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All Journal Althea Medical Journal Jurnal Respirologi Indonesia
Desi Rahmawaty
Faculty of Medicine, Lambung Mangkurat Univesity, Banjarmasin
Health Professions Medicine & Pharmacology

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Clinical Characteristic of Different SARS-CoV-2 Variants in South Kalimantan, Indonesia: A Case Study Haryati Haryati; Desi Rahmawaty; Mohamad Isa; Ali Assagaf; Ira Nurrasyidah; Erna Kusumawardhani
Althea Medical Journal Vol 10, No 1 (2023)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v10n1.2810

Abstract

Background: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has undergone various mutations of Corona Virus Disease 2019 (COVID-19). The World Health Organization (WHO) has designated B.1.617.2 (Delta) and B.1.1.529 (Omicron) as variants of concern (VOC). Since clinical features and epidemiological characteristics of patients infected with SARS-CoV-2 variants remain largely unknown, especially in Indonesia, this study aimed to identify the clinical characteristics of COVID-19 patients from South Kalimantan, Indonesia.Methods: Data from medical records of COVID-19 patients at Ulin General Hospital Banjarmasin from June 2021 to February 2022 were randomly extracted, containing demographic data, comorbidities, and laboratory data, as well as the type of virus. Results: In total, 32 patients were included, 9 were infected with delta, 14 with probable omicrons, and 9 with non-VOC. Patients in the probable Omicron group were significantly older than other groups (median age 64 years old, range 54–73 years; p=0.049), had hypertension as the dominant comorbidity (85.7%; p=0.039), the onset appeared slightly earlier (median 3 days; range 2-3 days, p=0.062), with no anosmia symptom (p=0.006). Critical illness predominated and mostly survived in all variants but was not statistically significant (p=0.590 and 0.726, respectively). The three variants showed similarities in laboratory findings; hence, statistical analysis suggested that the leucocytes differed significantly (p=0.020).Conclusions: Patients with the likely Omicron variant are much older, have hypertension as their main comorbidity, do not have any symptoms of anosmia, and have higher leukocyte counts compared to other variants.
Late-Onset Pneumothorax and Bullous Disease in Post-COVID-19 Pneumonia with Severe ARDS Ira Nurrasyidah; Vincentius Adrian Madargerong; Desi Rahmawaty
Jurnal Respirologi Indonesia Vol 43, No 2 (2023)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v43i2.354

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Background: Patients with COVID-19 pneumonia may develop bullae that can rupture into spontaneous pneumothorax (SP) during the diagnosis and treatment, which can be a predictor of a poor prognosis. However, late-onset bullous disease and SP after recovering from COVID-19 are unusual.Case: A 48-year-old male presented with sudden shortness of breath accompanied by chest pain. Three weeks earlier, the patient had finished treatment in the COVID-19 isolation room for 20 days with a diagnosis of COVID-19 pneumonia with severe ARDS. Physical examination demonstrates tachypnea, desaturation, decreased vesicular breath sounds, and hyperresonance percussion on the right hemithorax; without rhonchi or wheezing. Chest X-ray and CT scan showed a right pneumothorax with infected subpleural giant bullae in right perihilar, right lung collapse, minimal right-to-left lung herniation and post-covid pulmonary fibrosis. Culture and sensitivity examination of the pleural fluid showed the growth of Providencia stuartile. A chest tube was placed for the management of the pneumothorax. Subsequently, according to the results of culture and antibiotic sensitivity test, the patient was treated using piperacilin/tazobactam and amikacin. The patient showed clinical and radiological improvement following 41 days of treatment and could be managed as an outpatient.Conclusion: Our patient had infected giant bullae and pneumothorax post COVID-19 pneumonia and severe ARDS. The patient did not undergo a bullectomy in consideration of the post-COVID-19 condition and was managed conservatively using adequate chest tube and antibiotics. Patient responded well to therapy, showed clinical improvement and could be discharged.
Co-Authors Ali Assagaf Erna Kusumawardhani Haryati Haryati Ira Nurrasyidah Mohamad Isa Vincentius Adrian Madargerong