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Acta Med Indones ; 54(1):97-106, 2022.
Article in English | PubMed | ID: covidwho-1782295


BACKGROUND: The use of complementary and alternative medicine (CAM) is widespread among patients with chronic disease despite lack of supporting evidence for most CAM types. Concerned regarding higher risk of COVID-19 for HIV-infected patients, probably increase the use of CAM during COVID-19 pandemic in this population. This study aimed to assess the prevalence and factors related to CAM use among HIV-infected patients during COVID-19 pandemic, then identify drug- to-drug interaction (DDI) of antiretroviral (ARV) drugs with CAM that they used. METHODS: The study was conducted in HIV Clinic Cipto Mangunkusumo Hospital in September-October 2021, specifically targeting adults HIV-infected patients routinely using ARV. Demographic and clinical data, including COVID-19 and vaccine history, were taken from clinic survey and hospital medical records data. RESULTS: 554 of 1275 patients (43.5%) reported using any type of ingested CAM during COVID-19 pandemic, mostly vitamins and/or minerals. Factors related to CAM use were history of COVID-19 infection (aOR 2.28;95% CI 1.65-3.14) and 2-5 years ARV duration compared to more than 10 years (aOR 1.4;95% CI 1.02-1.91). Five known potential interactions involving 20 patients and two potential weak interactions involving 8 patients were found, but many of other interactions categorized as unknown. Only limited number of patients (3.8%) were aware about the drug interaction between ARV and CAM that they used. CONCLUSION: CAM was commonly used by HIV-infected patients on ARV during the COVID-19 pandemics, but patient awareness related to CAM-ARV drug interactions was exteremely low.

Acta Medica Indonesiana ; 53(4):371-373, 2021.
Article in English | MEDLINE | ID: covidwho-1624257


Healthcare workers pose a substantial risk of acquiring COVID-19 infection during their daily works. We have seen various conditions during the pandemic, such as limited adequate personal protective equipment (PPE), accurate diagnostic tests, lack of information regarding disease management, unsupportive work environment, and excessive workload, increased the number of HCWs-infected COVID-19. Compared to the general population, the risk of COVID-19 infection was several-fold higher in HCWs.Employers and health care workers both should share the responsibility to prevent occupationally acquired infections and avoid causing harm to patients by taking reasonable precautions to prevent vaccine-preventable disease transmission. This year, WHO has launched a year-long campaign under the theme -protect, invest, together'. It highlights the urgent need to invest in health care workers, not only during COVID-19. We need to ensure that all health care workers are supported, protected, motivated, and equipped to deliver safe health care at all times, to provide a high-quality standard of care to the patients.

Acta Medica Indonesiana ; 53(4):407-415, 2021.
Article in English | MEDLINE | ID: covidwho-1624206


BACKGROUND: Many studies identified the risk factors and prognostic factors related to in-hospital COVID-19 mortality using sophisticated laboratory tests. Cost and the availability of supporting blood tests may be problematic in resource-limited settings. This multicenter cohort study was conducted to assess the factors associated with mortality of COVID-19 patients aged 18 years and older, based on history taking, physical examination, and simple blood tests to be used in resource-limited settings. METHODS: The study was conducted between July 2020 and January 2021 in five COVID-19 referral hospitals in Indonesia. Among 1048 confirmed cases of COVID-19, 160 (15%) died during hospitalization. RESULTS: Multivariate analysis showed eight predictors of in-hospital mortality, namely increased age, chronic kidney disease, chronic obstructive pulmonary disease, fatigue, dyspnea, altered mental status, neutrophil-lymphocyte ratio (NLR) >= 5.8, and severe-critical condition. This scoring system had an Area-under-the-curve (AUC) of 84.7%. With cut-off score of 6, the sensitivity was 76.3% and the specificity was 78.2%. CONCLUSION: The result of this practical prognostic scoring system may be a guide to decision making of physicians and help in the education of family members related to the possible outcome.

Acta Medica Indonesiana ; 53(3):326-330, 2021.
Article in English | MEDLINE | ID: covidwho-1451730


SARS CoV-2 virus has infected more than 200 million people worldwide and more than 4.4 million in Indonesia. The vaccination program has become one of the solutions launched by many countries globally, including Indonesia, to reduce the transmission rate of COVID-19. Various vaccination platforms are produced, such as inactivated, viral vector, mRNA, and protein subunit. The vaccination booster program with mRNA platform (Moderna) was launched by the Indonesian government to give better protection for health care workers, particularly from delta variant. In this case report, we discuss one of the typical side effects of Moderna vaccine, which is referred to as the COVID arm.