Background: Clinical features of COVID-19 are variably from asymptomatic, to severe symptoms including acute respiratory distress syndrome (ARDS), multiple organ failure, and death. A specific biomarker is needed to predict the possibility of COVID-19 patients fall into severe complications and disease severity. D-dimer and C-Reactive Protein (CRP) are biomarkers that are elevated in COVID-19 patients. Method: This is an observational analytic study. The purpose of this research is to explore the correlation between D-dimer serum concentration and CRP with disease severity and mortality in hospitalized COVID-19 patients. This research used secondary data from a medical record with inclusion criteria patient more than 18 years old, confirmed COVID-19 by real-time Polymerase chain reaction (rt-PCR), that hospitalized in Wangaya General Hospital during July 2020 until December 2020. Result: Statistical analysis show that there is Latar Belakang: Fitur klinis pasien dengan COVID-19 bervariasi dari tanpa gejala maupun dengan gejala ringan hingga terjadinya acute respiratory distress syndrome (ARDS), gagal multi organ, dan kematian. Dibutuhkan suatu biomarker yang dapat digunakan dalam memprediksi kemungkinan pasien yang akan jatuh kedalam derajat penyakit maupun komplikasi yang berat. D-dimer dan C-Reactive Protein (CRP) merupakan biomarker yang diketahui meningkat pada pasien COVID-19. Metode: Penelitian ini merupakan penelitian analitik observasional, yang bertujuan untuk mengetahui significant mean difference between D-dimer and CRP concentration based on COVID-19 disease severity (p <0.001 dan p <0.001). AUC value on ROC curve for CRP and D-dimer concentration in predict the mortality of COVID-19 patient are 0.88 (p <0.001, 95% CI: 0.829 -0.48) and 0.88 (p < 0.001, 95% CI = 0.821 -0.950) respectively. In this research, serum D-dimer with concentration more than 4,181 ng/mL statistically significant affect the mortality of COVID-19 patient (OR = 11.713; CI = 1.620 -84.682; p = 0.015). CRP concentration statistically is not significant affect the mortality of COVID-19 patient. Conclusion: There is a statistically mean difference in both D-dimer and CRP concentration based on COVID-19 disease severity. D-dimer concentration of more than 4,181 ng/mL significantly affects the COVID-19 mortality. CRP concentration is not correlated with COVID-19 mortality hubungan konsentrasi D-dimer serum dan CRP dengan derajat keparahan dan mortalitas pasien COVID-19 yang dirawat inap. Penelitian ini menggunakan data sekunder yang bersumber dari rekam medis dengan kriteria inklusi pasien usia diatas 18 tahun dengan diagnosis terkonfirmasi COVID-19 dengan real-time Polymerase chain reaction (rt-PCR), yang dirawat inap di RSUD Wangaya Denpasar periode Juli 2020 hingga Desember 2020. Hasil: Hasil uji statistik menunjukan terdapat perbedaan rerata konsentrasi D-dimer dan CRP berdasarkan derajat keparahan pasien COVID-19 yang

BackgroundThe coronavirus disease (COVID-19) pandemic causes fear and anxiety symptoms on some vulnerable populations such as patients living with human immunodeficiency virus (HIV) (PLWH). Physical distancing (during consultation in the clinic) and isolation restrictions will likely have a negative impact on/disruption to all care continuum services of HIV diseases although healthcare services and access to anti-retroviral therapy (ART) have continued to operate.ObjectiveTo investigate the factors associated with ART adherence among PLWH during the COVID-19 pandemic.MethodologyA cross-sectional study was conducted on 324 PLWH who had been on ART for at least 6 months between June 2020 and January 2021. A semi-structured questionnaire was used to interview participants to collect data on sociodemographic characteristics and other factors.ResultsOf 324 PLWH taking ART, 264 (81.48%) had high adherence (≥95%) and 60 (18.52%) had low adherence (&lt; 95%). Factors independently associated with high ART adherence were employment status (adjusted odds ratio (AOR): 0.030, 95% confidence interval (CI): 0.010–0.088; p &lt; 0.001), type of antiretroviral (ARV) (AOR: 3.101, 95% CI: 1.137–8.456; p = 0.027), family support (AOR: 0.157, 95% CI: 0.052–0.475; p = 0.001), the perception that the COVID-19 pandemic negatively impacts the ability to attend clinics (AOR: 7.339, 95% CI: 1.46–36.79; p = 0.015), and the perception that the COVID-19 pandemic negatively impacts the ability to take ART (AOR: 10.611, 95% CI: 2.98–37.72; p &lt; 0.001).ConclusionsDuring the COVID-19 pandemic, factors associated with high ART adherence among PLWH attending the Hospital of Wangaya in Denpasar, Bali, Indonesia were employment status, ART type [non-fixed dose combination (FDC)], family support, and the perception that the COVID-19 pandemic negatively impacts the ability to attend clinics and to take ART.

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in coronavirus disease 2019 (COVID-19) involve so many inflammatory cytokines, especially Interleukin-6 (IL-6). The usage of tocilizumab as an anti-IL-6 receptor antibody had been approved as COVID-19 medication.Case Presentation: This article reports a 51-year-old woman diagnosed with severe-critical COVID-19. The patient made significant progress after tocilizumab administration. The patient was hospitalized for 14 days before being discharged.Conclusion: Tocilizumab administration showed a significant improvement in COVID-19 patients.  However, further investigations are needed to explain this further.

Background: Wide spectrum of clinical manifestation and severity of COVID-19 led to further studies to find a simple biomarker used to predict the severity of COVID-19. We investigated the role of mean platelet volume (MPV) and platelet distribution width (PDW), widely available parameters, as predictor of COVID-19 severity.Methods: We conducted a single center analytic observational study to evaluate the relationship between MPV and PDW values and COVID-19 severities. A total of 123 subjects of COVID-19 within October to December 2020 included in the analysis.Results: Analysis showed a statistically significant difference in MPV, PDW, and D-dimer between COVID-19 severities (p<0.001, p=0.002, and p<0.001). Correlation coefficient between MPV, PDW, and D-dimer with COVID-19 severity were 0.28 (p=0.002); 0.22 (p<0.001), and 0.81 (p<0.001), but there’s no correlation between MPV (p=0.176) and PDW (p=0.383) with D-dimer. The AUC value of the ROC curve of MPV, PDW and D-dimer in predicting severity was 79% (p=0.001, 95% CI: 0.696-0.885), 72.5% (p<0.001, 95% CI: 0.598-0.852), and 97% (p<0.001, 95% CI: 0.937-1.00).Conclusions: This study found a relationship between MPV and PDW values on the severity of COVID-19. There’s no relationship of MPV and PDW to D-dimer concentration.

Lung cancer with symptomatic small intestinal metastasis is a rare case but potentially fatal with poor diagnosis in most advanced stages. A-82 years old male patient with chronic cough, chest pain, progressive dyspnea abdominal pain, obstipation, and distended abdomen. Chest computed tomography (CT)-scan revealed right inferior pulmonary lobe of lung tumor. Abdominal X-ray and abdominal ultrasound showed ileus obstruction features. The patient underwent emergency laparotomy under the diagnosis of total ileus obstruction. Surgical resection of two masses in the small intestinal were performed with ileo-ileal anastomosis. Histomorphology of the surgical specimen revealed poorly differentiated adenocarcinoma involving the small intestine without precursor lesions that suggested a metastasis. The patient underwent thoracentesis and pleural fluid cytology that reported seeding of non-small cell lung cancer (NSCLC) tend to adenocarcinoma type. A diagnosis of lung adenocarcinoma with small intestinal metastasis was concluded based on correlation of these anatomopathological examination. Clinicians should consider possibility of lung cancer with small intestinal metastasis in patient with abdominal symptoms.