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Journal : Medica Hospitalia

Evaluasi Dengan High Resolution Computed Tomography (HRCT) Setelah Infeksi Covid-19: Laporan Kasus di Rumah Sakit dr. Kariadi Semarang Satoto, Bambang; Widyasari, Maya Nuriya; Apriansah, Apriansah
Medica Hospitalia : Journal of Clinical Medicine Vol. 7 No. 1A (2020): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (468.567 KB) | DOI: 10.36408/mhjcm.v7i1A.469

Abstract

Pendahuluan SARS-CoV-2 merupakan virus RNA yang terutama menginfeksi sel-sel pada saluran napas pelapis alveoli. Virus SARS-CoV-2 yang terhirup mengikat sel epitel di rongga hidung dan mulai bereplikasi. Virus ini menyebar serta bermigrasi ke saluran pernapasan, memicu respons imun bawaan dan pada akhirnya berkembang menjadi Acute Respiratory Distress Syndrome (ARDS). Gambaran ground glass infiltrates dapat terdeteksi pada pencitraan toraks. Pemeriksaan X-ray toraks dan MSCT toraks memegang peranan penting dalam deteksi dan follow up COVID-19. Metode dan Bahan Laporan kasus 2 pasien laki-laki yang terkonfirmasi COVID-19 umur 43 tahun dan 48 tahun dengan keluhan utama sesak napas, batuk dan demam. Pasien pertama mempunyai riwayat perjalanan ke Amerika Serikat 3 minggu sebelum masuk rumah sakit, sedangkan pasien kedua mempunyai riwayat kontak dengan pasien terkonfirmasi COVID-19. Pada pemeriksaan X-ray toraks kedua pasien menunjukkan gambaran konsolidasi disertai air bronchogram pada lapangan paru bilateral yang tampak dominan pada perifer. Berdasarkan pedoman Severe Acute Respiratory Syndrome (SARS) terdahulu, evaluasi dapat dilakukan 2 bulan dan 6 bulan setelah terinfeksi. Dua bulan setelah terinfeksi COVID-19 dilakukan pemeriksaan HRCT toraks dengan hasil normal. Kesimpulan Lesi berupa konsolidasi disertai air bronchogram dengan distribusi yang dominan pada perifer merupakan gambaran radiologis yang khas pada pasien Covid-19 seperti yang ditemukan pada kedua kasus yang dipaparkan dalam artikel ini. Evaluasi sequele dengan pemeriksaan HRCT yang dilakukan 2 bulan pasca penyembuhan menunjukkan gambaran paru paru yang normal, tidak ada infiltrat maupun fibrosis pada kedua pasien tersebut. Kata kunci X-ray toraks, konsolidasi, air bronchogram, COVID-19 Introduction SARS-CoV-2 is an RNA virus that mainly infects cells in the alveoli lining airways. The inhaled virus binds to epithelial cells in the nasal cavity then begins to replicate. This virus spreads, migrates to the respiratory tract, triggering an innate immune response, and develop to Acute Respiratory Syndrome. The ground-glass opacities can be detected in thoracic imaging eventually. Chest X-ray and CT-scan have an important role in the detection and follow-up of COVID-19. Materials and Methods The case report of 2 male patients confirmed COVID-19 aged 43 years and 48 years with major complaints of shortness of breath, coughing, and fever. The first patient had a history of raveling to the United States 3 weeks before hospitalization, while the second patient had a history of contact with a confirmed COVID-19 patient. On chest X-ray examination, both patients showed multiple consolidation with air bronchogram in bilateral lung field which appeared dominant in the periphery. According to the previous Severe Acute Respiratory Syndrome (SARS) guideline, evaluation for patients can be done in two months and six months after firstly infected. Two months after COVID-19 infection, a chest HRCT examination was performed with normal results. Conclusion Consolidation with air bronchogram which dominantly seen in peripheral distribution is a typical radiological picture in COVID-19 patients as found in two cases described in this article. Sequelae evaluation with chest HRCT conducted 2 months after healing showed normal lung appearance with no sign of infiltrates or fibrosis seen in both patients. Keywords: Chest X-ray, consolidation, air bronchogram, COVID-19
Correlation Between Brixia Score Imaging and Clinical Laboratory Results In Severe-Critical Covid-19 Patients Receiving Standard Therapy Compared To Tocilizumab Fitriani, Aulia; Wahyuni, Frederica Mardiana; Satoto, Bambang; Handoyo, Thomas; Santoso, Antonius Gunawan; Nawangsih, Christina Hari; Baskoro, Nurdopo
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 2 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i2.991

Abstract

Background. Coronavirus infection disease 19 (COVID-19) is a global health issue. Brixia score and inflammatory markers can assess COVID-19 severity. Severe-critical phase becomes the main concern of clinicians in the management of COVID-19 to reduce mortality. Standard therapy for moderate to severe COVID-19 is convalescent plasma which functions as an antiviral and immunomodulator, while tocilizumab is an IL-6 antagonist which underlies the occurrence of cytokine storms in severe-critical COVID-19. Aims. To examine the correlation between the Brixia score and clinical laboratory results in patients with severe-critical degree of Covid-19 who received both standard therapy and tocilizumab Method. A retrospective cohort study of Brixia score, with clinical laboratory results of D-dimer, fibrinogen, ferritin, and CRP (C-reactive protein) COVID-19 patients with severe-critical phase who were administered standard therapy and tocilizumab who were treated at RSUP DR Kariadi Semarang, then a correlation was carried out between the Brixia score and clinical laboratory results using a correlation test Spearman. Results. The research data consisted of 72 subjects divided into groups that were adiminstered tocilizumab therapy (36 subjects) and standard therapy (36 subjects). There was a significant correlation between the Brixia score and the D-dimer result with p = 0.024 (p <0.05), correlation coefficient = 0.377 in the standard pre-therapy and post therapy. A p-value of less than 0.05 indicates no significant correlation between the Brixia score and clinical laboratory results before or after tocilizumab therapy. Conclusion. There is a significant correlation between the Brixia score results and the D-dimer results in COVID-19 patients who are adiministered standard therapy, but not significant correlation in tocilizumab
Significant Relationship Between Brixia Score And The Degree Of Acute Respiratory Distress Syndrome In Covid 19 Patients Ibrahim, Irni Dwi Aprianty; Satoto, Bambang; Handoyono, Thomas; Santoso, Antonius Gunawan; Sukmaningtyas, Hermina; NINGRUM, FARAH HENDARA
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 2 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i2.993

Abstract

BACKGROUND: Chest X-ray has an important role in detecting early features of COVID-19. To improve risk stratification, a scoring system in chest x-ray called Brixia Score was developed. The Brixia score is designed to measure the severity of lung abnormalities in COVID-19, with an 18-point severity scale. Deaths in COVID-19 occur mainly due to Acute Respiratory Distress Syndrome (ARDS). ARDS is classified into mild, moderate, and severe degrees. If the degree can be predicted earlier, patients can receive earlier therapy and death rate can be reduced. AIMS:  to analyze relationship between Brixia Score and degree of ARDS in COVID-19 patients. METHOD: the research used an observational analytic method with a cross-sectional approach to 95 subjects who are positive for COVID-19 and diagnosed with ARDS, in January to December 2021. Brixia Score data was collected based on chest X-ray expertise, ARDS degree was based on medical records and blood gas analysis. Analysis of relationship between Brixia score and degree of ARDS was carried out using the Kruskal-Wallis test. RESULT:  There was a significant difference in Brixia score based on degree of ARDS (p value <0.05). The highest Brixia score was obtained in severe ARDS, while the low Brixia score was obtained in mild ARDS. This proves that there is a relationship between Brixia score and degree of ARDS. CONCLUSION: Brixia score has a significant relationship to the degree of ARDS in COVID-19 patients.
The Relationship between the Duration of Suffering from Diabetes and HbA1c Levels with the Degree of Liver Stiffness in Type 2 Diabetes Mellitus Patients Amna, Faza Khilwan; Widyasari, Maya Nuriya; Purnomo, Hery Djagat; Wahyuni, Frederica Mardiana; Satoto, Bambang; Sukmaningtyas, Hermina
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 1 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i1.1011

Abstract

BACKGROUND : Type 2 diabetes mellitus (DM) is one of the major problems faced by the health system. Diabetes is a multifactorial, chronic and progressive metabolic disorder characterized by chronic hyperglycemia. Persistent hyperglycemia is associated with long-term damage to the  liver. Ultrasound elastography is one of imaging modality that can assess liver stiffness, thus can assist clinicians in determining therapy, evaluating, and predicting disease progression. AIMS :  Aim of this study was to determine the relationship between liver stiffness degree by using ultrasound elastography with the duration of T2DM and HbA1c levels. METHOD : This study was an observational analytic research with a cross-sectional approach which carried out from May to September 2022 at the radiology department of Dr. Kariadi Hospital Semarang. Fifty subjects were included in this study and Rank-Spearman correlation test was used to analyze the relationship between liver stiffness degree with T2DM duration and HbA1c levels. RESULT :  Using ultrasonography elastography, the liver stiffness average was 7.92 + 6.72 kPa. The average of HbA1c levels was 8.55 + 2.63%. T2DM duration average was 9.10 + 6.50 years.   The rank-spearman test showed a significant correlation between HbA1c levels and the degree of liver stiffness (p = 0.000) with a correlation coefficient (r) of 0.68. There was no significant correlation between the T2DM duration and the degree of liver stiffness (p = 0.052). CONCLUSION : There was a significant correlation between liver stiffness and HbA1c levels, but there is no correlation between liver stiffness and T2DM duration