The aim of the research is to analyze the differences in the subset of T lymphocytes and NK cells at various degrees of disease severity in order to be used in stratification of patients’ management and to predict outcomes for optimal treatment. The study sample of 123 patients with confirmed COVID-19 was classified based on the degree of severity: 50 patients with mild severity, 34 patients with moderate severity and 39 patients with severe to critical severity who were subjected to complete blood count and T lymphocyte subsets (CD3, CD4, CD8) and NK cells with Flowcytometry. There were significant differences in the number of CD 3 cells (p=0.000), CD4 (p=0.000), CD8 (p=0.000), and NK cells (p=0.000) in the three groups. In the severe to critical group there was a decrease in lymphocytes accompanied by decrease of the number of CD3, CD4, CD8 and NK cells as well as an increase in WBC and neutrophils. Based on the outcome, there were significant differences in the number of CD 3 cells (p=0.000), CD4 (p=0.001), CD8 (p=0.000), and NK cells (p=0.001) between the Discharged and death groups. The decrease in the number of CD3, CD4, CD8 and NK cells indicates a relationship between changes in lymphocyte subsets and the pathogenesis of SARS-CoV-2, namely immune system disorders such as SARS infection. Increased of WBC with a decrease in CD3, CD4, CD8 and NK cell counts are associated with poor patient outcome. A significant decrease in the number of CD3, CD4, CD8 and NK cells in COVID-19 patients with severe to critical and moderate symptoms compared to mild groups and associated with poor patient clinical outcome.

Introduction: Emergency use of molecular rapid test kits approved by the Food and Drug Administration (FDA) includes the Xpert Xpress SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) kit. The rapid molecular test is one of the examinations using the reverse transcription-polymerase chain reaction (RT-PCR) method. Compared to conventional PCR, the examination time is faster, so it is suitable for diagnostic purposes. Objectives: Determining the diagnostic capabilities of the Xpert Xpress SARS-CoV-2 rapid molecular test in detecting the SARS-CoV-2 virus in the Indonesian population. Methods: A cross-sectional study was conducted with consecutive sampling, in which participants were diagnosed with coronavirus disease 2019 (COVID-19) infection using the RT-PCR Abbott M2000 SARS-CoV-2 System. A molecular rapid test examination was carried out using the Xpert Xpress SARS-CoV-2 kit. Assessing the correlation between the cycle threshold (CT) value of Xpert Xpress SARS-CoV-2 and the Abbott M2000 SARS-CoV-2 System using the Pearson and Spearmen test with P<0.05. Results: Molecular rapid test using Xpert Xpress has a compatibility of 100% with RT-PCR using Abbott M2000 SARS-CoV-2 and a sensitivity and specificity value of 100%. The Xpert Xpress SARS-CoV-2 CT value had a significant correlation with the Abbott M2000 SARS-CoV-2 System CT value, with moderate correlation strength for the CT protein E value (r=0.444; P=0.007) and robust correlation for CT value of protein N2 (r=0.829; P<0.001). The negative predictive and positive predictive values were 100% each. Conclusion: The Xpert Xpress SARS-CoV-2 molecular rapid test has a sensitivity and specificity of 100% and can be recommended for diagnosing COVID-19.

ABSTRAK Wabah COVID-19 (coronavirus disease 2019) yang pertama kali berasal dari Wuhan, Cina telah menyebar ke 219 negara dan telah menginfeksi sekitar 104.911.243 penduduk di seluruh dunia. Sejak kasus ini pertama kali dilaporkan pada tanggal 2 Maret 2020 di Indonesia, jumlah kasus terkonfirmasi terus meningkat dan penularan penyakit menyebar dengan cepat di seluruh wilayah tanah air. Hal ini turut berdampak pada keselamatan dan kesehatan tenaga kesehatan yang bertugas dalam penanganan COVID-19. Faktor paparan virus, tekanan kerja yang terlalu berat, penggunaan APD yang tidak adekuat, hingga kelelahan fisik dan mental menjadi pemicu utama krisis kesehatan di lingkungan tenaga kesehatan. Kegiatan pengabdian masyarakat ini diharapkan dapat mengendalikan jumlah tenaga kesehatan yang tertular COVID-19 saat melakukan pelayanan kesehatan kepada pasien. Kegiatan pengabdian masyarakat yang dilaksanakan di ruang pertemuan Hotel Ningrat, Kabupaten Bangkalan berupa edukasi dan penyuluhan tentang pencegahan dan pengendalian infeksi (PPI) di dalam pemeriksaan spesimen COVID-19. Sebanyak 100 peserta tenaga kesehatan puskesmas Dinas Kesehatan Kabupaten Bangkalan mempraktekkan Gerakan Cuci Tangan (hand hygiene) sesuai standar WHO, serta pemasangan dan pelepasan alat pelindung diri (APD) yang benar. Nilai post-test para partisipan petugas kesehatan puskesmas baik dokter umum, perawat, bidan, maupun ATLM yang telah mendapatkan pengetahuan, informasi, dan ketrampilan pencegahan dan pengendalian infeksi (PPI) sebesar 78 peserta (86,7%) dari 100 partisipan mengalami peningkatan dibandingkan nilai pre-test sebelum pemberian materi edukasi. Kegiatan ini dapat meningkatkan pemahaman mengenai penyakit COVID-19 dan cara penularannya, yang dapat diamati pada peningkatan nilai postes peserta penyuluhan. Kegiatan edukasi dan penyuluhan tentang PPI perlu dilakukan berkesinambungan agar dapat menurunkan jumlah tenaga Kesehatan yang tertular COVID-19. Kata Kunci: COVID-19, Pencegahan dan Pengendalian Infeksi.  ABSTRACT The COVID-19 (coronavirus disease 2019) outbreak, which first originated in Wuhan, China, has spread to 219 countries and has infected around 104,911,243 people worldwide. Since this case was first reported on March 2, 2020, in Indonesia, the number of confirmed cases has continued to increase, and disease transmission has spread rapidly throughout the country. This also has an impact on the safety and health of health workers on duty in handling COVID-19. Factors such as exposure to viruses, excessive work pressure, inadequate use of PPE, and physical and mental exhaustion are the main triggers for the health crisis in the health workforce. This activity is expected to control the number of health workers who are infected with COVID-19 when providing health services to patients. Community service activities carried out in the Ningrat Hotel meeting room, Bangkalan Regency in the form of education and counseling about infection prevention and control in examining COVID-19 specimens. A total of 100 health workers at the Bangkalan District Health Office practiced hand hygiene according to WHO standards and the correct installation and removal of personal protective equipment (PPE) The post-test scores of participants in health center health workers, including general practitioners, nurses, midwives, and ATLM who had received knowledge, information, and infection prevention and control (PPI) skills, were 78 participants (86.7%) out of 100 participants, an increase compared to pre-test values before giving educational materials. This activity can increase understanding of the COVID-19 disease and its mode of transmission, which can be observed in the increase in the posttest value of the counseling participants. Education and outreach activities about PPI must be carried out continuously to reduce the number of health workers infected with COVID-19. Keywords: COVID-19, Infection Prevention and Control.

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Osteoporosis is a disorder represented by manifestations of low bone mass, decreased bone tissue, and disrupted bonemicroarchitecture. The diagnosis of osteoporosis so far has been based on fracture manifestations after minimal trauma orby detecting low Bone Mineral Density (BMD). Measurement of Receptor Activator of Nuclear Factor-κβ Ligand (RANKL)and Osteoprotegerin (OPG) levels has opened the discourse of a more specific assessment of osteoblast and osteoclastregulation. The RANKL/OPG ratio can represent resorption and bone formation more significantly when correlated withBMD features. This study aimed to analyze the correlation between serum RANKL and OPG levels and ratio with BMD. A totalof 58 post-menopausal females from 13 elderly in Integrated Community Health Care Surabaya and Sidoarjo were enrolled.Data were collected by recording age, onset of menarche, onset of menopause, and Body Mass Index (BMI). Serum RANKLand OPG levels were evaluated using sandwich ELISA from Elabscience®. The RANKL/OPG ratio was obtained from the ratiobetween measured RANKL and OPG levels in serum. The proximal femur and lumbar spine BMDs were measured usingHologic® Discovery™ QDR™ Dual-Energy X-ray Absorptiometry (DEXA). Pearson's correlation test in this study showed nosignificant correlation between BMD and RANKL levels (lumbar: p=0.203; hip: p=0.283). The insignificant result was alsoshown in the correlation between BMD and OPG levels (lumbar: p=0.412; hip: p=0.617). A significant result between lumbarBMD and RANKL/OPG ratio was only found in the osteopenia subjects (p=0.001). The RANKL/OPG ratio had a significantcorrelation only with osteopenia-BMD in post-menopausal females. Therefore, it could be used as supporting data inosteoporosis screening.