Severe acute respiratory syndrome coronavirus-2 antibody response after Moderna vaccine booster on healthcare providers.

INTRODUCTION: As an endeavor to control SARS-CoV-2 infection, the Moderna vaccine booster was given to healthcare workers to prevent reinfection and reduce the risk of complications from COVID-19. A heterologous booster vaccine is also thought to provide better protection against the current SARS-CoV-2 variants of concern. However, research that evaluates the effectiveness of the Moderna vaccine booster and the resulting SARS-CoV-2 antibody concentration is needed. OBJECTIVE: To evaluate the concentration of SARS-CoV-2 antibodies after the Moderna vaccine booster and the severity of SARS-CoV-2 infection before and after the Moderna vaccine booster. RESULTS: A total of 93 healthcare providers who received Moderna vaccine booster were included in the study. Examination of antibody concentration 3 months after the booster showed an average concentration of 10081.65 U/mL. There was an increase in antibody concentration before the booster and 3 months after, from a median of 1.7 U/mL to 9540 U/mL. Every subject showed a statistically significant increment of antibody concentration 3 months after the booster (p < 0.01). Thirty-seven (39.8%) subjects received two doses of the Sinovac vaccine and were confirmed to have COVID-19 with the Delta variant. After the booster, 26 (28%) subjects were infected with the Omicron Variant. Among the subjects who received two doses of the Sinovac vaccine and were confirmed with COVID-19, 36 (30.1%) had mild symptoms, and 1 (1.1%) was asymptomatic. CONCLUSIONS: Heterologous Moderna vaccine booster effectively increases antibody response against SARS-CoV-2 variants and shows mild symptoms of COVID-19 infection.

Bronchoscopy Findings of Severe and Critical COVID-19 Patients Treated in ICU: A Year of Experience in a Developing Country.

Background: Bronchoscopy procedure in patients with COVID-19 poses significant challenges, especially in a developing country with limited resources. Objectives: We aim to describe the clinical characteristics of severe and critical COVID-19 patients treated in an intensive care unit (ICU) and their bronchoscopy findings. Methods: We performed a retrospective analysis of clinical data of ICU patients with COVID-19 treated and received bronchoscopy procedures. This study retrospectively included all consecutive patients who underwent bronchoscopy at a teaching hospital in Depok, Indonesia, from May, 2020, until May, 2021. Results: A total of 57 bronchoscopy procedures in 54 patients were performed in this study. Primary procedure indications were retained mucus (68.4%) and ventilatory support weaning failure (15.8%). Bronchoscopic findings were mostly hyperaemic mucosa (95.00%) and purulent secretion (50.90%). Microbiological findings from bronchoalveolar samples were Acinetobacter baumanii, Klebsiella pneumoniae, and Candida albicans (33.3%, 26.6%, and 10.5%, respectively). The most common fungal isolated were Candida albicans (28%), followed by Candida tropicalis (16%) and Aspergillus sp. (8%). The overall length of hospital stay was 24 days, and the in-ICU stay was 22.06 ± 10.99 days. The patients' survival of 28-days postprocedural outcome was 25.9% (14 subjects). Follow-up found that 20.4% of patients survived after sixty days of hospitalization. Conclusion: Diagnostic and therapeutic bronchoscopy in ICU patients with COVID-19 was safe and feasible to perform in developing countries with limited resources. It could help bronchial mucous clearance and confirm microbiological infection. The procedures should be strictly performed for patients with indications and comply with safety standards.

Possible intraindividual evolution of SARS-CoV-2 in nasopharyngeal and anal swab in an octogenarian: a case report.

Introduction: COVID-19 is an emerging infectious disease that remains to be further investigated. Case report: Here, we describe a case of COVID-19 in an octogenarian woman with comorbidities who slowly recovered during hospitalization, but died due to sudden cardiac death after 2 weeks of hospitalization. Her nasopharyngeal and anal swabs returned positive for SARS-CoV-2 by RT-PCR on day 7 of hospitalization. The NGS showed possible intraindividual evolution of virus. The sample from the nasopharyngeal swab yielded a B.1470 variant classified as clade GH. This variant showed mutation in the spike gene D614G; N gene; NS3 gene; NSP2 gene and NSP12 gene. The sample from the anal swab showed similar mutation but with additional point mutation in spike gene S12F and was classified as B.1.465 variant. Conclusions: The possibility of the gastrointestinal tract that served as reservoir for virus mutation accumulation should also be considered and the potential impact of viral fecal transmission in the environment should be further investigated.

The Tuberculosis and COVID-19 coinfection: A report of two cases at a tertiary referral in Indonesia.

COVID-19 cases are still rising globally in the middle of the tuberculosis epidemic. Several countries have reported TB-COVID-19 coinfection that could pose a double burden in the health care facilities in developing countries. We reported two pulmonary tuberculosis patients coinfected with COVID-19 with an overlapping clinical manifestation of tuberculosis and COVID-19 with a good prognosis at the end of COVID-19 treatment. This paper aims to discuss TB patients' susceptibility against SARS-COV-2 infection, the clinical profile of TB-COVID-19 coinfection, and the disease's prognosis. The clinician should be aware of both common disease symptoms that appear in a patient and should be confirmed and treat promptly.

Manifestasi gastrointestinal dan peran swab anal pada COVID-19: Laporan kasus dari rumah sakit rujukan tersier Jakarta

Coronavirus Disease 2019 (COVID-19) merupakan penyakit infeksius yang masih menjadi permasalahan serius di dunia. Meskipun presentasi klinis utama COVID-19 adalah gejala respirasi manifestasi gastrointestinal seperti nyeri perut dan diare dapat ditemukan sebagai satu-satunya presentasi dari penyakit ini. Swab anal dapat dilakukan untuk penegakkan diagnosis COVID-19 dengan presentasi gastrointestinal. Namun peranannya dalam diagnosis COVID-19 masih belum diketahui secara pasti.Laporan kasus: Laporan kasus ini membahas seorang pasien dewasa yang datang dengan keluhan gastrointestinal tanpa adanya gejala respirasi. Pasien ini kemudian terkonfirmasi COVID-19 melalui pemeriksaan polymerase chain reaction (PCR) pada sampel swab nasofaring dan swab anal. Diskusi: COVID-19 dapat ditandai dengan berbagai gejala dari organ tubuh manapun salah satunya adalah gejala gastrointestinal. Swab anal menjadi sampel yang cukup representatif dalam membantu penegakkan diagnosis COVID-19 dengan gejala gastrointestinal.  Kesimpulan: Di tengah pandemi ini presentasi gastrointestinal tanpa gejala respirasi perlu dipertimbangkan sebagai presentasi klinis atipikal dari COVID-19. Hal ini menuntut kehati-hatian tenaga kesehatan untuk menghindari misdiagnosis COVID-19 dengan menggunakan pengambilan sampel dari organ lain seperti swab anal.