Efficacy of COVID convalescent plasma therapy in hospitalized moderate coronavirus disease 2019 patients.

INTRODUCTION: Covid Convalescent Plasma (CCP) failed to demonstrate its efficacy in severe and life-threatening coronavirus disease 2019 (COVID-19) cases. However, the role of CCP in hospitalized moderate cases is unclear. This study aims to examine the efficacy of administering CCP to hospitalized moderate coronavirus disease 2019 patients. METHODOLOGY: An open-label randomized controlled clinical trial design was used from November 2020 - August 2021 at two referral hospitals in Jakarta, Indonesia, and the primary outcome was mortality at 14 days. The secondary outcomes were mortality at 28 days, the time-to-discontinuation of supplemental oxygen, and the time-to-hospital discharge. RESULTS: This study recruited 44 subjects, and the intervention arm consisted of 21 respondents who received CCP. The control arm consisted of 23 subjects who received standard-of-care treatment. All subjects survived during the fourteen-day follow-up period, and the 28-day mortality rate in the intervention group was lower than the control (4.8% vs 13.0%; p = 0.16, HR = 4.39 (95% CI = 0.45-42.71). There was no statistically significant difference in the time-to-discontinuation of supplemental oxygen and time-to-hospital discharge. During the total follow-up period (41 days), the mortality rate in the intervention group was also lower than the control (4.8% vs 17.4%, p = 0.13, HR = 5.47, 95% CI = 0.60-49.55). CONCLUSIONS: This study concluded that in hospitalized moderate COVID-19 patients, CCP did not reduce 14-day mortality compared to the control. Mortality during 28 days and total length of stay (41 days) were lower in the CCP group compared to the control, although they did not reach statistical significance.

Diagnostic Model of COVID-19 Infection Based on the Combination of Clinical Symptoms, Chest Radiography and Laboratory Test.

BACKGROUND: COVID-19 is an infection caused by SARS-COV 2.For screening the patient, Rapid antigen for COVID-19 is used with a high diagnostic value. However, there are still some cases of false-negative even with clinical symptoms suggesting COVID-19. Undetected COVID-19 patients certainly will increase  transmission. A simple and practical diagnostic model, using determining factors, is required to guide physicians through a quicker decision making process, especially when deciding the need for the isolation rooms for patients with COVID-like symptoms. METHODS: This study is a cross-sectional study. The study was conducted at CiptoMangunkusumo Hospital, Jakarta.History of contact with COVID-19, clinical symptoms, laboratory examination, and chest radiograph data were taken from medical records. Bivariate and multivariate analyses were conducted to assess the effect sizes of patient factors on the diagnostic results.ROCcurve and Hosmer-Lemeshow calibration was used to make the scoring. RESULTS: There were 187 patients with the majority of subjects in the age group < 60 years old. The selected variables in this scoring systemwere contact history,fever/history of fever, dyspnea with respiratory rate >20 breaths/minute, leucocyte ≤ 10.000 cells/mLand typical chest radiography. The area under the curve for this model was 0,777 (CI95% (0,706-0,847), P<0,001). The probability was 82% with a cut-off point ≥ 4. CONCLUSION: Determinant models based on the combination of contact history, presence or history of fever, dyspnea, leucocyte count ≤ 10.000 cells/mL and typical chest radiography provides good accuracy to aid physicians in managing isolation room needs for patients with suspected COVID-19.

Coronavirus Disease 2019: Tinjauan Literatur Terkini

Pada awal 2020, dunia dikejutkan dengan mewabahnya pneumonia baru yang bermula dari Wuhan, Provinsi Hubei yang kemudian menyebar dengan cepat ke lebih dari 190 negara dan teritori. Wabah ini diberi nama coronavirus disease 2019 (COVID-19) yang disebabkan oleh Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Penyebaran penyakit ini telah memberikan dampak luas secara sosial dan ekonomi. Masih banyak kontroversi seputar penyakit ini, termasuk dalam aspek penegakkan diagnosis, tata laksana, hingga pencegahan. Oleh karena itu, kami melakukan telaah terhadap studi-studi terkait COVID-19 yang telah banyak dipublikasikan sejak awal 2020 lalu sampai dengan akhir Maret 2020. Kata Kunci: COVID-19, pandemi, SARS-CoV-2, Wuhan Coronavirus Disease 2019: Review of Current Literatures

The Management of Cytokine Storm in COVID-19.

Cytokine storm in COVID-19 infection is an excessive immune response to external stimuli where the pathogenesis is complex. The disease progresses rapidly and the mortality is high. Certain evidence shows that the severe deterioration of some patients has been closely related to the strong upregulation of cytokine production in SARS-Co-V2 induced pneumonia with an associated cytokine storm syndrome. Identification of existing approaved therapy with proven safety profile to treat hyperinflammation is critical unmet need in order to reduce COVID-19 associated mortality. To date, no specific therapeutic drugs are available to treat COVID-19 infection. Preliminary studies have shown that immune-modulatory or immune suppressive treatments might be considered as treatment choices for COVID-19, particularly in severe disease. This article review the pathogenesis and treatment strategies of COVID-19 virus-induced inflammatory storm in attempt to provide valuable medication guidance for clinical treatment.

The Importance of Chest CT Scan in COVID-19.

The coronavirus disease 2019 (COVID-19) is a highly transmissible acute respiratory disease that is caused by the Severe Acute Respiratory Syndrome CoronaVirus-2 (SARS-CoV-2), a beta coronavirus first discovered in Wuhan, China, in late 2019. COVID-19 has been spreading swiftly globally, and as of March 2020, has been officially declared a pandemic by the World Health Organization (WHO). One of the challenges in managing COVID-19 is the identification of a swift, accessible, and reliable diagnostic modality that could serve as an alternative to a reverse-transcriptase polymerase chain reaction (RT-PCR). As of the writing of this paper, RT-PCR is still the recommended tool in diagnosing COVID-19, but the notion of a more prompt and accurate diagnostic tool is a possibility worth looking into. The objective of this case study is to investigate the importance and utility of chest computed tomography (CT) in the diagnosis of COVID-19, as increasing pieces of evidence suggest that chest CT could prove useful in the clinical pathway in diagnosing COVID-19.