Background Little is known how COVID-19 is affecting children. Autopsies help gain an understanding of the pathophysiology of new and developing diseases. Numerous post-mortem studies had been conducted in adults with COVID-19, but few in children. Thereby, this systematic review aims to investigate the autopsy findings from pediatric COVID-19 patients. Results There were a total of 15 patients from eight studies. COVID-19 mainly affects the heart and lungs. Pathology findings from the heart of COVID-19 pediatric patients include diffuse inflammatory infiltrate, myocarditis, cardiomyocyte necrosis, pericarditis, and interstitial edema. Histopathology abnormalities observed in the lungs are diffuse alveolar damage, cytopathic changes, thrombi in arterioles and septal capillaries, lung congestion, focal acute hemorrhage and edema, focal exudative changes, and mild pneumocyte hyperplasia. In addition, pathological findings from other organs, such as the liver, kidney, brain, bone marrow, lymph node, skin, spleen, muscle, colon, parotid gland, and adrenal of COVID-19 pediatric patients are also included in this review. Conclusion Cardiomyocyte necrosis, interstitial edema, lung congestion, and diffuse alveolar damage are the most significant pathologic findings of the heart and lung in pediatric COVID-19 patients. More studies are needed to elucidate the pathophysiology of SARS-CoV-2 in autopsy findings and to determine the exact cause of death since it could be related to COVID-19 or other comorbidities.

Background: In malnourished patients with colorectal cancer, hypoalbuminemia is common and was proposed to determine the postoperative outcome of colorectal surgery. Mounting articles published but have not been evaluated. We aim to assess the predictive value of preoperative hypoalbuminemia in patients undergoing colorectal surgery.Methods: We performed a literature search from PubMed, Euro PMC, and Cochrane with the terms serum albumin, hypoalbuminemia, prognosis, outcome, colorectal cancer, and neoplasm. We also hand-searched and included any relevant papers. Hypoalbuminemia is defined as plasma albumin level < 3.5 mg/dL. We restricted the included studies to English language and adults undergoing colectomy, laparotomy, laparoscopy, or abdominoperineal resection. Any types of articles were included, except an abstract-only publication and those that did not report the key exposure or outcome of interest. The key exposures were mortality, hospitalization time, and morbid conditions (thrombosis, surgical site infection, sepsis, and wound events). We pooled the odds ratio from each included literature as effect size. The Newcastle Ottawa scale and GRADE were used to determine the quality of each included study.Results: Hereof 7 observational studies (236,480 individuals) were included. Our meta-analysis found that preoperative hypoalbuminemia can predict the postoperative outcome in colorectal cancer patients. Individuals with hypoalbuminemia were not associated with 30-day mortality (risk ratio [RR] 2.05 [0.72, 5.86], P = .18, I 2 = 99%) but were associated with morbidity (RR 2.28 [1.78,2.93], P < .00001, I 2 = 87.5%), surgical complication (RR 1.69 [1.34,2.13], P < .00001, I 2 = 98%), and hospitalization (RR 2.21 [1.93,2.52], P < .00001, I 2 = 0%). According to newcastle ottawa scale, the included studies are of moderate to sound quality. Conclusions:The current systematic review and meta-analysis showed that preoperative hypoalbuminemia was significantly associated with morbidity, length of stay, and surgical complication but not mortality.Abbreviations: BSA = basal serum albumin, CRC = colorectal cancer, NOS = newcastle ottawa scale, RR = risk ratio.

Background: Indonesia has a great potential in the development of digital health technologies. However, several challenges might also arise in hand with the development of telemedicine. Aims: We aimed to conduct a literature review of the use of telemedicine in Indonesia in order to know how the start is, the development, and future considerations of its usage. Methods: From the digital databases of PubMed, Google Scholar, and Neliti (Indonesia's Research Repository), each author completed literature searches of telemedicine in Indonesia from 1985 to 2021. Results: A total of 8 studies were included in current literature review. In 1985-1987, Indonesia undertook the first satellite-based telemedicine. During the early twenty-first century, rapid improvements in information technology have expanded to other industries, including health care through telemedicine. Covid-19 dilemma compels physicians to adopt. Through telemedicine, many is experienced the benefit during the pandemic. However, in developing telemedicine system for the future, the use of telemedicine has several challenges, namely related to human resources, infrastructure and ethical regulations. Conclusion: When telehealth is successfully implemented in Indonesia, it will benefit both the developer and the consumer. Despite the benefits, the challenge of implementing and developing a comprehensive eHealth environment in Indonesia might be seen as tremendous, given that the country is currently developing its infrastructure.

Objectives: Recently, the subject of reopening schools has raised several concerns, especially on the possibility of new COVID-19 cluster cases. The parent's role is essential in this matter. Therefore, this study aims to understand the parents' knowledge, attitude, and behavior toward COVID-19 in Indonesia. Methods:  A cross-sectional study was conducted on 206 Indonesian parents. A 55-items questionnaire was used to assess the knowledge, attitude, and behavior of subjects. In this study, median split tests, Kruskal-Wallis, Cronbach's α, and Pearson correlation test were used. Results:  Subjects were found to have high levels of knowledge, especially in the knowledge of COVID-19 as a contagious viral disease (98.5%), and the necessity for children to maintain personal hygiene to prevent COVID-19 (98.5%). Subjects' attitudes were highest at understanding how to prevent COVID-19 (95.1%) and teaching children how to avoid COVID-19 (98.1%). Subjects' attitude was lowest at hearing the news of the death of COVID-19 scares them (72.8%), and on how their child(ren) are getting bored at home because of COVID-19 (69.9%). Subjects' are shown to have high levels of behavior in every question. This study found a significant correlation between socioeconomic status and subjects' knowledge (p = 0.007). Conclusion:  This study revealed a lack of understanding of prevention strategies among low-income households. Hence, there is a need for targeted messaging and health education in low-income settings that consider the challenges they may face when attempting their children to practice COVID-19 prevention if schools reopen. Keywords: COVID-19, Knowledge, Attitude, Behavior, Parents, Indonesia

No abstract