study provides valuable information on COVID-19 vaccination hesitancy, and we recommend special interventions in the sub-populations with increased risk to reduce COVID-19 vaccine hesitancy.

Background: Coronavirus Disease emerge as a new global health crisis. COVID-19 has a wide range of clinical feature, from mild cough to severe respiratory failure. This study aims to learn more about clinical feature of This cross sectional analytic descriptive study includes all COVID-19 patients that yield positive result through GeneXpert-SARS-CoV-2 or Polymerase Chain Reaction (PCR). All data was taken from inpatient form March 12 th -June 30 th 2020. Results: There were 103 patients with 58 men and 45 women. Patients with male sex tend to experience severe pneumonia than women. It was also found that patients exposed to cigarette smoke tended to experience severe pneumonia symptoms. Patients with more than 1 comorbid tend to develop severe pneumonia symptoms. The dominant clinical symptoms in the patient were cough (84.5%), fever / history of fever (70.9%), and shortness of breath (67.9%). Hematological parameters that correlate with the degree of severity are leucocytes, thrombocyts, lymphocytes, neutrophils, CRP, LDH, creatinine, procalcitonin, SGOT, and SOFA Score. The most common radiological picture obtained was bilateral infiltrate (78.2%). The most common complication was sepsis (38.9%). The mortality rate for COVID-19 patients treated at RSSA tends to be high (26.2%). Discussion: clinical characteristics such as gender, smoking history, comorbides, clinical symptoms (fever, shortness of breath and cough), laboratory (leukocytes, % lymphocytes, % neutrophils and neutrophil counts, CRP, LDH, procalcitonin, creatinine, SGOT, and SOFA scores) has a significant effect on the severity of Covid infection 19 Conclusion: The clinical characteristics of COVID-19 patients affects the severity of the disease.

Latar Belakang: Hiperkoagulopati merupakan salah satu komplikasi pada COVID-19. Mekanisme koagulopati pada COVID-19 masih belum diketahui secara pasti, dimana salah satunya adalah peningkatan fibrinogen bebas dalam darah yang merupakan salah satu mekanisme penyebab koagulopati pada COVID-19. Objective: Menganalisis faktor koagulopati pada pasien COVID-19 yang dirawat di rumah sakit dan hubungannya dengan derajat oksigenasi. Metode: Kami melakukan analisis observasional, cross sectional, single-center, pada 25 pasien terkonfirmasi COVID-19. Uji statistik dipergunakan untuk menilai faktor faktor koagulasi seperti fibrinogen, D-dimer, trombosit dan hubungannya dengan derajat keparahan penyakit serta hubungannya dengan derajat oksigenasi yang dinilai dari PaO2/FiO2. Hasil: Subjek terdiri dari 12 pasien (48%) pada kelompok ringan-sedang dan 13 pasien (52%) pada kelompok berat. D-dimer dengan rerata 1,30 mg/L (0,43 mg/L-4,08 mg/L) meningkat pada 11 pasien (91,67%) pada kelompok ringan-sedang dan 11 pasien (84,61%) pada kelompok berat dengan rerata 11,42 mg/L (0,34 mg/L–66,30 mg/L). Fibrinogen dengan rerata 399,73 mg/dL (235,10 mg/dL -529 mg/dL) meningkat pada 7 pasien (58,33%) kelompok ringan sedang dan 10 pasien (76,92%) pada kelompok berat dengan rerata 444,31 mg/dL (284,7 mg/dL–543,0 mg/dL). Analisis statistik menunjukkan D-dimer berkaitan dengan derajat keparahan penyakit (p=0,039) dan fibrinogen berkorelasi terbalik dengan derajat oksigenasi yang dinilai dari PaO2/FiO2 ) (p=0.019; Pearson correlation = -4,67). Kesimpulan: Peningkatan kadar fibrinogen berkorelasi dengan penurunan derajat oksigenasi dan D-dimer berkaitan dengan derajat keparahan penyakit pada pasien rawat inap, diperkirakan  peningkatan faktor koagulasi seperti fibrinogen dan D-dimer mungkin merupakan faktor kunci berkembangnya COVID-19 menjadi kondisi yang lebih berat.

Background: Epidermal growth factor (EGFR) is a transmembrane receptor that plays an important role in the development of cancer phenotypes. Some patients with lung cancer have genetic mutations. Several studies have found a close correlation of EGFR gene mutation with 15-20% of lung adenocarcinoma cases. This study aimed to determine the EGFR profile in adenocarcinoma lung cancer patients at Haji Adam Malik General Hospital.Methods: This was a prospective cohort study conducted at Haji Adam Malik General Hospital, Medan. This study used patients data for 3 years, starting from January 1, 2014 to D1ecember 31, 2016. The sample size in this study was 34 patients. The data were then analyzed using SPSS.Results: All patients were adenocarcinoma lung cancer patients with positive EGFR mutation. There were 9 subjects with EGFR mutation in exon 19; 11 subjects with exon 21 L858R mutation; and 3 subjects with exon 21 L861Q mutation. Meanwhile, there were 3 subjects with uncommon EGFR mutations, namely exon 18 mutation. Majority of subjects with exon 19 mutation were male, aged >60 years, smokers with mixed types of cigarettes and severe brinkmann index. In subjects with exon 21 L858R mutation, most of the patients were male, aged 50-60 years, smokers with mixed cigarette types and severe brinkmann index. The same characteristics were also observed in subjects with exon 18 mutation. However, for exon 21 L861Q mutation, the majority of subjects were female with varying ages, and were not smokers. Conclusion: Most of the study subjects profiles were male, aged over 60 years, smokers, with mixed types of cigarettes, and with severe Brinkman Index. The EGFR mutations most commonly occured in exon 21, followed by exon 19 (ins/del exon 19), exon 18, and a combination of 2 exons.