An outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that began in Wuhan, China has spread rapidly in multiple countries of the world and has become a pandemic. Currently, there is no vaccine or specific antiviral for COVID-19. A study reported 7.3% of critical patients admitted to ICU, 71% of them required mechanical ventilation, and 38.5% of them were survived. Herein, we reported a 54-year-old man with Acute Respiratory Distress Syndrome (ARDS) of COVID-19 who survived the disease. Real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay of nasopharyngeal and oropharingeal swabs were positive for SARS-CoV-2. Diagnosis of ARDS was also according to clinical symptoms, laboratory, chest radiograph, and chest CT scan. Alcaligenes faecalis and Candida albicans were also identified from sputum culture. Treatment for this patient was causal and supportive therapy, including antibiotic, antiviral, and antifungal therapy according to the culture results, fluid resuscitation, and oxygen supply from the mechanical ventilator. This patient was survived and discharged on hospital day-29. A fibrosis in parenchyma pulmonary and sensory peripheral neuropathy occurred after survived from ARDS. Monitoring of clinical, laboratory, and chest radiograph were continued after the patient discharged from the hospital. This case highlights the importance of early diagnosis and effective treatment to the care of COVID-19 patient.

An outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that began in Wuhan, China has spread rapidly in multiple countries of the world and has become a pandemic. Currently, there is no vaccine or specific antiviral for COVID-19. A study reported 7.3% of critical patients admitted to ICU, 71% of them required mechanical ventilation, and 38.5% of them were survived. Herein, we reported a 54 year old man with Acute Respiratory Distress Syndrome (ARDS) of COVID-19 who survived the disease. Real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay of nasopharyngeal and oropharingeal swabs were positive for SARS-CoV-2. Diagnosis of ARDS was also according to clinical symptoms, laboratory, chest radiograph, and chest CT scan. Alcaligenes faecalis and Candida albicans were also identified from sputum culture. Treatment for this patient was causal and supportive therapy, including antibiotic, antiviral, and antifungal therapy according to the culture results, fluid resuscitation, and oxygen supply from the mechanical ventilator. This patient was survived and discharged on hospital day-29. A fibrosis in parenchyma pulmonary and sensory peripheral neuropathy occurred after survived from ARDS. Monitoring of clinical, laboratory, and chest radiograph were continued after the patient discharged from the hospital. This case highlights the importance of early diagnosis and effective treatment to the care of COVID-19 patient.

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This study aimed to identify the cost analysis between survivor and non-survivor of mechanically ventilated COVID-19 patients. We conducted a cohort retrospective study analysing the cost comparison among mechanically ventilated COVID-19 patients in our hospital, DR.Soetomo Hospital, which is a tertiary referral hospital in our country, from from June to September 2020. COVID-19 patients who was mechanically ventilated was included in our study, but for those who were passed away <24 hours upon ICU admission, or patients who were discharge against medical advice, were excluded from this study. A total of 72 mechanically ventilated COVID-19 patients were analysed. These patients were divided into 2 groups: survivor and non-survivor groups. Survivor group consisted of 21 patients and 51 patients in non-survivor group. Baseline characteristics were significantly different for the variables of: body mass index, presenting blood pressure, acute kidney injury complication, prothrombin time, albumin, P/F ratio and SOFA scores. The average total cost spent in survivor group was $3711,7 while in non-survivor group was $5417,7. This result showed a significant finding (p=0.047). Cost distribution pattern was similar in both groups, that cost medical items was the highest cost that spent during ICU stays among mechanically-ventilated COVID-19 patients; but significant difference of medical item cost was documented between survivor and non-survivor group. An average of cost medical items was spent of $1145,5 in survivor group, compared to $2353,8 in non-survivor group (p=0.003). We conclude that non-survivor group of mechanically ventilated patients tend to spend more cost during ICU stays, especially for the medical items cost.

Introduction: The report of doctors who died with COVID-19 in Indonesia was high and influenced by several factors. This study examined COVID-19 infected doctors and mortality risk factors in East Java. Material and Methods: This observational cohort study was conducted among doctors infected with COVID-19 in East Java during March 2020-September 2021 and collected the COVID-19 infected doctors’ deaths report. Doctors received a questionnaire on the status of COVID-19, history of covid-19 infection, age, sex, type of doctor, type of specialization and resident, pregnancy, underlying disease and nutritional status. All data were described and potential risk factors’ association was analyzed. Results: We reported 2041 doctors infected with COVID-19. Majority of them (52,5%) was male, 162 doctors were more than 59 years old, 162 doctors (7,9%) were died and 41,4% was general practitioner. The odds ratio in each risk factor for mortality was older age doctors 15,468 (95% CI 10,587-22,601), male 6,128 (95% CI 3,906-9,614), general practitioner 2,461 (95% CI 1,769-3,423), doctors with underlying disease 39,842 (95% CI 23,077-68,798), Type II diabetes mellitus 82,504 (95% CI 42,767-159,162), cardiovascular disease 50,152 (95% CI 16,672-150,866), hypertension 19,425 (95% CI 10,528-35,840), Chronic Obstructive Pulmonary Disease 5,52 (95% CI 0,610-49,992), Asthma 2,091 (95% CI 0,626-6,986), Obesity 30.750 (95% CI 15,293-61,828) and Pregnant doctors 43.013 (95% CI 10.986-168.414) (p<0,05). Conclusion: Older age, male, general practitioner, doctors with underlying disease, cardiovascular disease, Type II diabetes mellitus, hypertension, chronic obstructive pulmonary disease, asthma, obesity, pregnant doctors had been mortality risk factors among COVID-19 infected doctors.