BACKGROUND: In Coronavirus disease 2019 (COVID-19), the main manifestations were fever, cough, and anosmia. AIM: We aimed to investigate coagulopathy and disseminated intravascular coagulation in severe COVID-19 patients. METHODS: Five cases of COVID-19 with coagulopathy have been reported. RESULTS: All patients presented with various main complaints such as fever, cough, shortness of breath, and diarrhea. An increase in D-dimer value was found in all cases, with an increase of 4–5 times from the upper limit of normal. All patients were evaluated with the IMPROVE-VTE and PADUA thrombotic risk assessment models. Thromboprophylaxis with low molecular weight heparin LMWH intensive dosage was given to four patients. However, one patient was not given thromboprophylaxis because of the high risk of bleeding. All cases were not given long-term thromboprophylaxis after the patients were discharged from the hospital. All hospitalized COVID-19 patients can be considered to give thromboprophylaxis unless contraindicated. Thromboprophylaxis is preferable to use LMWH with a dose adjusted to the severity of COVID-19. Administration of thromboprophylaxis after hospitalization may be considered in patients who have thromboembolic risk factors. CONCLUSION: More research is being encouraged to increase understanding of the prevention and treatment of thrombotic complications of COVID-19.

BACKGROUND: Coronavirus disease-19 (COVID-19) pandemic has resulted high number of mortalities globally. Several inflammatory and coagulation biomarkers have been studied for predicting and differentiating severe COVID-19 such as C-reactive protein (CRP) and D-dimer. However, those markers may not readily available in developing countries. AIM: The aim of the study was to assess the utility of neutrophil-to-lymphocyte ratio (NLR), a widely available and inexpensive laboratory examination, as reliable inflammatory biomarkers for Indonesian COVID-19 patients; by analyzing the correlation of NLR level with CRP and D-dimer plasma level. METHODS: We conducted cross-sectional study in Professor Dr. R.D. Kandou Hospital, Manado involving RT-PCR confirmed and hospitalized COVID-19 patients. Lymphocyte count, NLR, CRP, and D-dimer were examined in severe and non-severe COVID-19 cases at hospital admission. Correlation test was done using Spearman correlation test. RESULTS: A total of 40 COVID-19 patients were included in the analysis, with 50% having mild disease and other half having severe disease. The NLR, CRP, and D-dimer were significantly higher in severe COVID-19 group. Significant correlation was found between NLR and CRP (p = 0.001 and r = 0.506) and also with D-dimer level (p = 0.000 and r = 0.570) in differentiating severity of COVID-19. CONCLUSION: NLR is correlated with CRP and D-dimer level; therefore, NLR may serve as reliable, cost-effective, and practical inflammatory biomarker for differentiating severe and non-severe COVID-19 cases.

BACKGROUND: Several pro-inflammatory cytokines have been shown to regulate cancer cell growth and contribute to cancer promotion and progression. Interleukin 6 (IL-6) regulates almost all the hallmarks of cancer such as inhibition of apoptosis, proliferation, angiogenesis, and invasiveness and is also known to regulate cell metabolism. The associated increase in serum ferritin is most likely induced by the inflammatory state. In several studies, IL-6 and ferritin have a significant role in the development and clinical outcome in solid cancer and the Glasgow Prognostic Score (GPS) is widely used as a prognostic score in solid cancer. It is currently unclear whether levels of IL-6 and ferritin correlate with GPS in solid cancer patients. AIM: The aim of this study is to determine the correlation between IL-6 and ferritin levels with the GPS in solid cancer patients. METHODS: This study was an analytical observational study with a cross-sectional study approach to examine the relationship between IL-6 and ferritin levels with GPS in solid cancer patients. The sampling method was carried out by consecutive sampling. The total number of samples used in the study was 32 solid cancer subjects who had just been diagnosed. IL-6 was examined by kit enzyme-linked immunosorbent assay and ferritin using immunochemiluminescent method at certified laboratory in Manado city, Indonesia. The GPS is based on the results of the patient’s C-reactive protein and albumin levels were also examined at certified laboratory in Manado city, Indonesia. Data analysis was done using SPSS version 22. RESULTS: There were 32 patients with solid cancer who are newly diagnosed and have not undergone chemotherapy. Out of 32 patients, 17 are men (53.13%) and 15 are women (46.87%). The median age of the subject was 52.5 (33–69) years. There was a significant relationship between IL-6 levels and GPS (p = 0.011; OR 16.67 95% CI 1.617–171.783). There was no significant relationship between ferritin levels and GPS (p = 0.148; OR 5.429 95% CI 0.807–36.506). There was a statistically significant relationship between IL-6 levels and ferritin (r = 0.554; p = 0.001). CONCLUSION: There was a significant correlation between IL-6 and GPS and there was a significant correlation between IL-6 and ferritin in solid cancer patients. IL-6 levels can be used to assess the risk of prognosis in solid cancer patients and help provide an idea of what kind of treatment will be given to patients, and can help to determine the plan treatment at the end of the life of cancer patients.

Polycystic liver disease is characterized by multiple cystic lesions on the liver. Liver cysts are typically incidental findings, with occasional complications including cyst hemorrhage, infection and rupture. Polycystic liver disease may be part of autosomal dominant polycystic liver disease (ADPLD). Autosomal dominant polycystic liver disease is considered rare autosomal dominant disease, with prevalence of 1/100,000-1,000,000. Without family history of polycystic liver disease, ADPLD is defined as the presence of more than 20 liver cysts with no renal cysts, however up to third of ADPLD may have small number of renal cysts without kidney function impairment. This case of a 73-year-old woman with symptomatic polycystic liver disease, and we performed cyst fenestration-deroofing via laparoscopic.

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