TREATMENT PROFILES AND RISK FACTORS FOR CLINICAL OUTCOMES OF CONFIRMED COVID-19 AND PNEUMONIA PATIENTS AT FATMAWATI GENERAL HOSPITAL JAKARTA
Keywords:clinical outcome, COVID-19, pneumonia, risk factors
Objectives: This study aimed to investigate the treatment profiles and the risk factor for clinical outcomes of confirmed coronavirus disease-19 (COVID-19) and pneumonia patients at Fatmawati General Hospital Jakarta.
Methods: This research was conducted using a cross-sectional design at Fatmawati General Hospital Jakarta. A total of 72 adults COVID-19 confirmed patients with pneumonia diagnosis from March to December 2020 were included in our study. Data were collected retrospectively by the patients’ medical record.
Results: The percentage of critical or severe confirmed COVID-19 with pneumonia inpatients (66.7%) was higher than those who were having non-severe diseases (33.3%). 36 (50%) death were reported in our patient population. Patients received antiviral, antibiotics, and steroids during a treatment period. The most common antibiotic regimens were levofloxacin intravenous (IV) (18.8%) and azithromycin per oral (PO) (13.9%). Oseltamivir (83.3%) was the most frequently prescribed antiviral for the patients. A total of 41.7% of patients used steroids. In multivariable logistic regression analyses, the severity of COVID-19 disease was the only predictive factor of death in COVID-19 and pneumonia patients (p<0.001, OR=26.714, 95% confidence intervals: 5.526–129.135).
Conclusion: Some drugs (antiviral, antibiotics, and steroids) have been prescribed to the confirmed COVID-19 with pneumonia patients. Oseltamivir and levofloxacin were the widely used antiviral and antibiotic agents in this study. The analysis showed that the disease severity was statistically associated with patient’s clinical outcomes. COVID-19 patients with the severe illness have a greater risk of death.
World Health Organization. WHO Coronavirus Disease Dashboard. Geneva: World Health Organization; 2021. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019. [Last accessed on 2021 Aug 09].
Ministry of Health of the Republic of Indonesia. Current Situation of the Development of COVID-19 in Indonesia 9 August 2021; 2021. Available from: https://www.infeksiemerging.kemkes.go.id/dashboard/ covid-19. [Last accessed on 2021 Aug 09].
Li H, Liu SM, Yu XH, Tang SL, Tang CK. Coronavirus disease 2019 (COVID-19): Current status and future perspectives. Int J Antimicrob Agents 2020;55:105951.
Sharov KS. SARS-CoV-2-related pneumonia cases in pneumonia picture in Russia in March-May 2020: Secondary bacterial pneumonia and viral co-infections. J Glob Health 2020;10:020504.
Mirzaei R, Goodarzi P, Asadi M, Soltani A, Aljanabi H, Jeda AS, et al. Bacterial co-infections with SARS-CoV-2. IUBMB Life 2020;72:2097-111.
World Health Organization. COVID-19 Clinical Management Living Guidance 25 January 2021. Geneva: World Health Organization; 2021.
Rozaliyani A, Ary S, Findra S, Titania N. Factors associated with death in COVID-19 patients in Jakarta, Indonesia: An epidemiological study. Acta Med Indones 2020;52:246-54.
Søgaard KK, Baettig V, Osthoff M, Marsch S, Leuzinger K, Schweitzer M, et al. Community-acquired and hospital-acquired respiratory tract infection and bloodstream infection in patients hospitalized with COVID-19 pneumonia. J Intensive Care 2021;9:10.
Manna S, Baindara P, Mandal SM. Molecular pathogenesis of secondary bacterial infection associated to viral infections including SARS-CoV-2. J Infect Public Health 2020;13:1397-404.
Indonesian Doctors Associations. Guidelines for COVID-19 in Indonesian 3rd Edition December 2020. Jakarta: Indonesian Doctors Associations; 2020.
Frediansyah A, Tiwari R, Sharun K, Dhama K, Harapan H. Antivirals for COVID-19: A critical review. Clin Epidemiol Glob Health 2021;9:90-98.
Acosta PE, Charles F. Antiviral agents (nonretroviral). In: Brunton LL, Chabner BA, Knollmann BJ, editors. Goodman and Gilman’s: The Pharmacological Basis of Therapeutics. 12th ed. New York: McGraw- Hill Education; 2011. p. 1608.
Liu J, Zhang S, Wu Z, Shang Y, Dong X, Li G, et al. Clinical outcomes of COVID-19 in Wuhan, China: A large cohort study. Ann Intens Care 2020;10:99.
Rahmani H, Davoudi-Monfared E, Nourian A, Nabiee M, Sadeghi S, Khalili H, et al. Comparing outcomes of hospitalized patients with moderate and severe COVID-19 following treatment with hydroxychloroquine plus atazanavir/ritonavir. Daru 2020;28:625-34.
Li X, Xu S, Yu M, Wang K, Tao Y, Zhou Y, et al. Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan. J Allergy Clin Immunol 2020;146:110-8.
Jin S, Hu W. Severity of COVID-19 and treatment strategy for patient with diabetes. Front Endocrinol 2021;12:602735.
Sun Y, Dong Y, Wang L, Xie H, Li B, Chang C, et al. Characteristics and prognostic factors of disease severity in patients with COVID-19: The Beijing experience. J Autoimmun 2020;112:102473.
Jutzeler CR, Bourguignon L, Weis CV, Tong B, Wong C, Rieck B, et al. Comorbidities, clinical signs and symptoms, laboratory findings,imaging features, treatment strategies, and outcomes in adult and pediatric patients with COVID-19: A systematic review and meta-analysis. Travel Med Infect Dis 2020;37:101825.
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet 2020;395:1054-62.
Zheng Z, Peng F, Xu B, Zhao J, Liu H, Peng J, et al. Risk factors of critical and mortal COVID-19 cases: Asystematic literature review and meta-analysis. J Infect 2020;81:e16-25.
Cen Y, Chen X, Shen Y, Zhang XH, Lei Y, Xu C, et al. Risk factors for disease progression in patients with mild to moderate coronavirus disease 2019-a multi-centre observational study. Clin Microbiol Infect 2020;26:1242-7.
Galbadage T, Peterson BM, Awada J, Buck AS, Ramirez DA, Wilson J, et al. Systematic review and meta-analysis of sex-specific COVID-19 clinical outcomes. Front Med 2020;7:348.
Chen X, Wenjia H, Jiaxin L, Pingzheng M, Zhang Y, Jiang Q, Ma Z, et al. Hypertension and diabetes delay the viral clearance in COVID-19 patients. medRexiv 2020;2020:40774.
How to Cite
Copyright (c) 2021 Nofria Rizki Amalia Harahap, Retnosari Andrajati, Ahmad Subhan
This work is licensed under a Creative Commons Attribution 4.0 International License.
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.