Factors related to maternal mortality rate in covid-19 patients - a cross-sectional study from an Indonesian covid-19 referral hospital.

BACKGROUND: The covid-19 pandemic may cause severe clinical manifestations in a vulnerable population, such as pregnant women. Based on Indonesian Obstetrics and Gynecology Association (POGI), the number of maternal deaths due to covid-19 from April 2020 to April 2021 reached 3% and increased to 9% since the delta variant of covid-19 emerged. This research was expected to identify factors that are related to the mortality rate of pregnant women with covid-19. MATERIALS AND METHODS: This was a cross-sectional study using secondary data collected from June 2020 to August 2021. The study was conducted in Universitas Indonesia Hospital, a national covid-19 referral hospital. Patient characteristics, pregnancy profile, comorbidities, laboratory results, chest X-ray examination, treatment options, and the severity of symptoms were evaluated. In addition, bivariate data analysis was carried out using the SPSS device. RESULTS: Out of 114 research subjects, seven patients (6.1%) died, and 107 patients (93.9%) survived. The risk of mortality was significantly (P < 0.05) related to patients' age, duration of hospitalization, gestational age, severity rate of covid-19, the level of hemoglobin, leukocyte count, platelet count, lymphocytes, the levels of D-dimer, C-reactive protein, transaminase enzymes, urea, creatinine, eGFR, sodium, potassium, and procalcitonin. In addition, significant differences (P < 0.05) related to maternal mortality rate were also shown in the presence of comorbidities (type 2 diabetes, congestive heart failure, coronary artery disease/acute coronary syndrome, and urinary tract infection), and the use of steroids and tocilizumab. CONCLUSION: Various factors significantly related to the mortality rate of pregnant women with covid-19. This study may become the basis for a further study with a larger number of subjects, adjustment of assessment and management of covid-19 infected pregnant women, thus hopefully reducing the risk of mortality in pregnant women with covid-19.

Evaluation of SARS-CoV-2 Antibody Response Post Third Dose COVID-19 mRNA Vaccination at Universitas Indonesia Hospital.

OBJECTIVE: The longevity of vaccine effectiveness and antibody titer after the Moderna mRNA COVID-19 vaccination booster in healthcare workers in Indonesia is not known. MATERIALS AND METHODS: We performed a prospective observational study of healthcare workers at the Universitas Indonesia Hospital after Moderna mRNA COVID-19 booster vaccination. An Immunology Analyzer with Chemiluminescence Immunoassay (CLIA) test was used to examine Anti SARS-CoV-2 S-RBD levels. Antibody levels were classified into two systems (3 categories, and 2 categories). RESULTS: There were 31 male subjects (75.6%), 33 subjects (80.5%) aged 25-39 years, 17 subjects (41.5%) with overweight BMI, 35 subjects (85.4%) without comorbidities, and 29 subjects without previous history of COVID-19 infection (70.7%) who had antibody titer >1000 AU/ml. There were 27 subjects (65.9%) who had a booster shot ≥6 months after the second vaccination with antibody titer >1000 AU/ml. In this study, there was no significant correlation between antibody titer with factors such as gender, age, BMI, comorbidities, history of COVID-19 infection and time between the 2nd vaccination and booster vaccination. CONCLUSION: There is no significant correlation between antibody titer with factors such as gender, age, BMI, comorbidities, history of COVID-19 infection and time between the 2nd vaccination and booster vaccination.

Factors Affecting the Self-Isolation Monitoring Program for COVID-19 Patients at the Universitas Indonesia Hospital.

When the outbreak of the COVID-19 delta variant occurred in June 2021, there was a marked increase in Indonesia's number of self-isolated patients. The Universitas Indonesia Hospital provided a One-Stop Service (OSS) to monitor COVID-19 patients on self-isolation. This study was conducted to determine the effectiveness of the self-isolation monitoring performed by hospitals and the factors that determined the outcomes of patients on self-isolation. This study was conducted using a cross-sectional method based on secondary data from electronic medical records. Data analysis was performed by determining the relationship of patient risk factors and characteristics with COVID-19 outcomes. The study found that poorer symptoms, administration of antibiotics, absence of shortness of breath, and normal ALT levels significantly improved the outcome of OSS patients. The study also suggested that during monitoring of patients on COVID-19 self-isolation, chest/thorax radiography is necessary. The self-isolation monitoring program is essential to observe the patient's condition and evaluate the possibility of deteriorating conditions that could lead to admission decisions in the early or middle stages of the program. This will be beneficial during pandemic emergencies.