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Factors Influencing the Delay in Negative Conversion of PCR Swab Test Results in Patients with COVID-19: Factors Influencing the Delay in Negative Conversion of PCR Swab Test Results in Patients with COVID-19 Nurkholis, Fathur; Hanang Wibisono, Banteng; Suryanto, Agus; Handoyo, Thomas; Farida, Farida; Tanamas, Jimmy
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 2 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (269.755 KB) | DOI: 10.36408/mhjcm.v9i2.755

Abstract

Background : The negative conversion duration of SARS-CoV-2 RNA was related to disease progression, and a prolonged negative conversion could provide early warning signal for poor prognosis in patients with COVID-19. The objectives of this study was to identify the factors influencing the delay in negative conversion of PCR swab test results in patients with COVID-19 as a consideration in determining the COVID-19 prevention policy in the community Methods : A retrospective cross-sectional study involving 68 patients diagnosed with COVID-19 that was treated in Dr. Kariadi General Hospital Medical Center Semarang from June 1st to December 30th 2020. Negative conversion was evaluated based on the results of the RT-PCR swab test on day 7, 14 and 21. Results : Mean negative conversion time for all patients was 11.63±5.08 days. Thirty-one factors were evaluated in the initial univariate Cox and Kaplan-Meier analysis. Older age (>59 years), overweight (>25 kg/m2), fever (>38°C), shortness of breath, diabetes mellitus, neutrophilia, hypoalbuminemia, CRP and antiviral treatment showed significant association with negative conversion time. These factors were then included in a multivariate regression analysis. Hypoalbuminemia or albumin level of <3.0 g/dL was found as an independent factor associated with negative conversion time of viral RNA (HR:1.986; 95%CI:1.098–3.594), and hypoalbuminemia was presumed to cause prolonged viral clearance time in patients with COVID-19. Conclusion : The factors influencing the prolong in negative conversion of viral RNA in patients with COVID-19 were older age, overweight, fever, shortness of breath, diabetes mellitus, neutrophilia, hypoalbuminemia, CRP and antiviral treatment. Hypoalbuminemia was an independent predictor for prolonged negative conversion of viral RNA in patients with 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