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: Indonesia has a high number of COVID-19 cases and mortalities relative to not only among the Asia Pacific region but the world. Children were thought to be less affected by the virus compared to adults. Most of the public data reported combined data between adults and children. The Indonesian Pediatric Society (IPS) was involved in the COVID-19 response, especially in the area of child health. One of IPS's activities is collecting data registries from each of their chapters to provide a better understanding of COVID-19 in children.Objective: The objective of this study was to share the data of suspected and confirmed COVID-19 cases in children from IPS's COVID-19 data registry.Method: This is a retrospective study from the IPS's COVID-19 registry data. We collected the data of COVID-19 in children during March to December 2020 from each of the IPS chapters. We analyzed the prevalence, case fatality rate (CFR), age groups, diagnosis, and comorbidities of the children diagnosed with COVID-19.Result: As of December 21, 2020, there were 35,506 suspected cases of children with COVID-19. In total, there were 522 deaths, with a case fatality ratio (CFR) of 1.4. There were 37,706 confirmed cases with 175 fatalities (CFR 0.46). The highest mortality in confirmed COVID-19 cases was from children ages 10–18 years (42 out of 159 cases: 26%). The most common comorbidity and diagnosis found were malignancy (17.3%) and respiratory failure (54.5%).Conclusion: The CFR of confirmed COVID-19 cases in children in Indonesia is high and should be a major public concern.

Background While the number of cases of multisystem inflammatory syndrome in children (MIS-C) is increasing, reported cases in Asian countries are still low, particularly in Indonesia. This study aimed to describe the characteristics of patients with MIS-C in a tertiary referral hospital in Indonesia. Methods This is a cross-sectional study with collected data of patients with MIS-C admitted to Dr. Cipto Mangunkusumo from March 2020 to April 2021. Results The first case of MIS-C was detected 5 months after the first reported coronavirus disease 2019 case in Indonesia. Thirteen patients out of 158 positive admitted patients for COVID-19 were diagnosed with MIS-C during the study period. Of these 13 patients, 2 patients (15%) had a fatal outcome. Subjects were predominantly male, and the median age was 7.58 years (IQR 12.3) years. Most patients required mechanical ventilation (7 out of 13 patients) and intubation (8 out of 13 patients). Patients who needed intubation usually needed mechanical ventilation. All inflammatory markers, white blood cells, neutrophil counts, and all coagulation factor parameters (except for normal prothrombin time and activated partial prothrombin time) were elevated. The median time to MIS-C diagnosis was 2 days in the survivor group (n = 11) compared to 8.5 days in the non-survivor group (n = 2). Compared to the non-survivor group, those who survived spent more days in the hospital, received vasopressors earlier, and did not require mechanical ventilation as early as the non-survivors. Conclusions Our work highlights the differences in MIS-C clinical course, treatment, and clinical outcomes between the two groups.

In the published article, the text in the first paragraph, Methods section showed an incomplete information on the intention of the original data collection and incomplete information on the information comparing the original data with Ministry of Health (MOH) COVID-19 data collection.

Definisi hipertensi pulmonal (HP) pada anak dan dewasa adalah sama, yaitu bila mean pulmonary arterialpressure 􀁲25 mmHg saat istirahat atau 􀁲30 mmHg saat aktivitas. Pada anak pascabedah koreksi penyakitjantung bawaan (PJB), HP berat merupakan komplikasi yang sangat dikhawatirkan, dengan angka kejadiansekitar 2%. Sildenafil telah digunakan secara luas pada pasien HP dewasa, baik sebagai terapi tunggalmaupun kombinasi. Makalah ini bertujuan untuk mengevaluasi pemberian sildenafil pada anak denganHP pascabedah jantung koreksi. Kedua pasien dirujuk ke RS Dr Cipto Mangunkusumo, Jakarta (RSCM)dengan keluhan tampak biru, sesak terutama saat menetek, dan berat badan sulit naik. Saat itu keduapasien didiagnosis memiliki kelainan jantung bawaan berupa transposisi arteri besar (TGA), defek septumventrikel (VSD) dan HP. Operasi koreksi total (arterial switch dan penutupan VSD) dilakukan pada saatpasien pertama berusia 3 bulan 10 hari dan pasien kedua berusia 4 bulan 22 hari. Kedua pasien mendapatinhalasi nitric oxide (iNO), inhalasi iloprost, dikombinasikan dengan sildenafil oral, dengan dosis awal 0,5mg/kg berat badan (BB) per kali tiap 6 jam dengan pemantauan tekanan arteri berkala. Pasien pertamadipulangkan pada hari ke-23 pascabedah dan mendapat sildenafil oral dengan penurunan dosis bertahapdalam kurun waktu 6 bulan. Pasien kedua dipulangkan pada hari ke-12 pascabedah dan masih mendapatterapi sildenafil oral dengan dosis yang sama sampai hari ini. Pada kedua pasien tidak dilaporkan kejadianefek samping. Sebagai kesimpulan sildenafil efektif dalam memperbaiki hemodinamika pembuluh darahpulmonal dan bekerja secara sinergik dengan iNO. Sildenafil oral merupakan terobosan terapi yang menarikdan cukup efektif karena mudah pemberiannya dan memiliki efek samping minimal.

BackgroundAll sectors are affected due to COVID-19 pandemic occurring worldwide, including the education industry. School closure had been taking place for more than a year in Indonesia. Despite the controversies, Indonesian government had decided to begin school reopening.ObjectivesThis study aims to assess parental readiness for school reopening, and factors affecting parental attitude toward school reopening.MethodsA cross-sectional study using online questionnaire distributed via official Indonesian Pediatric Society (IPS) official social media account collected between March and April 2021. The questionnaire contained the general characteristics of study participants, parents' knowledge, and perspectives on COVID-19, and health protocols for school reopening.ResultsA total of 17,562 responses were collected, of which 55.7% parents were ready to send their children to school should school reopens. Factors significantly contribute to parental decision to keep their child at home were: presence of vulnerable population at home [OR = 1.18 (1.10–1.27), p < 0.001], children with comorbidities [OR = 2.56 (2.29–2.87), p < 0.001], perception of COVID-19 as a dangerous disease [OR = 28.87 (14.29–58.33), p < 0.001], experience with COVID-19 positive cases in the community [OR = 1.75 (1.61–1.90), p < 0.001], COVID-19 related death in the community [OR = 2.05 (1.90–2.21), P < 0.001], approval for adult COVID-19 vaccination [OR = 1.69 (1.53–1.87), p < 0.001], and ownership of private transportation [OR = 1.46 (1.30–1.66), p <0.001].ConclusionWe identified several factors affecting parental perception on school reopening during COVID-19 pandemic that should be addressed. This study can be used for policy-maker to make further recommendations and health educations prior to school reopening in Indonesia.

Objectives. To identify parameters that can improve the effectiveness of COVID-19 screening in the pediatric population according to the demographic, clinical, and epidemiological characteristics of pediatric patients screened for COVID-19 at our hospital. Methods. A cross-sectional study of suspected and confirmed pediatric patients (0–18 years old) with COVID-19 using data from the electronic medical records of Dr. Cipto Mangunkusumo Central Hospital from March to December 2020. Results. From 1,018 data of suspected COVID-19 pediatric patients, there were 94 (9.2%) confirmed cases of COVID-19. The proportions of children with travel history ( p = 0.022 ), positive contact history ( p < 0.001 ), fever ≥38°C ( p = 0.034 ), cough ( p = 0.038 ), and abdominal pain ( p = 0.022 ) were significantly higher in the confirmed COVID-19 group compared to the non-COVID-19 group. Conclusions. A majority of the confirmed COVID-19 pediatric patients have travel and positive contact history, along with symptoms of fever, cough, and abdominal pain. However, these are nonspecific symptoms that may also be misdiagnosed as other diseases. Improving access and turnaround time of the RT-PCR test is mandatory, as no specific screening variables have been identified.

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