Objective. SARS-CoV-2 infection may cause multiple organ failure. However, scarce information can be found on the impact on the endocrine system. This study was conducted to determine plasma Adrenocorticotropic hormone (ACTH) and plasma cortisol levels in a cohort of COVID-19 patients with Acute Respiratory Distress Syndrome (ARDS). Methods. A prospective cohort study was conducted on COVID-19 patients who manifested ARDS and were admitted to the ICU of Dr. Soetomo Tertiary Hospital, Surabaya, Indonesia. Morning plasma ACTH and plasma total cortisol were measured on 45 recruited patients. The outcome of the patient was justified based on the survivance on days 7th and 30th during the follow-up with groupings of surviving for survived patients and nonsurvive for deceased patients. Results. The ACTH and cortisol median were 1.06 (0.5–64.57) pg/mL and 17.61 (0.78–75) μg/dL, respectively. Both parameters were assembled to allow the allocation of the 45 subjects into the survive and nonsurvive groups. There was a moderate correlation between ACTH and cortisol levels in all groups ( r = 0.46 , p < 0.002 ) and particularly ACTH and cortisol levels in COVID-19 patients who survived on the 7th-day and 30th-day follow-up ( r = 0.518 and r = 0.568 , respectively, with p < 0.05 ). It is important to note that there was no correlation for an individual parameter, either ACTH only or cortisol only, compared to the outcome among patients with various comorbid. Conclusion. ACTH or cortisol alone has no correlation to the outcome of these patients. Therefore, further study of the potential use of corticosteroid treatments guided by ACTH and cortisol levels in reducing the risk of ARDS warrants further investigation.

Both Non-Alcoholic Fatty Liver Disease (NAFLD) and metabolic syndrome are health problems worldwide. Various studies suggest that NAFLD and metabolic syndrome have a two-way relationship. Metabolic syndrome can be preceded by NAFLD and NAFLD can be a manifestation of the metabolic syndrome. Because of the relationship between the two, the diagnosis and management of NAFLD and metabolic syndrome are important to prevent complications such as cardiovascular disease, liver cirrhosis, and malignancy. The diagnosis of metabolic syndrome can be made based on various diagnostic criteria determined by several health organizations, such as WHO, IDF, and NCEP-ATP. Since NAFLD is asymptomatic until advanced disease, many patients are only identified at advanced stages. Liver biopsy is currently the gold standard for diagnosing NASH, which is a type of NAFLD. This procedure is invasive, and many studies are currently looking for and assessing non-invasive markers for NAFLD and metabolic syndrome. Laboratory as diagnostic support plays an important role in the diagnosis of NAFLD and metabolic syndrome. Non-invasive laboratory tests with high sensitivity and specificity are expected to contribute to the early diagnosis of NAFLD and metabolic syndrome. Various laboratory parameters have been developed to support the diagnosis of NAFLD and metabolic syndrome.

Quantitative HBsAg assay is an alternative marker of potential viremia and monitoring response to antiviral treatment. Various methods have been developed to assess HBsAg quantification. This cross-sectional observational research aims to understand the performance of quantitative HBsAg assay with CLEIA (Chemiluminescence Enzyme Immunoassay) and CLIA (Chemiluminescence Immunoassay) methods and their compliance with qPCR. Serum samples were obtained from 69 Hepatitis B patients at the Outpatient Clinic. Quantitative HBsAg assay was performed with Sysmex HISCL-5000 and Mindray CL-900i, HBV DNA by using GeneXpert® HBV Viral Load. The results showed that the HBsAg value of the CLEIA method ranged from 9.77 to >2,500 IU/mL, while the CLIA method ranged from 19.97 to >50,000 IU/mL. Analysis of the CLEIA and CLIA methods showed agreement ((LoA: -5014.01 – 1815.33) with the relationship between the two methods showed a positive correlation (p <0.05). There is a positive correlation between HBsAg results using CLEIA method and HBV DNA (p <0.05) and also between the HBsAg CLIA method and HBV DNA (p <0.05).