Association between cigarette smoking patterns and severity of COVID-19: Findings from a study in 15 private Hospitals in Indonesia.

INTRODUCTION: Indonesia is ranked fourth among countries with the highest smoking rates and has the highest number of male smokers globally. This study aimed to assess the association between cigarette smoking patterns and the severity of COVID-19 among patients in 15 Indonesian hospitals. METHODS: A cross-sectional study was conducted from April to August 2020 using medical records of 490 COVID-19 patients, including the history of their smoking patterns from 15 private referral hospitals in 5 provinces. The severity was defined based on the Guidelines on the Prevention and Control of COVID-19 issued by the Indonesian Ministry of Health, which was indicated by the care provided to patients, namely outpatient, inpatient, and Intensive Care Unit (ICU) services for mild, moderate, and severe symptoms. Smoking patterns were grouped based on adult tobacco use classifications of the Centers for Disease Control and Prevention (CDC). Univariate and bivariate analyses were performed. RESULTS: The results showed that 69.8% of respondents had not smoked cigarettes, 17.1% were active smokers, and 13.1% were former smokers. A significant difference was seen in the number of cigarettes smoked by patients in the ICU, inpatients, and outpatients, among current smokers and passive smokers (p=0.018 and p=0.005, respectively). Furthermore, there was no significant difference in the severity of COVID-19 among current smokers, former smokers, and non-smokers. The time from when smoking was stopped among former smokers was not associated with the severity of COVID-19. CONCLUSIONS: There was no significant difference in COVID-19 severity between groups of smokers. Passive smoking and the number of cigarettes smoked by smokers daily were associated with the severity of COVID-19. Smoke-free policies should be implemented continuously to protect people from the dangers of secondhand smoke.

Congregational Worshiping and Implementation of the COVID-19 Preventive Behavioral Measures During the Re-opening Phase of Worship Places Among Indonesian Muslims.

This research aimed at exploring the congregational form of worshiping and the preventative behaviors against COVID-19 among Indonesian Muslims during the re-opening phase of worship places. One thousand and ninety-seven (1097) participants who were a part of one of the largest Indonesian socio-religious organizations (Muhammadiyah) were included in the study. This study found most of the respondents to have performed tarawih prayers (66.7%) and Eid prayers (67.4%) at home during the pandemic. Furthermore, some Muslim worshipers did not observe COVID-19 preventive behavioral measures during the congregational prayers, and the attended mosques had inadequate facilitation for COVID-19 prevention. Neverthless, mosques are important settings for health promotion programs, whose religious leaders can be partners in delivering health related messages to their attending members.

The roles of Islamic Faith-Based Organizations on countermeasures against the COVID-19 pandemic in Indonesia.

This study aimed to examine the strengths of Indonesia's two largest Islamic Faith-Based Organizations (FBOs) and the challenges experienced while performing activities on countermeasures against COVID-19 in Indonesia. In-depth interviews, focused group discussions, and document analysis were used to collect data. The participants (informants) were administrators of a special Islamic FBOs unit that handles COVID-19 programs at central and regional levels and the beneficiaries of Islamic FBOs COVID-19 programs, selected using expert sampling. As part of data collection, an interview guideline was set to explore the participants' strengths and challenges in performing various programs for overcoming the pandemic. The data was analyzed using the thematic content analysis. The results showed that Islamic FBOs had special units that performed various countermeasures against COVID-19, including primary prevention like delivering health education and psychological consultation, and secondary prevention, mainly treating the pandemic, managing its prevailing conditions, and minimizing its economic impact, and supporting its vaccine. Moreover, the large members and participants, organizational structures involving grassroots levels, and financial support from the organizations' reputable philanthropic agencies were their strengths in performing those activities. However, coordination in the organization from central board to branch level was considerably challenging, especially where the coordination path was long. The insufficient information technology facilities also made the process difficult online. Therefore, profound religious FBOs served indispensable contributions and potencies in directing the community and minimizing the impact of the pandemic and other disasters in terms of health and social-economic welfare.

Significance of Chronic Diseases and Smoking Behavior in the Development of Acute Respiratory Distress Syndrome Among Hospitalized COVID-19 Patients in Indonesia.

Acute respiratory distress syndrome (ARDS) is one of the main causes of high mortality among coronavirus disease 2019 (COVID-19) patients. This study aimed at determining the association between presence of chronic diseases and smoking behaviors with the development of ARDS among hospitalized COVID-19 patients in Indonesia. This study was carried out in 15 Muhammadiyah-'Aisyiyah-affiliated COVID-19 referral hospitals in Indonesia. Four hundred ninety participants who tested positive for the COVID-19 were recruited in this study. Demographic data, history of chronic diseases, and the development of ARDS were retrieved from hospital patient records. Information about the smoking behavior was collected after respondents were discharged from the hospital. Presence of chronic diseases such as diabetes, chronic heart disease, hypertension, and chronic liver diseases were significantly associated with the development of ARDS. In a similar regard, patients who currently smoked had a 5 times greater risk of developing ARDS compared with those who never smoked.

The performance of point-of-care antibody test for COVID-19 diagnosis in a tertiary hospital in Bandung, Indonesia.

INTRODUCTION: We aim to describe the performance of combined IgM and IgG point-of-care antibody test (POC-Ab) (Wondfo®) compared to real-time reverse transcriptase (rRT-PCR) (Allplex™ 2019-nCoV Assay) in detecting coronavirus disease 2019 (COVID-19). METHODOLOGY: We compared POC-Ab with rRT-PCR results among patients in a tertiary hospital from January to March 2020 in Bandung, Indonesia. We selected presumptive COVID-19 patients with positive rRT-PCR consecutively and 20 patients with negative rRT-PCR results were selected randomly from the same group of patients as controls. We described the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) with corresponding 95% confidence interval using serum and capillary blood samples. We also tested POC-Ab using non-COVID-19 (confirmed dengue and typhoid) patients' sera. RESULTS: Twenty-seven patients with positive rRT-PCR result and 20 negative controls were included (68.1% males, mean age 46 (SD: 15.4)). Using the serum, the sensitivity of the POC-Ab was 63.0% (42.4-80.6), specificity was 95.0% (75.1-99.9), PPV was 94.4% (72.7-99.8), NPV was 65.5% (45.7-82.1). A subset of 20 patients was tested using a capillary blood sample. The accuracy of the capillary blood sample is lower compared to serum (50.0% vs. 78.7%). None of the non-COVID-19 sera tested were reactive. CONCLUSIONS: POC-Ab for COVID-19 has a high specificity with no false-positive result in non-COVID-19 sera. Therefore, it can be used to guide diagnostic among symptomatic patients in resource limited settings. Given its low sensitivity, patients with high suspicion of COVID-19 but non-reactive result should be prioritized for rRT-PCR testing.

The Impact of Large-scale Social Restrictions on the Incidence of COVID-19 : A Case Study of Four Provinces in Indonesia

The Indonesian government has chosen to implement large-scale social restrictions (Pembatasan Sosial Berskala Besar/PSBB) to minimize the spread of COVID-19. Large-scale social restrictions is a government policy aimed at restricting the internal movement of people in a bid to reduce the spreading of SARS-CoV-2. This study aims at assessing the impact of large-scale social restriction measures on the incidence of COVID-19 cases in the four provinces of Indonesia. Time series analysis was used to describe the trends of COVID-19 case by using surveillance data from the Ministry of Health of Indonesia. Quasi-Poisson regression with an interaction model was used to estimate the incidence rate ratio (IRR). IRR was calculated to compare an incidence rate before and during PSBB implementation. The trend of COVID-19 cases in the provinces of West Java, East Java, Banten, and Jakarta continued to fluctuate. These four provinces continue to experience a significant increase in COVID-19 incidence rate ratio after the first and second PSBB period implementation compared to the time of before PSBB implementation. Lack of proper implementation of the large-scale social restriction led to the PSBB's ineffectiveness in reducing the number of COVID-19 cases in each of the provinces.