ABSTRACT. Background Since its first sighting in China at the end of 2019, COVID-19 had spread rapidly around the world, with no exception, to Indonesia. World Health Organization officially declared COVID-19 as a pandemic in March 2020. COVID-19 causes severe symptoms for those immunocompromised, making it an urgent matter to end the pandemic as soon as possible. In only 1 year since COVID-19 was found, the world has successfully developed COVID-19 vaccines which experts believe may bring an end to the pandemic. However, the vaccination also carries risk of adverse effect.  Aim The aim of this study is to report how the adverse effect of third dose mRNA-1273 vaccine in healthcare workers at Udayana University Hospital. Methods The descriptive study collects data from all healthcare workers in Udayana University Hospital receiving third-dose mRNA-1273 vaccine using online questionnaires. We excluded incomplete responds to maintain quality of data. This report comprises demographic characteristics, clinical history, and the adverse effects and was approved by the ethical committee of Udayana University. Result We received a respond rate of 86.9% (N=553) from a total of 636 healthcare workers who received the third-dose mRNA-1273 vaccine. Our respondents had a mean age of 37 (SD ± 7.81) years old. Most were female (55.8%) aging 20-29 years old (57.1%), and had an interval between their initial and third dose between 3-5 months (53.4%). Adverse effect most recorded was local pain (82.8%), followed by fever (56.4%), weakness/fatigue (39.3%), excessive sleepiness (32.5%), dizziness (30.1%), headache (27.6%), nausea/vomiting (21.5%), excessive hungerness (18,4%), other symptoms (11.0%)  and local erythema (10.4%). About 39.9% of the respondents felt the adverse effect 12-24 hours post-vaccination.    Conclusion Adverse effects following third-dose mRNA-1273 vaccination in healthcare workers of Udayana University Academic Hospital includes local pain, fever, weakness/fatigue, excessive sleepiness, dizziness, headache, nausea and vomiting, excessive hunger, and local erythema. Most of these symptoms occurred within the first 24 hours post-vaccination.   Key Words: Vaccine, Adverse Effect, mRNA-1273, COVID-19, Healthcare Worker

Recently, a respiratory infectious disease labeled as COVID-19 caused by SARS-CoV-2 had taken over the world by storm. This RNA virus can cause various symptoms such as malaise, anosmia, ageusia, fever, cough, headache, myalgia, diarrhea, and ARDS. COVID-19 patients have specific symptoms such as fever. In another study, it was said that anosmia could be a benchmark for screening for COVID-19. in a study of young patients and was more common in women. The average onset of anosmia occurs on day 4 after infection and lasts for 8 days. the evidence says that this disease can cause a decrease in a person's quality of life. The exact cause of anosmia is still unknown, but several theories suggest that anosmia can occur due to damage to nerve receptors, inflammation of olfactory epithelial cells, and dysfunction of nerve receptors. The popular theory is that anosmia occurs due to inflammation of the olfactory epithelial cells, thereby damaging the olfactory receptors. The inflammation blocks odors from reaching the nasal mucosa and can inhibit receptor excitability and signal transduction. Anosmia may be associated with lower hospital mortality rates. However, further research and discovery is needed to fully grasp the pathophysiological concept of COVID-19 induced anosmia. This review will discuss the pathophysiology and review the lower anosmia mortality rate. This article reviews current understandings about the pathophysiology of anosmia and its potential as a marker towards better clinical prognosis. This narrative review aims to provide knowledge about updates regarding the pathophysiology of anosmia as a clinical predictor of mild and severe COVID-19 symptoms.

Though COVID-19 caught healthcare authorities worldwide off guard, several countries successfully dampened the morbidity and mortality curve by imposing strict biosecurity protocols. We would like to observe the effect of healthcare policies enforced in correlation to the formation of new clusters during early phases of the pandemic, thereby providing statistical justification for laws enforced by authorities. With access to medical records from Udayana University Hospital, a tertiary COVID-19 referral health center, we then observe epidemiological data of patients admitted and their admission date in correlation to dates where major changes in national COVID-19 protocols were established. We found a double distinctive curve that is mainly made of two distinct demographic groups: migrant workers and private employees. We found that during March 2020, when strict travel protocols are yet to be imposed, the viral introduction was mostly carried by returning migrant workers. Sporadic cases emerged, though soon vanishing due to the enforcement of quarantine protocols. Subsequently, in June 2020, a work-from-office setting was adopted, where some offices perform at a capacity higher than allowed. This incites the formation of new office-linked clusters. After this period,  no recognizable pattern found due to massive local transmission affecting all layers of society. However, it can be concluded that COVID-19 law does shape the curve, and strict protocols may end the pandemic sooner. Keywords: COVID-19, Migrant Workers, Health Policy, Private Employee

An unknown pneumonia-like disease has emerged in Wuhan, China, in late 2019. It is later named as SARS-CoV-2 which cause COVID-19. This virus spreads easily due to high mobilization and its transmission through droplets or aerosol and fomite. The World Health Organization (WHO) then declared this disease as a global outbreak in March 2020. As the world faces the outbreak of SARS-CoV-2, many researchers race to find the most efficacious treatment for COVID-19. Until now, the most common treatments for COVID-19 were only symptomatic such as decongestant, corticosteroid, interleukin inhibitor, and existing antiviral. The researchers then develop a brand new antiviral that works efficiently to inhibit SARS-CoV-2 and might become prophylaxis. This disease is called Molnupiravir or EIDD-2801, a nucleotide analog which inhibits SARS-CoV-2 replication, resulting in damaged mRNA and lethal virions. Molnupiravir works to produce mutagenesis in RNA viruses and prevent the virus from spreading widely throughout the human body. However, this drug is still needed to undergo clinical trial phase three. In this article, we will discuss how Molnupiravir works and its efficacy compared to existing drugs. This review article aims to provide an update about novel efficacious antiviral for COVID-19, Molnupiravir.

Impacting the community does not always mean creating exponential growth, it can also mean bringing small and sustainable changes to improve people’s quality of life. Living in a developing country, we had a first-hand experience of seeing life in underprivileged communities. This experience expanded our desire to serve communities around us. However, due to the emergence of COVID-19 in Indonesia, most of the plans to contribute to our community were halted. Strict outbreak control measures, which restricted people’s mobility, prohibited visits to these underprivileged communities.