ABSTRACT
BACKGROUND AND AIM: BACKGROUND: Indonesia has experienced two waves of SARS-CoV-2 infection during 2 years of pandemic. The first wave was October 2020 - February 2021 and the second was between May - July 2021. Only few studies comparing the clinical profiles and predictors of severe COVID-19 children between the waves. AIM: To compare the clinical profiles and predictors of severe COVID-19 children between the first and second wave of pandemic. METHOD(S): METHOD: There were 270 children hospitalized with SARSCoV- 2 infection confirmed by RT-PCR during the study period. Twelve children with severe COVID-19 in PICU of 3 hospitals in North Sumatera Indonesia during the first and second waves were enrolled. The data collected were related to clinical characteristics, interventions provided, laboratory findings, and outcomes. RESULT(S): RESULTS: Twelve (4.4%) patients developed severe and critical COVID-19. Eight children in the first wave and the others in the second wave, all of them had comorbidities. Male infants were 50% cases. Fever, cough, dyspnea, and SpO2 < 93% were the most prominent symptoms in first wave cases but neither in the second wave. Low platelet and lymphocyte count with markedly increased C-reactive protein and D-dimer were considered as the predictors of severity. All of the cases were at risk of PARDS with SF ratio below 150. Poor outcome was observed in 87,5% in the first wave versus 25% in the second wave. CONCLUSION(S): CONCLUSION(S): There were major differences comparing the clinical profiles and predictors of severe COVID-19 children between first and second wave of SARS-CoV-2 pandemic.
ABSTRACT
Background : Covid 19 was first reported in the early of march 2020, increasingly rapidly and today reaching 1,386,556 cases. Meanwhile the worldwide cases reach 117,727,822 cases as reported at 9 of march 2021. Clotting plays a big role in mortality and morbidity of Covid-19 infection, Ddimer a fibrin degradation product was used as a marker of hypercoagulable state were studied among patients admitted in Murni Teguh Memorial Hospital (MTMH) between March 2020 until February 2021. Aims : This study aims to study the relationship between the increase of Ddimer levels and the number of deaths among Covid 19 patients. Methods : This is a cross-sectional study to investigate the increase of Ddimer levels among the death cases in Covid 19 patients. Results : A total of 981 covid 19 cases admitted at MTMH with the number of deaths 156 cases (15.8%), The ddimer level was elevated in 80.7% death cases. There was no statistical difference within the survive and death cases. ( P = 0.085). The mortality rate of the renal failure ongoing dialysis with covid 19 was 100 % with ddimer level above 2 (cut off level 0.5). Prothrombin time and Activated partial thromboplastin time levels were elevated in 57 % of death cases and there was a statistical difference between the survival and death cases ( P = 0.035). Conclusions : Ddimer levels were elevated in 80.7 of death cases in Covid 19 patients, with 57 % cases elevated in prothrombin time and activated partial thromboplastin time.
ABSTRACT
AIMS & OBJECTIVES: The genetic factor may influence the response against SARS-CoV-2 infection and how resilient host to the COVID-19. The immune system and gut microbiome were closely linked to genetic as well, to control the course of the disease.The identical twins have almost identical genetic and the constitutional makeup seems to be an important factor. METHODS: to report a case of COVID-19 in twin adolescent children RESULTS: A twin 11-year-old girls were living together with their mother who have anosmia, shortness of breath, fever and were confirmed of COVID-19. The twin have confirmed COVID-19 from nasal and pharyngeal swab RT-PCR, and they were hospitalized in isolation ward. The twin presented different clinical appearance and psychological response. One girl have fever, hoarseness, flu-like syndrome and cough. The chest x-ray showed infiltrates and slight ground grass appearance in the thoracic CT-scan. She suffered depression and sign of posttraumatic stress disorders (PTSD). The other girl showed low grade fever, anorexia and diarrhoea, no symptom of mental illness and no abnormality in chest x-ray Azithromycin 250 mg once daily and 60 mg oseltamivir orally every 12 hours was started since admission, with another symptomatic treatment according their condition. Fever and sign of infection improved gradually. Repeated follow up of swab PCR was negative after 18 days of onset. The girl with PTSD need minor tranquillizer and psychiatric supporting to stabilize her mental health. CONCLUSIONS: We would like to emphasis the different symptom of COVID-19 in twin adolescent children.