Andree Kurniawan
Bagian Penyakit Dalam, Fakultas Kedokteran Universitas Pelita Harapan Siloam General Hospital

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Coronavirus Disease 2019 and Gastrointestinal Involvement: A Systematic Review Monica, Moryella; Kurniawan, Andree
Medicinus Vol. 10 No. 1 (2020): October:2020
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v8i2.3443

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Introduction: The World Health Organization (WHO) announced the Coronavirus 2019 (COVID-19) as a Public Health Emergency of International Concern (PHEIC) toward the end of January 2020. There is still limited evidence to explain the gastrointestinal involvement in COVID-19. In this study, we aimed to further investigate current evidence describing the gastrointestinal involvement in COVID-19 patients.Methods: This systematic review has been registered in PROSPERO (CRD42020181584). A systematic search of literature for observational and randomized controlled trial was conducted in PubMed, PubMed central, and Google Scholar through April 16, 2020. Two reviewers independently searched and selected. The risk of bias was evaluated using the Newcastle-Ottawa Quality assessment tool. Results: A total of 1,480 articles were screened from which 12 articles with 5584 subjects were selected. SARS-CoV-2 can invade human body by binding to angiotensin converting enzyme 2 (ACE-2) receptor which also located to small intestinal epithelial cells, crypt cells and colon. The virus itself may cause disorders of the intestinal flora. The diagnosis should be based on a set of symptoms diarrhoea, nausea, vomiting, abdominal discomfort or pain, combined with positivity of faecal PCR test. Treatment of COVID-19 mainly is supportive care. The probiotic may modulate the gut microbiota to alter the gastrointestinal symptoms and reduced enteritis, ventilator associated pneumonia, and reverse certain side effect of antibiotics.Conclusion: Our synthesis of literature showed that there was no good evidence yet in overall area of gastrointestinal manifestations in COVID-19. Future research is needed to explore all areas, especially in mechanism and treatments
Coagulopathy in COVID-19: A Systematic Review Winata, Sharleen; Kurniawan, Andree
Medicinus Vol. 10 No. 1 (2020): October:2020
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v8i2.3444

Abstract

Introduction: Corona Virus Disease 2019 (COVID-19) firstly appeared in Wuhan, China in December 2019 and defined as a pandemic in March 2020. COVID-19 divided into asymptomatic, mild, and severe symptoms. Coagulopathy may have happened in severe COVID-19 infection, it was also associated with high mortality in COVID-19 patients. Laboratory examination is the main protocol to identify coagulopathy, thereby it also determined the prognosis of COVID-19 patients with coagulopathy. Here, we review the current evidence describing the mechanism, diagnosis, treatment, and mortality of coagulopathy in COVID-19.Method: We identify 8 studies and/or review articles evaluating coagulopathy in COVID-19 patients by searching PubMed and EMBASE databases.Results: DIC is most commonly found in death with COVID-19, the risk of VTE also higher in severe COVID-19 because of immobility and long-term bed rest. Sepsis-induced DIC is associated with organ dysfunction as in the patient with viral infection as in COVID-19 infection. Sepsis-induce Coagulopathy (SIC) score, D-dimer, and prothrombin time (PT) measured at the time the patient classified as severe COVID-19. Higher D-dimer and FDP levels, longer PT and activated partial thromboplastin time (APTT) may have a poor prognosis. Treatment with Low Molecular Weight Heparin (LMWH) effective to reduced 28-day mortality in patients with SIC ‰¥ 4 and D-dimer > six-fold of the upper limit of normal. Conclusion: Coagulopathy plays a big role to determine the prognosis of COVID-19 patients. Treatment with LMWH may give some benefits to COVID-19 patients.
Development and Validation of a “Pelita Harapan” Questionnaire Assessing Knowledge, Attitude, and Practice Toward Coronavirus Disease 2019 Among Young People in Indonesia Winata, Sharleen; Kurniawan, Andree; Agung, Fransisca Handy; Hardjo Lugito, Nata Pratama; Jodhinata, Claudia; Halim, Devina Adella; Angelina, Stella; Agatha, Cindy Monika
Medicinus Vol. 10 No. 2 (2021): February : 2021
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v8i3.3769

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Introduction: Coronavirus Disease 2019 (COVID-19) has become a pandemic. Much false information was circulating especially through social media and affected individual’s knowledge, attitude, practice (KAP) towards COVID-19. Currently, there is lack of validated questionnaires to assess KAP about COVID-19 especially in Indonesian young people.Aim: To develop and validate a new COVID-19 KAP questionnaire for young people population in Indonesian language.Methods: Some literature review was done to look for the concept to generate a new questionnaire.  Open-ended questions were generated to know the baseline knowledge. Then, close-ended questions were formulized for knowledge, attitude, and practice area. The experts and several respondents were asked to give their opinions about the contents of the questionnaire. The validity was examined using Cronbach's alpha coefficient. For reliability, internal consistency was examined by using Pearson or Spearmen correlation test.Results: A total of 59 subjects with median ages 21 (16-24) years old of non-medical individuals were included in this validation process. More than half were male, mostly held bachelor’s degree/diploma, and were dominated with students. This Indonesian COVID-19 KAP questionnaire for young people consists of 10 knowledge, 8 attitude, and 7 practice questions. The Cronbach’s alpha coefficient of knowledge, attitude, and practice areas were 0.87, 0.82, and 0.91, respectively.Conclusions: A questionnaire of KAP towards COVID-19 in Indonesian language had been developed and the results showed good validity.
Profile and Factors Associated with Depression, Anxiety, and Stress in Indonesian People During COVID-19 Pandemic Argo, Teresa Mika; Kurniawan, Andree; Liem, Jean Andrina; Sugianto, Jeremy Octavian; Michael, Rafael Jonathan; Tanuwijaya, Nathania Victoria Stevina; Agatha, Lisa; Wonsono, Beverley; Rivami, Dwi Savitri
Medicinus Vol. 10 No. 2 (2021): February : 2021
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v8i3.3770

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Background : As a result of the COVID-19 pandemic, Indonesia implemented various policies to break the chain of transmission of COVID-19, starting from large-scale social restrictions, quarantines, and even lockdowns. Without exception, schools were also closed. These conditions affect people psychologically, including levels of depression, anxiety, and stress in students. The aim of this study is to determine profile and factors associated with depression, anxiety, and stress in Indonesian people during the COVID-19 pandemic.Methods : A cross-sectional study among students in Indonesia was conducted to determine depression, anxiety, and stress levels in adolescents based on their sociodemographic characters. The DASS-21 questionnaire was distributed online.Results : A total of 913 people participated from all provinces in Indonesia. Depression, anxiety, and stress were found in 43.5%, 43.3%, 25.2%, respectively. The severity of depression was significantly associated with age (p<0.001), gender(p=0.003), and region(p=0.039). Adults (25-55) are 4.6 times odds more likely to have depression than adolescent during pandemic (OR=4.641, 95% CI=2.053-10.491). The severity of anxiety was significantly associated with age (p=0.002), gender(p<0.001), education (p=0.004) and region(p=0.004). The severity of stress was significantly associated with gender (p<0.001) and education (p=0.018).Conclusion : Depression, anxiety and stress quite common found in Indonesian during COVID-19 pandemic. Several sociodemographic factors were associated with depression, anxiety and stress among Indonesia
Psychometric Properties of the Indonesian Version of Impact of Event Scale-Revised Questionnaire During COVID-19 Pandemic Wijovi, Felix; Kurniawan, Andree; Lugito, Nata Pratama Hardjo; Agung, Fransisca Handy; Cipta, Darien Alfa; Angelina, Stella; Halim, Devina Adella; Jodhinata, Claudia; Orlin, Sisilia; Hamdoyo, Audrey; Evangelista, Nadya Nathalia
Medicinus Vol. 11 No. 1 (2021): October
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v9i2.4703

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Background: COVID-19 is a respiratory infection caused by SARS CoV-2. A health-related disaster may result in a wide range of mental consequences, including PTSD. IES-R is a self-reported instrument, and it corresponds to DSM-IV symptoms of PTSD. However, there were scarce data about the validation of the Indonesian version of IESR.Aim: The purpose of this study was to validate the IES-R in the Indonesian adult population by comprehensively and systematically assessing the epidemiological evidence about PTSS during the COVID-19 pandemic.Methods: This was a cross-sectional study. The IES-R questionnaire was translated from English to Indonesian, back-translated. All health workers were excluded to avoid the biased result. Pearson correlation and Cronbach's alpha coefficients to determine the validity and reliability of the questionnaire.Results: A total of 234 Indonesian-speaking adults completed the survey. The Indonesian IES-R had proven to be a valid (r= 0.756 -0.938, p= 0.000) and reliable (alpha coefficient: 0.858-0.868) measure for PTSS in a sample of Indonesian adults during the COVID-19 pandemic. In addition, the final model which consisted of 3 subscales with 20 items demonstrated acceptable factor loadings.Conclusion: The results of this study suggested IESR is valid and reliable to be used in the Indonesian population especially during pandemics.
The Determinants of COVID-19 Vaccine Acceptance in Sumatra Sidarta, Cindy; Kurniawan, Andree; Lugito, Nata P H; Siregar, Jeremia Imanuel; Sungono, Veli; Heriyanto, Rivaldo Steven; Sieto, Novia Lauren; Halim, Devina Adella; Jodhinata, Claudia; Rizki, Saraswati Anindita; Sinaga, Terry Devita; Marcella, Chintya; Wijovi, Felix; Susanto, Billy; Marcella, Elizabeth; Wibowo, Johan; Anurantha, Jonathan Juniard; Imanuelly, Michelle; Indrawan, Michele; Heryadi, Nadia Khoirunnisa
Kesmas Vol. 17, No. 1
Publisher : UI Scholars Hub

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Abstract

In light of the current coronavirus disease 2019 (COVID-19) vaccination programs being implemented worldwide, this study aimed to evaluate the COVID-19 vaccine acceptance survey in Indonesia conducted by the World Health Organization (WHO), the Ministry of Health of the Republic of Indonesia, the National Immunization Technical Advisory Group (NITAG), and the United Nations Children's Fund (UNICEF), published in November 2020. It was found that Sumatra Island having lower COVID-19 vaccine acceptance rates, with Aceh Province displaying the lowest level of vaccine acceptance. Thus, a cross-sectional study was conducted, and a logistic regression analysis was used to identify the factors affecting COVID-19 vaccine acceptance. Out of 368 respondents who participated in the survey, 143 (38.9%) accepted the vaccine, and 225 (61.1%) refused it. Vaccine safety concerns constituted the most reported reason for refusal (43.6%). This study also found that province of residence and basic immunization status were determinants of COVID-19 vaccine acceptance in Sumatra. Concerns regarding vaccine safety might be the reason for the low level of vaccination in Sumatra. Increased education and encouragement from healthcare professionals and regional authority figures can alleviate public concerns and improve vaccine acceptance.
Efficacy of Cloth Face Mask in Reducing COVID-19 Transmission: A Literature Review Rizki, Saraswati Anindita; Kurniawan, Andree
Kesmas Vol. 15, No. 5
Publisher : UI Scholars Hub

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Abstract

Coronavirus disease 2019 (COVID-19) has become a public health concern. Preventive measures, such as wearing personal protective equipment, must be done. On April 2020, the Center for Disease Control stated cloth face mask was recommended to be used by the public. This systematic review aimed to eva - luate the efficacy of cloth face masks in reducing COVID-19 transmission and to compare the fabric material that suits best for a cloth face mask. Journals included were from databases such as Google Scholar, PubMed, search engines, and references from other studies. The MeSH keywords, such as "cloth mask efficiency", "surgical mask", "COVID-19" and "filtration performance of common fabrics cloth mask" were used. Studies that used particle microorganisms sized ≤ 0.072 μm were included in this study. Studies showed that cloth face mask still can filter to a certain extent, however, it is inferior compared to surgical mask. Results show that the efficacy of cloth face mask depends on its fabric, and that polyester provides the best filtration efficiency. However, the pressure drop of polyester is unknown and more studies should be done.
The Hidden Clot: A Case of Recurrent Atypical Venous Thrombosis Highlighting the Need for Vigilant Diagnostic Evaluation Mangkuliguna, Gladys; Sutanto, Ratna; Violetta, Olivia; Kurniawan, Andree
Medicinus Vol. 15 No. 2 (2026): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v15i2.10592

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Background: Venous thromboembolism (VTE) is the third most common cardiovascular disorder worldwide. While lower-extremity deep vein thrombosis and pulmonary embolism are typical presentations, thrombosis in atypical sites remains challenging to recognize and diagnose.   Case Description: A 27-year-old female flight attendant with history inflammatory bowel disease (IBD), tuberculosis and combined oral contraceptive (COC) use presented with an acute abdominal pain. Initial contrast-enhanced CT revealed thrombosis of the left renal and ovarian veins. Laboratory tests showed elevated hs-CRP and D-dimer, with positive ANA but negative antiphospholipid antibodies. She was treated with intravenous heparin followed by oral rivaroxaban, though adherence was inconsistent due to episodes of heavy vaginal bleeding. Repeat CT imaging eight months later demonstrated resolution of the initial thrombi but revealed a new thrombus in the inferior vena cava extending into the right common iliac vein, accompanied by recurrent elevation of D-dimer.   This case illustrates the interplay of multiple risk factors for VTE, including IBD, prolonged immobility during long-haul travel, COC use, tuberculosis, and rifampicin therapy. These overlapping chronic and transient triggers likely contributed to recurrent thrombosis despite ongoing treatment.   Conclusions: Recurrent VTE in unusual venous sites can occur particularly in patients with multiple risk factors. Early recognition, appropriate imaging, and anticoagulant therapy adherence are essential to preventing progression and recurrence
Diagnostic Accuracy of Coronary Artery Calcium Scoring in Detecting Significant Coronary Artery Stenosis Compared with Invasive Coronary Angiography Erico, Adelbertus; Muljadi, Rusli; Yuniarti, Mira; Pardede, Ingrid Maria; Kurniawan, Andree; Jorizal, Patricia
Medicinus Vol. 15 No. 2 (2026): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v15i2.10757

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Background: Coronary artery disease (CAD) remains a leading cause of mortality, emphasizing the importance of early non-invasive diagnostic strategies. This study evaluated the diagnostic accuracy of coronary artery calcium scoring (CACS) in detecting significant coronary stenosis, using invasive angiography as the reference standard.   Methods: Sixty-three patients who underwent both CACS and quantitative coronary angiography were retrospectively analyzed. The mean total CACS was 684.1 ± 1030.8, and significant stenosis (≥70%) was most prevalent in the left anterior descending artery (92.1%).   Result: Spearman’s analysis revealed positive correlations between CACS and angiographic stenosis in the right coronary artery (ρ = 0.338, p = 0.007), left anterior descending artery (ρ = 0.492, p = 0.001), and left circumflex artery (ρ = 0.314, p = 0.012). Receiver operating characteristic (ROC) analysis demonstrated moderate-to-good diagnostic performance, with area under the curve (AUC) values of 0.699 for RCA, 0.769 for LAD, and 0.690 for LCX.   Conclusions: These findings indicate that CACS can serve as a reliable, low-cost, and non-invasive modality for preliminary screening and risk stratification of CAD, particularly in identifying patients who may benefit from invasive coronary angiography.
Association Between Ultrasound-Derived Fat Fraction (UDFF) Values and Metabolic Syndrome Laboratory Parameters in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) Syahputra, Rheza Maulana; Jorisal, Patricia; Tarigan, Vera Nevyta; Lucas, Brian; Setiawan, Hardianto; Kurniawan, Andree
Medicinus Vol. 15 No. 2 (2026): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v15i2.10815

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Background: Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), formerly known as Non-Alcoholic Fatty Liver Disease (NAFLD), is highly prevalent worldwide and is strongly associated with metabolic syndrome and its related conditions such as diabetes mellitus and hypertension. Without early detection and intervention, hepatic steatosis can progress to hepatic inflammation, fibrosis, cirrhosis, and even hepatocellular carcinoma (HCC). This study aims to evaluate the relationship between ultrasound-derived fat fraction (UDFF) values and laboratory parameters of metabolic syndrome in MASLD, particularly liver enzymes, lipid profile, and glycemic profile, as well as to determine the optimal UDFF cut-off value for detecting metabolic syndrome risk in Indonesian patients.   Methods: A cross-sectional study was conducted on 96 patients who underwent UDFF and laboratory assessments including liver enzymes (SGOT/AST, SGPT/ALT), lipid profile (total cholesterol, HDL, LDL, triglycerides), and glycemic profile (HbA1c, fasting blood glucose). Data analysis included bivariate-multivariate correlation and ROC analysis.   Result: The distribution of UDFF (%) was as follows: normal ≤6% (27.1%; n=26), mild >6–15% (37.5%; n=36), moderate >15–25% (21.9%; n=21), and severe >25% (13.5%; n=13). UDFF showed a moderate positive correlation with SGPT (ρ=0.370; p<0.01) and triglycerides (ρ=0.380; p<0.01), and a weak negative correlation with HDL (ρ=−0.221; p<0.05). A UDFF threshold of 14% was able to predict abnormal SGPT levels and elevated triglycerides.   Conclusions: UDFF shows a significant correlation with laboratory parameters of metabolic syndrome in MASLD, confirming its potential as an accessible, effective, efficient, non-radiative, and non-invasive imaging modality. These findings support the central role of radiology in the early detection and therapeutic monitoring of MASLD and metabolic syndrome, as well as in preventing disease progression from hepatic steatosis to inflammation, fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). Large-scale multicenter validation is required to optimize these findings.
Co-Authors Achmad Fauzi ACHMAD FAUZI Agatha, Cindy Monika Agatha, Lisa Agung, Fransisca Handy Allen Widysanto Andhika Rachman Andri Sanityoso Sulaiman Angelina, Stella Anurantha, Jonathan Juniard Argo, Teresa Mika Ari Fahrial Syam Armen Armen Arshita Auliana Audrey Hamdoyo Billy Susanto Ceva W. Pitoyo Chandra, Margaret Chintya Marcella Cindy Sidarta Claudia Jodhinata Cucunawangsih Cucunawangsih, Cucunawangsih Daniel Chung Darien Alfa Cipta Darti Isbandiarti Devina Adella Halim Devina Adella Halim Dewi Purnamasari Diah Martina, Diah Edy Gunawan Edy Gunawan, Edy Elizabeth Marcella Erico, Adelbertus Euphemia Seto Euphemia Seto, Euphemia Evangelista, Nadya Nathalia Fajar L. Gultom Febby Hutomo Felix Wijovi Felix Wijovi Fidelia Octaviani Halim, Devina Adella Hamdoyo, Audrey Hariyanto, Timotius I. Hartoyo, Vinson Heriyanto, Rivaldo Steven Heryadi, Nadia Khoirunnisa Imanuelly, Michelle Indrawan, Michele Isbandiarti, Darti Ivana Dewi Mulyanto Jane Olivia Lorens Jeremia Imanuel Siregar Jodhinata, Claudia Johan Wibowo Johan Wibowo Jonathan Juniard Anurantha Jorisal, Patricia Jorizal, Patricia Jovita Jovita Khie Chen Liem, Jean Andrina Lorens, Jane Olivia Lucas, Brian Lugito, Nata P H Mangkuliguna, Gladys Marcella, Chintya Marcella, Elizabeth Marcellus Simadibrata Marcellus Simadibrata Margaret Chandra Margaret Merlyn Tjiang, Margaret Merlyn Maria, Eva Michael Susanto Michael Susanto Michael, Rafael Jonathan Michele Indrawan Michelle Imanuelly Mira Yuniarti Monica, Moryella Nadia Ayu Mulansari, Nadia Ayu Nadia Khoirunnisa Heryadi Nadya Nathalia Evangelista NATA LUGITO, NATA Nata P H Lugito Nata P Hardjo Lugito, Nata P Nata Pratama Nata Pratama Hardjo Lugito Novia Lauren Sieto Nugroho Prayogo Octaviani, Fidelia Orlin, Sisilia Pardede, Ingrid Maria Patricia Budimulia Prima Yuriandro Rahmat Cahyanur Ralph Girson Gunarsa Resa Setiadinata Resti Mulya Sari Rivaldo Steven Heriyanto Rivami, Dwi Savitri Rizki Yaruntradhani Rizki, Saraswati Anindita Rusli Muljadi, Rusli Ryan Yudistiro Saraswati Anindita Rizki Saraswati Anindita Rizki Setiadinata, Resa Setiawan, Hardianto Sharfina, Ratuafni Sidarta, Cindy Sieto, Novia Lauren Sinaga, Terry Devita Siregar, Jeremia Imanuel Sisilia Orlin Soputri, Christin Stella Angelina Stevent Sumantri Stevent Sumantri, Stevent Sugianto, Jeremy Octavian Susanti - Susanto, Billy Sutanto, Ratna Syahputra, Rheza Maulana Tan, Christine Tanuwijaya, Nathania Victoria Stevina Tarigan, Vera Nevyta Terry Devita Sinaga THEO AUDI YANTO, THEO AUDI Timotius Ivan Hariyanto Veli Sungono Vinson Hartoyo Violetta, Olivia Wijaya, Indra Wijovi, Felix Wilson Matthew Raffaello Winata, Sharleen Wong, Clarinda Wonsono, Beverley Yohanes Deo Fau