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.

The increase in mask waste and a lack of understanding about the management of single-use mask waste raises the potential for environmental pollution and COVID-19 transmission. Aim: This study aimed to assess the level of understanding of medical mask waste management and strengthening health protocols in controlling COVID-19 infection in Banjar Purwa Santhi, Benoa, Badung Regency. Methodology and Results: A cross-sectional method and descriptive study design were used with a sample of 100 respondents selected via stratified sampling. The research and service activities at Banjar Purwa Santhi Benoa include public campaign and assessment of the level understanding of medical mask waste management. Based on univariate analysis, 91% of respondents know that mask waste contains hazardous and toxic substances. If mask waste is disposed carelessly, 98% of respondents stated that it can pollute the environment, and 98% of respondents also stated that it has the potential to become a means of transmitting COVID-19. However, 85% of respondents disposed of the masks in the household trash. Conclusion, significance and impact study: Respondents had a good level of knowledge about health protocols and mask waste management but have not separated masks from household waste. By holding the community service activity, it is hoped that changes in community behavior will occur.

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.

Elderly COVID-19 patients have been associated with worse outcomes and have been presented with the highest mortality rate. However, studies on the clinical features and the differences between critical and non-critical elderly COVID-19 patients in Indonesia and even other countries are still lacking and rare. In this retrospective study, the epidemiological and clinical features of critical and non-critical elderly COVID-19 patients admitted to Udayana University Academic Hospital between April 2020 and March 2021 were analyzed and then compared. Of the 280 medical records analyzed, 60.7% were male and the median age was 65.0 years old. Based on the medical records, 18.2% of elderly patients met our criteria of critical patients. The most common symptoms presented in both category upon admission included fever and coughing. The most common comorbidity found in critical patients was heart disease and hypertension in non-critical patients. Laboratory results differences included leukocytes, neutrophils, lymphocytes, Neutrophil-to-Lymphocyte Ratio, platelets, SGOT, SGPT, and urea. Only 9.9% of critical patients and 6.1% of non-critical patients were given antiviral therapy. In contrast, 68.6% of critical patients and 76% of non-critical patients were given antibiotics. The mortality rate in critical patients was 70.6% and 0.4% in non-critical patients. Based on the results, a multimodal approach in the treatment of elderly COVID-19 patients is very essential. The higher mortality rate in elderly patients should be able to be reduced by giving early and timely antiviral therapy with the addition of effective choice of drugs.