ABSTRACT
Background: Coronavirus disease 2019 (COVID-19) is an infectious disease caused by a coronavirus (SARS-CoV-2) that can induce cytokine storm. To this point, no specific drug has been effective for curing COVID-19. Objectives: The aim of this study was to determine the effects of a combination of acupuncture intervention and pharmacologic treatment in hospitalized COVID-19 patients with mild-moderate symptoms. Methods: A single-blinded randomized controlled clinical trial of hospitalized COVID-19 patients confirmed by RT-PCR examination with mild-moderate symptoms was conducted from August to September 2020. Participants were assigned to the treatment group (receiving pharmacologic treatment and manual acupuncture intervention) or the control group (receiving only pharmacologic treatment). Laboratory outcomes, including complete blood count, C-reactive protein (CRP) and ferritin levels, and erythrocyte sedimentation rate (ESR), were measured before and after the intervention. For clinical outcomes, we evaluated the duration of the cough symptom. Results: We found that participants in the treatment group had a shorter duration of the cough symptom compared to the control group, and the difference was statistically significant. In the treatment group, we found an increase in the percentage of lymphocyte count and ESR, while in the control group, both parameters were decreased; however, the differences were not statistically significant. There was a decrease in the mean of CRP and ferritin levels in both groups, and the differences were not statistically significant. Conclusion: Our study has shown promising results for the effects of combined treatment of acupuncture and pharmacologic treatment on the duration of the cough symptom in hospitalized COVID-19 patients with mild-moderate symptoms. Further large-scale studies with rigorous design are needed to examine these preliminary results.
Subject(s)
Acupuncture Therapy , COVID-19 , Humans , COVID-19/therapy , SARS-CoV-2 , Cough , Ferritins , Treatment OutcomeABSTRACT
Munculnya virus korona SARS-CoV-2 pada bulan Desember 2019 kemudian menyebabkan COVID-19 yakni penyakit yang sifatnya akut menyerang terutama pada organ saluran napas. SARS-CoV-2 merupakan jenis ketiga dari virus korona yang sangat patogen menginfeksi manusia setelah SARS dan MERS dan telah menjadi pandemi di abad 21. Beberapa studi virologi preklinik klinik serta kesehatan komunitas terkait dengan COVID-19 telah mulai dipublikasikan sejak awal pertama terjadinya wabah yakni awal tahun 2020. Adanya kajian riset tersebut mampu memengaruhi pengambilan keputusan dalam rangka eradikasi COVID-19 dan kebijakan kesehatan masyarakat yang akan ditetapkan. Pengambilan keputusan yang keliru dalam aspek klinik bisa berakibat fatal bagi individu maupun sub kelompok terinfeksi dalam populasi di suatu wilayah. Begitu juga kesalahan pengambilan kebijakan akan berpengaruh pada strategi penanganan wabah. Tinjauan pustaka ini akan lebih menilai pemahaman virologi mengenai karakteristik SARS-CoV-2 cara penularan (transmisi) virus patogenisitas virus manajemen kasus klinis dan aspek epidemiologi klinik COVID-19. Pandemi global COVID-19 berujung pada munculnya berbagai masalah terkait penanganan wabah dan kebijakan kesehatan masyarakat di Indonesia. Rekomendasi yang tepat dalam penanganan wabah dan perspektif masa depan COVID-19 juga diperlukan dalam menghadapi pandemi global COVID-19.
ABSTRACT
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has been a major threat to global public health. In Indonesia, the cases have rapidly increased, and the case fatality rate remains high. With COVID-19, most of the deaths have been caused by acute respiratory distress syndrome and dysregulation of the immune response. A lung biopsy from a patient with COVID-19 showed inflammatory cellular infiltration with diffuse alveolar damage. Massive pulmonary destruction has also been reported as a result of highly increased levels of proinflammatory cytokines, such as tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), IL-1ß, interferon-γ (IFN-γ), induced protein 10 (IP-10), and monocyte chemoattractant protein-1 (MCP-1). IL-6 is an inflammatory cytokine produced by various cell types, including immune cells and nonleukocytes, such as endothelial cells, fibroblasts, epithelial cells, type II pneumocytes, and certain tumor cells. Several studies have shown that IL-6 contributes to the severity and mortality of COVID-19. In this review, we would like to explore the immune response in COVID-19 and the role of IL-6 in the immunopathogenesis of COVID-19.