Clinical characteristics and outcomes of COVID-19 patients in Bali, Indonesia.

INTRODUCTION: The spectrum of illness and outcomes of coronavirus disease 2019 (COVID-19) patients may vary. This study reports the characteristics of COVID-19 patients in Bali, Indonesia, and evaluates the diagnostic value of their clinical symptoms. METHOD: This observational study was conducted in eight hospitals. The patients were classified as non-severe COVID-19, severe COVID-19, and non-COVID-19. Demographics, clinical, laboratory, and radiologic characteristics, and outcomes of COVID-19 patients were collected. Factors associated with the severity and outcomes were assessed using the chi-squared test or ANOVA when appropriate. We also compared the clinical features of non-severe COVID-19 and non-COVID-19 patients to evaluate the diagnostic accuracy. RESULTS: This study included 92 patients: 41 non-COVID-19 and 51 COVID-19 patients, comprising 45 non-severe and six severe cases. The most common symptoms of COVID-19 were cough (47.1%), fever (31.0%), and dyspnea (25.3%). Cough, fatigue, and anosmia have high accuracy, and combining these complaints in clinical diagnostics offered a higher accuracy in predicting COVID-19 patients (60.1%). We found lower lymphocyte counts and interleukin-1R levels and higher levels of C-reactive protein, interleukin-6, and interleukin-8 in severe compared than in non-severe COVID-19 patients. Lactate dehydrogenase was associated with intensive care unit admission and ventilator use, while other markers such as neutrophil-lymphocyte ratio, C-reactive protein, and interleukin-6 were not. CONCLUSION: A battery of symptoms, including cough, fatigue, and anosmia, is likely associated with COVID-19 in Bali. Clinicians should be aware of these symptoms to ensure a prompt diagnostic test for COVID-19, beyond other causes of acute febrile illnesses.

Interleukin-15 is a significant predictor of sarcopenia in human immunodeficiency virus infected patients on antiretroviral therapy: A cross-sectional study

Objective: To identify the relationship between interleukin (IL)-15 levels and sarcopenia in human immunodeficiency virus (HIV)- infected patients who have received antiretroviral therapy. Methods: This study was a cross-sectional design with 70 participants conducted from January to March 2021. All the participants were assessed for sarcopenia and the IL-15 levels. Sarcopenia was established based on the the Asian Working Group for Sarcopenia (AWGS) 2019 criteria. Plasma IL-15 was determined. This analysis was carried out by means of 2×2 tabulation and the statistical test used is Chi-square. Results: Seventy patients received antiretroviral therapy >6 months and showed a good clinical response. Among them, 36 (51.4%) took zidovudine-based antiretroviral therapy with a median duration of illness of 5 years. The proportion of sarcopenia in patients with HIV infection was 32.9%. The median CD4 cell count was 395.5 cells/L (range: 203-937 cells/L). Logistic regression analysis revealed that age>50 years (aOR 8.3, 95% CI 1.6-44.5), underweight (aOR 7.7, 95% CI 1.5-40.5), IL-15≥150.5 ng/L (aOR 4.9, 95% CI 1.3-19.0) and female (aOR 4.8, 95% CI 1.2-18.3 were significant and independent adverse predictors of sarcopenia in subjects with HIV infection. Conclusions: There is an association between high levels of IL-15 and sarcopenia in HIV-infected patients on antiretroviral therapy for more than 6 months with good clinical response.