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All Journal Medical Journal of Indonesia The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal Penyakit Dalam Indonesia
Adityo Susilo, Adityo
Divisi Tropik Infeksi, Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Indonesia
Medicine & Pharmacology

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Mutation and Variant of Coronavirus Disease 2019 (COVID-19): Review of Current Literatures Susilo, Adityo; Jasirwan, Chyntia Olivia Maurine; Wafa, Syahidatul; Maria, Suzy; Rajabto, Wulyo; Muradi, Akhmadu; Fachriza, Ihza; Putri, Myranda Zahrah; Gabriella, Stacy
Jurnal Penyakit Dalam Indonesia Vol. 9, No. 1
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Since March 2020, the Coronavirus Disease 2019 (COVID-19) pandemic has engulfed the world, including Indonesia, for nearly two years. SARS-CoV-2 has undergone several mutations during its evolution as a pathogen, resulting in various variants of global concern. Variants of this virus are suspected to impede the outbreak resolution and possibly causing the outbreak to spiral out of control. There is still considerable debate and research underway regarding the new SARS-CoV-2 variants. Rapid transmission mechanisms and widespread vaccination coverage have accelerated the virus’s mutation rate and resulted in numerous new variants. To date, this has resulted in the discovery of a new variant Omicron (B.1.1.529) in November 2021 in South Africa, which has since spread to 103 countries. Omicron is designated a Variant of Concern (VoC) due to its more powerful transmission than the previous variant. Although some information indicates that the symptoms associated with this variant are typically mild, the rapid transmission of Omicron can increase the next wave of COVID-19 cases. Additional research is required to determine transmissibility, pathogenesis, diagnosis, and proper management. As a result, we conducted an adjunct to studies on various COVID-19 mutations and variants until January 2022.
Peranan Gejala Klinis dan Pemeriksaan Darah Tepi dalam Diagnosis Dini Influenza pada Pasien dengan Gejala Influenza Like Illness Susilo, Adityo; Suwarto, Suhendro; Rengganis, Iris; Harimurti, Kuntjoro
Jurnal Penyakit Dalam Indonesia Vol. 1, No. 2
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Pendahuluan. Influenza merupakan penyakit infeksi yang disebabkan oleh virus influenza. Pada manusia, influenza sering menimbulkan penyakit pernapasan akut dengan manifestasi klinis berupa influenza like illness. Penegakkan diagnosis influenza seringkali sulit oleh karena manifestasi klinis yang tidak khas. Demam disebut sebagai gejala klinis terpenting dan limfopenia didapatkan sebagai suatu temuan laboratoris yang konsisten. Usaha untuk mengetahui proporsi dan mengelaborasi gejala klinis dan pemeriksaan darah tepi sederhana diperkirakan dapat meningkatkan probabilitas diagnosis influenza. Tujuan. Mengetahui proporsi influenza serta mengevaluasi peranan gejala klinis dan pemeriksaan laboratorium sederhana pada pasien penyakit pernapasan akut dengan influenza like illness sehingga dapat digunakan sebagai faktor prediktif terhadap diagnosis influenza. Metode. Studi potong lintang berbasis diagnostic research pada pasien penyakit pernapasan akut dewasa dengan gejala influenza like illness di Puskesmas Kecamatan Pulo Gadung dan Puskesmas Kelurahan Rawamangun antara Maret hingga Juni 2011. Spesimen analisis virus menggunakan bahan apus nasofaringeal, dengan teknik analisis PCR kualitatif dan imunokromatografi antigen. Hasil. Dari 90 orang subyek penelitian didapatkan 13 orang (14,4%) terbukti terinfeksi virus influenza A melalui teknik PCR. Variabel demam menunjukkan hasil uji kemaknaan yang signifikan terhadap influenza (p 0,003) dengan prevalence ratio 6,28 (95% CI 1,476-26,759). Sensitifitas demam, batuk dan pilek terhadap influenza masing-masing adalah 85% dan negative predictive value demam sebesar 98%. Variabel determinan lainnya tidak menunjukkan hasil yang bermakna terhadap influenza pada uji kemaknaan statistik. Simpulan. Proporsi influenza pada pasien dengan gejala ILI diperoleh cukup tinggi dengan proporsi demam yang terbukti lebih tinggi pada pasien influenza. Sensitivitas demam, batuk dan pilek terhadap influenza tinggi dengan negative predictive value yang memuaskan untuk seluruh variabel determinan
Association between Early Antibiotic Administration and In-Hospital Mortality in Moderate and Severe COVID-19 Patients Chen, Lie Khie; Nathanael, Jason; Shakinah, Sharifah; Pasaribu, Adeline; Sinto, Robert; Nainggolan, Leonard; Susilo, Adityo
Jurnal Penyakit Dalam Indonesia Vol. 9, No. 4
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Introduction. Patients with moderate and severe COVID-19 generally receive antibiotic therapy with consideration of the possibility of co-infection or secondary bacterial infection which clinically is difficult to distinguish from COVID-19 symptoms. Overuse of antibiotics can lead to an increased risk of bacterial resistance to antibiotics which is associated with poor outcomes in COVID-19 patients. This study aimed to assess the effect of early antibiotic administration on mortality in moderate and severe COVID-19 patients. Methods. An observational study with a retrospective cohort design was conducted at Dr. Cipto Mangunkusumo Hospital. Data were obtained from medical records of patients admitted from March to September 2020. Patients who received early antibiotics were defined as patients who received antibiotics hospital, 108 subjects were included in this study, 74 (68.5%) with moderate degrees and 34 (31.5%) with severe degrees. Early antibiotics were administered to 79 (73.1%) subjects with a median start time of one day. The results of the bivariate analysis did not find a significant effect of early antibiotic administration on mortality in moderate or severe COVID-19 patients (p=0.42). Subgroup analysis based on the degree of disease also found no significant results. Conclusion. There is no relationship between early antibiotic administration and mortality of moderate and severe COVID-19 patients.
Coronavirus Disease 2019: Review of Current Literatures Susilo, Adityo; Rumende, C. Martin; Pitoyo, Ceva W; Santoso, Widayat Djoko; Yulianti, Mira; Herikurniawan, Herikurniawan; Sinto, Robert; Singh, Gurmeet; Nainggolan, Leonard; Nelwan, Erni J; Chen, Lie Khie; Widhani, Alvina; Wijaya, Edwin; Wicaksana, Bramantya; Maksum, Maradewi; Annisa, Firda; Jasirwan, Chyntia OM; Yunihastuti, Evy
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 1
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Peran Prediktif IL-6, IL-10, dan TNF-α Plasma terhadap Gagal Ginjal Akut pada Pasien dengan COVID-19 Derajat Sedang dan Berat Gathmyr, Dewi; Bonar, Maruhum Bonar H; Susilo, Adityo; Harimurti, Kuntjoro; Nainggolan, Ginova; Tagor, Alvin; Shatri, Hamzah; Lesmana, Cosmas Rinaldi Adithya; Amin, Zulkifli
Jurnal Penyakit Dalam Indonesia Vol. 12, No. 2
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Introduction. Acute kidney injury (AKI) is associated with higher mortality rate in COVID-19 patients due to inflammation and immune dysregulation. This study aimed to correlate serum levels of IL-6, IL-10, and TNF-α with serum creatinine changes and their roles to predict incidence of acute kidney injury (AKI) in patients with moderate and severe COVID-19. Methods. This prospective cohort study was conducted among patients with moderate to severe COVID-19 in Pertamina Central Hospital Jakarta, Indonesia during November 2020 to January 2021. All serum levels of cytokines (IL-6, IL-10, and TNF-α) and creatinine were collected on the first day and seventh day of hospitalization. They might be collected earlier if the patients died or discharged early. AKI was defined as deterioration in serum creatinine or urine output based on Kidney Disease Improving Global Outcomes (KDIGO) guideline. The correlation between cytokine and creatinine serum level changes were analyzed using Spearman test. Receiver operator characteristic curve was calculated to explore predictive roles of cytokines on AKI incidence. Results. A total of 43 patients were included in the study, with a mean age of 59.3 years (SD 12.59), and the majority were male (74%). The incidence of AKI was 7%. Serum creatinine changes were correlated with serum levels changes IL-10 (r= -0.343; p=0.024), but not for IL-6 (r=-0.198; p=0.202) and TNF-α (r=-0.129, p=0.409). Meanwhile, serum TNF-α level on the first day was able to predict AKI incidence on the seventh day of hospitalization (AUC 85%; p=0.045; 95% CI=0.737 to 0.963). Conclusions. TNF-α on the first day is potential to be predictor on AKI incidence on the seventh day in moderate and severe COVID-19 patients.
Health Related Quality of Life and Associated Factors of Inflammatory Bowel Disease Outpatient Unit in Dr. Cipto Mangunkusumo Hospital Afistianto, Muhammad Fikri; Simadibrata, Marcellus; Putranto, Rudi; Abdullah, Murdani; Setiati, Siti; Wisnu, Wismandari; Antono, Dono; Susilo, Adityo
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 26, No 2 (2025): VOLUME 26, NUMBER 2, August, 2025
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2622025107-113

Abstract

Background: Inflammatory Bowel Disease (IBD), encompassing ulcerative colitis (UC) and Crohn's disease (CD), is an inflammatory digestive tract condition with unknown causes. Its unpredictable symptoms affect quality of life. In Indonesia, the quality of life of IBD patients remains unreported. Factors such as advanced age, long disease duration, active disease, corticosteroid use, comorbidities, unemployment, and poor sleep quality may reduce quality of life. This study aims to assess the quality of life profile of IBD patients and its associated factors.Methods: This cross-sectional study collected data from October to November 2024 through interviews at the outpatient unit of Dr. Cipto Mangunkusumo Hospital (RSCM). Quality of life was measured using the Inflammatory Bowel Disease Questionnaire 9 (IBDQ-9), and sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI). Both tools were validated in Indonesian. Eligible participants met inclusion and exclusion criteria. Bivariate and multivariate logistic regression analyses identified factors associated with quality of life.Results: Among 201 participants, 95% reported a good quality of life. Multivariate analysis identified active disease (PR 4.072 [1.133–14.633], p = 0.031) and combination therapy (PR 12.803 [1.423–115.147], p = 0.023) as factors associated with poor quality of life. Age, disease duration, comorbidities, employment status, and sleep quality showed no significant associations.Conclusion: Most IBD patients (95%) in the RSCM outpatient unit reported a good quality of life. Active disease and combination therapy were linked to poorer quality of life.
Faktor-Faktor yang Berhubungan dengan Gejala Depresi pada Pasien Insomnia Usia Lanjut di Rawat Jalan Pratiwi, Amalia Nur; Wahyudi, Edy Rizal; Kusumaningrum, Profitasari; Shatri, Hamzah; Rinaldi, Ikhwan; Gani, Rino Alvani; Wijaya, Ika Prasetya; Susilo, Adityo; Renaldi, Kaka
Jurnal Penyakit Dalam Indonesia Vol. 12, No. 3
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Introduction. The elderly population is increasing globally, including in Indonesia, where 10.7% of the population in 2020 were elderly. Insomnia is a common health issue among older adults and has been identified as a predictor of depression. This study aims to identify factors associated with depressive symptoms in elderly outpatients with insomnia. Methods. This cross-sectional study was conducted in 2024 on patients aged ≥60 years at the outpatient unit of Cipto Mangunkusumo Hospital (RSCM), Jakarta, Indonesia, using consecutive sampling to select participants. Elderly patients were screened using the Pittsburgh sleep quality index (PSQI), and those with a score >5 (indicating insomnia) were included as study subjects. Data were collected through interviews, covering sociodemographic characteristics, level of loneliness, duration of insomnia, depressive symptoms [Geriatric Depression Scale–15 (GDS-15) items], functional status [Barthel Activities of Daily Living (B-ADL)], cognitive status [Mini-Mental State Examination (MMSE)], nutritional status [Mini Nutritional Assessment (MNA)], and chronic diseases [Cumulative Illness Rating Scale for Geriatrics (CIRSG) score]. Results. The study included 209 elderly subjects with insomnia, with a mean age of 72.88 (SD 6.98) years, and a depression prevalence of 6.7%. Bivariate analysis showed significant associations between dependency (PR 5.24; 95% CI 1.50 – 18.29), malnutrition (PR 11.54; 95% CI 4.77 – 27.92), and chronic disease with a CIRSG score ≥9 (PR 4.15; 95% CI 1.18 – 14.50) and depressive symptoms in elderly patients with insomnia. No significant associations were found between sociodemographic factors, loneliness, duration of insomnia, or cognitive status and depression. Multivariate logistic regression analysis revealed a statistically significant association between malnutrition and depressive symptoms (p < 0.001). Conclusions. There is a significant association between malnutrition and depressive symptoms in elderly outpatients with insomnia. Further cohort studies are recommended to explore the causal relationship between malnutrition and depression in elderly patients with insomnia.
Validity and reliability of the Indonesian version of the 9-item Inflammatory Bowel Disease Questionnaire (IBDQ-9) Esa, Dekta Filantropi; Shatri, Hamzah; Rumende, Cleopas Martin; Susilo, Adityo; Maulahela, Hasan; Fauzi, Achmad; Simadibrata, Marcellus
Medical Journal of Indonesia Vol. 32 No. 3 (2023): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.236848

Abstract

BACKGROUND Decreasing the quality of life (QoL) of patients with inflammatory bowel disease (IBD) will increase morbidity and mortality. A valid and reliable instrument is needed to assess the QoL of patients with IBD. This study aimed to analyze the validity and reliability of the Indonesian version of the 9-item Inflammatory Bowel Disease Questionnaire (IBDQ-9). METHODS This cross-sectional study was conducted using the Indonesian version of the IBDQ-9 in adult patients with IBD at the Gastroenterology Outpatient Clinic, Cipto Mangunkusumo Hospital, Jakarta, in November 2022. Patients aged 18 to 59 years who had experienced IBD for at least 2 weeks and provided informed consents were included. The total score of the IBDQ-9 Indonesian version was compared with the 36-item Short-Form Health Survey (SF-36) using the Spearman's correlation test. Reliability tests were examined using Cronbach’s alpha and the intraclass correlation coefficient (ICC). RESULTS A total of 124 participants were included in this study. The Spearman's test showed a high and significant result for the IBDQ-9 Indonesian version and the SF-36 (r = 0.769 and p<0.001). Cronbach’s alpha and ICC coefficient were equal to 0.883. CONCLUSIONS This study provided evidence of the good validity and reliability of the IBDQ-9 Indonesian version for assessing the QoL of patients with IBD in Indonesia.
Skoring Risiko Mortalitas pada Pneumonia Komunitas Sedang-Berat Kusuma, Ni Nyoman Indirawati; Singh, Gurmeet; Wulani, Vally; Rumende, Cleopas Martin Martin; Fauzar, Fauzar; Kamelia, Telly; Koesnoe, Sukamto; Susilo, Adityo; Shatri, Hamzah
Jurnal Penyakit Dalam Indonesia Vol. 13, No. 1
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Introduction. Community Acquired Pneumonia (CAP) is a lung parenchyma infection acquired outside of the hospital and is significantly associated with morbidity and mortality rates. Identifying patients with moderate-severe CAP at high risk of mortality through a combination of these variables is expected to serve as a basis for prompt and appropriate intervention, ultimately improving clinical outcomes for CAP patients. This study aimed to develop a scoring system using clinical characteristics, radiological findings, and serum biomarkers to assess the mortality risk in patients with moderate-severe CAP. Methods. This study employs a retrospective cohort design with moderate-severe CAP patients treated at Dr. Ciptomangunkusumo Hospital, Jakarta. The sample data were secondary, derived from medical records of patients diagnosed with moderate-severe CAP between January 2022 and December 2023. Predictor variables for mortality risk were obtained through multivariate analysis using Cox regression. Results. The study included 277 subjects, with 124 (44.77%) deaths and 153 (55.23%) survivors. Predictor variables consistently influencing mortality risk in moderate-severe CAP patients were low BMI (HR 1.609, 95% CI 1.047 – 2.472), procalcitonin (HR 1.778, 95% CI 1.200 – 2.634), and lactate levels (HR 1.451, 95% CI 0.994 – 2.119). The prediction model’s performance, based on the ROC curve analysis, showed moderate predictive ability (AUC = 0.641), and calibration performance, as assessed by the Hosmer-Lemeshow test, showed good validation (p = 0.082). Conclusions. There is an association between BMI, procalcitonin, and lactate levels with the mortality risk in moderate-severe CAP patients. A mortality risk scoring model for moderate-to-severe CAP patients has been established.
Campak dan Vaksinasi Campak pada Orang Dewasa Sinto, Robert; Koesnoe, Sukamto; Nelwan, Erni Juwita; Widhani, Alvina; Shakinah, Sharifah; Pasaribu, Adeline; Duindrahajeng, Bernadine Gracia; Suwarto, Suhendro; Nainggolan, Leonard; Chen, Lie Khie; Susilo, Adityo; Maria, Suzy; Hasibuan, Anshari Saifuddin; Wicaksana, Bramantya
Jurnal Penyakit Dalam Indonesia Vol. 13, No. 1
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Measles is a highly contagious viral infection that remains a significant global health problem despite the availability of an effective vaccine. Measles re-emergence is driven by gaps in immunization coverage, waning post-vaccination immunity, and increased population mobility. In adults, measles infection is associated with greater disease severity compared to children. This literature review was conducted by reviewing recent scientific publications addressing the epidemiology, pathogenesis, clinical manifestations, diagnosis, management, complications, and prevention of measles, with a focus on the adult population.  Measles is caused by an RNA virus of the Paramyxoviridae family and is transmitted through respiratory droplets and aerosols. Typical clinical features include fever, cough, coryza, conjunctivitis, and a maculopapular rash with a centrifugal and cephalocaudal distribution. Diagnosis is based on clinical findings and confirmed by laboratory tests such as RT-PCR and measles-specific IgM serology. Measles infection causes significant immunosuppression, including immune amnesia, which increases susceptibility to secondary infections. Management is primarily supportive and vitamin A supplementation has been shown to reduce mortality in certain populations. In adults, complications tend to be more severe, particularly pneumonia as the leading cause of morbidity and mortality, as well as neurological complications such as encephalitis and subacute sclerosing panencephalitis (SSPE). Measles vaccination with the MMR vaccine remains the main prevention strategy. However, its implementation faces challenges, including gaps in immunization coverage, vaccine hesitancy, and limited adult immunization record system. Measles in adults remains a significant health concern with a high risk of severe complication. Strengthening immunization program, improving public education, and developing integrated surveillance system are essential to reduce disease incidence and burden.
Co-Authors Achmad Fauzi Afistianto, Muhammad Fikri Alvina Widhani, Alvina Amanda, Rosvitha Annisa, Firda Birry Karim Bonar, Maruhum Bonar H Bramantya Wicaksana C Rinaldi A Lesmana C. Martin Rumende, C. Martin Ceva W. Pitoyo Chyntia Olivia Maurine Jasirwan, Chyntia Olivia Maurine Cleopas Martin Rumende Cleopas Martin Rumende Cynthia Olivia Maurine Jasirwan Dewi Gathmyr Dono Antono Duindrahajeng, Bernadine Gracia E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri Edwin Wijaya Edwin Wijaya, Edwin Edy Rizal Wahyudi Erni J Nelwan, Erni J Erni Juwita Nelwan, Erni Juwita Esa, Dekta Filantropi Evy Yunihastuti Fachriza, Ihza Fauzar, Fauzar Firda Annisa Gabriella, Stacy Ginova Nainggolan Gurmeet Singh Hasan Maulahela Hasibuan, Anshari Saifuddin Herikurniawan Herikurniawan Herikurniawan, Herikurniawan Ihza Fachriza Ika Prasetya Wijaya Ikhwan Rinaldi Iris Rengganis Iris Rengganis Jasirwan, Chyntia OM Juferdy Kurniawan Kaka Renaldi Khie Chen Kuntjoro Harimurti Kusuma, Ni Nyoman Indirawati Kusumaningrum, Profitasari Leonard Nainggolan Maksum, Maradewi Maradewi Maksum Marcellus Simadibrata Mira Yulianti Mira Yulianti, Mira Muradi, Akhmadu Murdani Abdullah Myranda Zahrah Putri Nathanael, Jason Pasaribu, Adeline Pratiwi, Amalia Nur Putri, Myranda Zahrah Rino Alvani Gani Robert Sinto Robert Sinto Rudi Putranto Rumende, Cleopas Martin Martin Shakinah, Sharifah Siti Setiati Stacy Gabriella Suhendro Suwarto Suhendro Suwarto, Suhendro Sukamto Koesnoe Suzy Maria Syahidatul Wafa Syahidatul Wafa, Syahidatul Tagor, Alvin Telly Kamelia Wicaksana, Bramantya Widayat Djoko Santoso Widayat Djoko Santoso, Widayat Djoko Wismandari Wisnu Wulani, Vally Wulyo Rajabto Zulkifli Amin