At the present time, COVID-19 vaccines are at the testing stage, and an effective treatment for COVID-19 incorporating appropriate safety measures remains the most significant obstacle to be overcome. A strategic countermeasure is, therefore, urgently required.This study aims to evaluate the efficacy and safety of a combination of lopinavir/ritonavir-azithromycin, lopinavir/ritonavir-doxycycline, and azithromycin-hydroxychloroquine used to treat patients with mild to moderate COVID-19 infections. Setting and Design. This study was conducted at four different clinical study sites in Indonesia. The subjects gave informed consent for their participation and were confirmed as being COVID-19-positive by means of an RT-PCR test. The present study constituted a randomized, double-blind, and multicenter clinical study of patients diagnosed with mild to moderate COVID-19 infection.Six treatment groups participated in this study: a Control group administered with a 500 mg dose of azithromycin; Group A which received a 200/50 mg dose of lopinavir/ritonavir and 500 mg of azithromycin; Group B treated with a 200/50 mg dose of lopinavir/ritonavir and 200 mg of doxycycline; Group C administered with 200 mg of hydroxychloroquine and 500 mg of azithromycin; Group D which received a 400/100 mg dose of lopinavir/ritonavir and 500 mg of azithromycin; and Group E treated with a 400/100 mg dose of lopinavir/ritonavir and 200 mg of doxycycline.754 subjects participated in this study: 694 patients (92.4%) who presented mild symptoms and 57 patients (7.6%) classified as suffering from a moderate case of COVID-19. On the third day after treatment, 91.7%-99.2% of the subjects in Groups A-E were confirmed negative by a PCR swab test compared to 26.9% in the Control group. Observation of all groups which experienced a significant decrease in virus load between day 1 and day 7 was undertaken. Other markers, such as CRP and IL-6, were significantly lower in all treatment groups (p < 0.05 and p < 0.0001) than in the Control group. Furthermore, IL-10 and TNF-α levels were significantly elevated in all treatment groups (p < 0.0001). The administration of azithromycin to the Control group increased CRP and IL-6 levels, while reduced IL-10 and TNF-α on day 7 (p < 0.0001) compared with day 1. Decreases in ALT and AST levels were observed in all groups (p < 0.0001). There was an increase in creatinine in the serum level of the Control, C, D, and E groups (p < 0.05), whereas the BUN level was elevated in all groups (p < 0.0001).The study findings suggest that the administration of lopinavir/ritonavir-doxycycline, lopinavir/ritonavir-azithromycin, and azithromycin-hydroxychloroquine as a dual drug combination produced a significantly rapid PCR conversion rate to negative in three-day treatment of mild to moderate COVID-19 cases. Further studies should involve observation of older patients with severe clinical symptoms in order to collate significant amounts of demographic data.
Background: prevalence of COVID-19 cases in Indonesia as of June 9, 2020, has been confirmed 32.076 positive cases, with 1.923 death cases. total number of deaths reached 92,941 cases. There has been a recent update on stem cell-based biological, medical therapy as an optional treatment to handling COVID-19 due to its potential viability besides using the prevalent conventional chemical drug therapy.
Methods: In this study, in vitro research was conducted to determine the potential of hematopoietic stem cells (HSCs) and natural killer cells (NK cells) against SARS-CoV-2 viruses, which virus isolates were collected in Indonesia. SARS-CoV-2 virus was planted in rat kidney cells and Vero cells. cells that had been planted with the virus were given HSCs and NK cells, followed by being evaluated at intervals of 24, 48, and 72 hours. evaluation was done by collecting cells and supernatant from the cell plate and then determining the viral load using a Polymerase Chain Reaction (PCR) machine.
Results: results showed that the addition of HSCs and NK on cells that had been infected by SARS-CoV-2 resulted in a decrease in viral load within 24 to 72 hours in all variations of Multiples of Infection (MoI) values.
Conclusions: administration of HSCs and NK cells has the potential to eliminate the SARS-CoV-2 virus. Although this study is only an in vitro study, it could be the basis for the development of alternative stem cell-based therapies to tackle COVID-19 cases.
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Pubmed Style
Purwati, Andang Miatmoko, Nasronudin, Deya Karsari, Aristika Dinaryanti, Eryk Hendrianto, Igo Syaiful Ihsan, Nora Ertanti, Disca Sandyakala Purnama, Tri Pudy Asmarawati, Erika Marfiani, Zamrotul Izzah, Alfian Nur Rosyid, Prastuti Asta Wulaningrum, Herley Windo Setiawan. Potency of Hematopoietic Stem Cells (HSCs) and Natural Killer (NK) Cells as A Therapeutic of SARS-CoV-2 Indonesia Isolates Infection by Viral Inactivation (In Vitro Study). SRP. 2020; 11(5): 772-777. doi:10.31838/srp.2020.5.112
Web Style
Purwati, Andang Miatmoko, Nasronudin, Deya Karsari, Aristika Dinaryanti, Eryk Hendrianto, Igo Syaiful Ihsan, Nora Ertanti, Disca Sandyakala Purnama, Tri Pudy Asmarawati, Erika Marfiani, Zamrotul Izzah, Alfian Nur Rosyid, Prastuti Asta Wulaningrum, Herley Windo Setiawan. Potency of Hematopoietic Stem Cells (HSCs) and Natural Killer (NK) Cells as A Therapeutic of SARS-CoV-2 Indonesia Isolates Infection by Viral Inactivation (In Vitro Study). http://www.sysrevpharm.org/?mno=127004 [Access: March 29, 2021]. doi:10.31838/srp.2020.5.112
AMA (American Medical Association) Style
Purwati, Andang Miatmoko, Nasronudin, Deya Karsari, Aristika Dinaryanti, Eryk Hendrianto, Igo Syaiful Ihsan, Nora Ertanti, Disca Sandyakala Purnama, Tri Pudy Asmarawati, Erika Marfiani, Zamrotul Izzah, Alfian Nur Rosyid, Prastuti Asta Wulaningrum, Herley Windo Setiawan. Potency of Hematopoietic Stem Cells (HSCs) and Natural Killer (NK) Cells as A Therapeutic of SARS-CoV-2 Indonesia Isolates Infection by Viral Inactivation (In Vitro Study). SRP. 2020; 11(5): 772-777. doi:10.31838/srp.2020.5.112
Vancouver/ICMJE Style
Purwati, Andang Miatmoko, Nasronudin, Deya Karsari, Aristika Dinaryanti, Eryk Hendrianto, Igo Syaiful Ihsan, Nora Ertanti, Disca Sandyakala Purnama, Tri Pudy Asmarawati, Erika Marfiani, Zamrotul Izzah, Alfian Nur Rosyid, Prastuti Asta Wulaningrum, Herley Windo Setiawan. Potency of Hematopoietic Stem Cells (HSCs) and Natural Killer (NK) Cells as A Therapeutic of SARS-CoV-2 Indonesia Isolates Infection by Viral Inactivation (In Vitro Study). SRP. (2020), [cited March 29, 2021]; 11(5): 772-777. doi:10.31838/srp.2020.5.112
Harvard Style
Purwati, Andang Miatmoko, Nasronudin, Deya Karsari, Aristika Dinaryanti, Eryk Hendrianto, Igo Syaiful Ihsan, Nora Ertanti, Disca Sandyakala Purnama, Tri Pudy Asmarawati, Erika Marfiani, Zamrotul Izzah, Alfian Nur Rosyid, Prastuti Asta Wulaningrum, Herley Windo Setiawan (2020) Potency of Hematopoietic Stem Cells (HSCs) and Natural Killer (NK) Cells as A Therapeutic of SARS-CoV-2 Indonesia Isolates Infection by Viral Inactivation (In Vitro Study). SRP, 11 (5), 772-777. doi:10.31838/srp.2020.5.112
Turabian Style
Purwati, Andang Miatmoko, Nasronudin, Deya Karsari, Aristika Dinaryanti, Eryk Hendrianto, Igo Syaiful Ihsan, Nora Ertanti, Disca Sandyakala Purnama, Tri Pudy Asmarawati, Erika Marfiani, Zamrotul Izzah, Alfian Nur Rosyid, Prastuti Asta Wulaningrum, Herley Windo Setiawan. 2020. Potency of Hematopoietic Stem Cells (HSCs) and Natural Killer (NK) Cells as A Therapeutic of SARS-CoV-2 Indonesia Isolates Infection by Viral Inactivation (In Vitro Reviews in Pharmacy, 11 (5), 772-777. doi:10.31838/srp.2020.5.112
Chicago Style
Purwati, Andang Miatmoko, Nasronudin, Deya Karsari, Aristika Dinaryanti, Eryk Hendrianto, Igo Syaiful Ihsan, Nora Ertanti, Disca Sandyakala Purnama, Tri Pudy Asmarawati, Erika Marfiani, Zamrotul Izzah, Alfian Nur Rosyid, Prastuti Asta Wulaningrum, Herley Windo Setiawan. The Potency of Hematopoietic Stem Cells (HSCs) and Natural Killer (NK) Cells as A Therapeutic of SARS-CoV-2 Indonesia Isolates Infection by Viral Inactivation (In Vitro Study). Systematic Reviews in Pharmacy 11 (2020), 772-777. doi:10.31838/srp.2020.5.112
MLA (The Modern Language Association) Style
Purwati, Andang Miatmoko, Nasronudin, Deya Karsari, Aristika Dinaryanti, Eryk Hendrianto, Igo Syaiful Ihsan, Nora Ertanti, Disca Sandyakala Purnama, Tri Pudy Asmarawati, Erika Marfiani, Zamrotul Izzah, Alfian Nur Rosyid, Prastuti Asta Wulaningrum, Herley Windo Setiawan. The Potency of Hematopoietic Stem Cells (HSCs) and Natural Killer (NK) Cells as A Therapeutic of SARS-CoV-2 Indonesia Isolates Infection by Viral Inactivation (In Vitro Study). Systematic Reviews in Pharmacy 11.5 (2020), 772-777. Print. doi:10.31838/srp.2020.5.112
APA (American Psychological Association) Style
Purwati, Andang Miatmoko, Nasronudin, Deya Karsari, Aristika Dinaryanti, Eryk Hendrianto, Igo Syaiful Ihsan, Nora Ertanti, Disca Sandyakala Purnama, Tri Pudy Asmarawati, Erika Marfiani, Zamrotul Izzah, Alfian Nur Rosyid, Prastuti Asta Wulaningrum, Herley Windo Setiawan (2020) Potency of Hematopoietic Stem Cells (HSCs) and Natural Killer (NK) Cells as A Therapeutic of SARS-CoV-2 Indonesia Isolates Infection by Viral Inactivation (In Vitro Reviews in Pharmacy, 11 (5), 772-777. doi:10.31838/srp.2020.5.112
Tuberculosis is an acute infectious disease that primarily affects the lungs. Probiotics supplementation can increase the number and activity of NK cell in peripheral blood by modulation of IL-12, thus increasing IFN-γ production by Th1 response. Vitamin B 1 acts on macrophages and affects neutrophil motility. Vitamin B 6 is associated with the release of cytokines and the responsiveness of NK cells, while vitamin B 12 affects to lymphocytes, Tcell proliferation, CD4 + ratios, and NK cell activity. To analyze the effects of probiotics and vitamin B 1 , B 6 , B 12 supplementation on IFN-γ and IL-12 levels during intensive phase of antituberculosis treatment. The study was pre-post test randomised control by time series. The control group was TB patients with standard therapy of antituberculosis and vitamin B6, while the intervention group was TB patients receiving therapy plus once daily probiotics and vitamin B 1 , B 6 , B 12 supplementation during the intensive phase. Blood samples were withdrawn at baseline, one month, and two months after therapy to measure plasma IFN-γ and IL-12 levels using the ELISA method. Twenty two patients were divided equally into two groups. There was a tendency to greater increase of IFN-γ in the first month of the intervention group, followed by a significant decline after two-month therapy ( p < 0.05). In both groups there was a rise in IL-12 levels after one month followed by a decrease in the second month ( p > 0.05). However, the percentage was higher in the supplementation group. Adding probiotics and vitamins B 1 , B 6 , B 12 could improve immune response through IL-12 and IFN-γ modulation during intensive phase therapy.
A potent therapy for the infectious coronavirus disease COVID-19 is urgently required with, at the time of writing, research in this area still ongoing. This study aims to evaluate the in vitro anti-viral activities of combinations of certain commercially available drugs that have recently formed part of COVID-19 therapy. Dual combinatory drugs, namely; Lopinavir-Ritonavir (LOPIRITO)-Clarithromycin (CLA), LOPIRITO-Azithromycin (AZI), LOPIRITO-Doxycycline (DOXY), Hydroxychloroquine (HCQ)-AZI, HCQ-DOXY, Favipiravir (FAVI)-AZI, HCQ-FAVI, and HCQ-LOPIRITO, were prepared. These drugs were mixed at specific ratios and evaluated for their safe use based on the cytotoxicity concentration (CC 50 ) values of human umbilical cord mesenchymal stem cells. The anti-viral efficacy of these combinations in relation to Vero cells infected with SARS-CoV-2 virus isolated from a patient in Universitas Airlangga hospital, Surabaya, Indonesia and evaluated for IC 50 24, 48, and 72 hours after viral inoculation was subsequently determined. Observation of the viral load in qRT-PCR was undertaken, the results of which indicated the absence of high levels of cytotoxicity in any samples and that dual combinatory drugs produced lower cytotoxicity than single drugs. In addition, these combinations demonstrated considerable effectiveness in reducing the copy number of the virus at 48 and 72 hours, while even at 24 hours, post-drug incubation resulted in low IC 50 values. Most combination drugs reduced pro-inflammatory markers, i.e. IL-6 and TNF-α, while increasing the anti-inflammatory response of IL-10. According to these results, the descending order of effective dual combinatory drugs is one of LOPIRITO-AZI>LOPIRITO-DOXY>HCQ-AZI>HCQ-FAVI>LOPIRITO-CLA>HCQ-DOX. It can be suggested that dual combinatory drugs, e.g. LOPIRITO-AZI, can potentially be used in the treatment of COVID-19 infectious diseases.
Abstract Background: The prevalence of COVID-19 cases in Indonesia until June 9 th 2020, Government has confirmed the number of 32.076 positive cases from 34 provinces in Indonesia with 1.923 fatalities. Along with the development of technology, stem cell-based biological medical therapy, and stem cell-based immunotherapy were developed to find out its potential in the case of COVID-19 treatment besides using chemical drugs as a therapy. Methods: In this study, in vitro research will be conducted to determine the potential of hematopoietic stem cells (HSC) against SARS-CoV-2 (COVID-19) viruses with virus isolates from Indonesia. The SARS-CoV-2 virus was planted in rat kidney cells and Vero cells, then cells that had been planted with the virus were given HSC cells and then evaluated at 24, 48, and 72 hours. The evaluation is done by collecting cells and supernatant from the cell plate and then evaluating the viral load using a Polymerase Chain Reaction (PCR) machine. Results: The results showed that the addition of HSC on cells that had been infected by SARS-CoV-2 decrease in viral load within 24 to 72 hours in all variations of Multiples of Infection (MoI) values. Conclusions: The administration of HSC cells has the potential to eliminate SARS-CoV-2 virus. Although this research is an in vitro study, this study could be the basis for the development of alternative stem cell-based therapies to handle COVID-19 cases in Indonesia.
Background: Data on the prevalence of bacterial co-infections among COVID-19 patients are limited, especially in our country, Indonesia. We aimed to assess the rate of bacterial co-infections in hospitalized COVID-19 patients and report the most common microorganisms involved and the antibiotic use in these patients.Methods: This study is a cross sectional study with retrospective approach, among COVID-19 adult patients admitted to Universitas Airlangga Hospital Surabaya from 14 March-30 September 2020. The bacterial infection is defined based on clinical assessment, laboratory parameters, and microbiology results.Results: A total of 218 patients with moderate to critical illness and confirmed COVID-19 were included in this study. Bacterial infection was confirmed in 43 patients (19.7%). COVID-19 patients with bacterial infections had longer hospital length of stay (17.6 ± 6.62 vs 13.31±7.12), a higher proportion of respiratory failure, intensive care treatment, and ventilator use. COVID-19 patients with bacterial infection had a worse prognosis than those without bacterial infection (p<0.04). The empirical antibiotic was given to 75.2% of the patients. Gram-negative bacteria were commonly found as causative agents in this study (n = 39; 70.37%).Conclusion: COVID-19 patients with bacterial infection have a longer length of stay and worse outcomes. Healthcare-associated infections during intensive care treatment for COVID-19 patients must be carefully prevented.
Coronavirus disease 2019 (COVID-19) is an infectious disease that has caused millions of deaths. COVID-19 patients with diabetes mellitus have increased mortality rates in comparison to COVID-19 patients without diabetes mellitus. Laboratory findings such as C-reactive protein, D-dimer, and glomerular filtration rates may potentially provide predictive value on mortality in COVID-19 patients with diabetes mellitus. The purpose of this literature review is to summarize previous findings on the association of C-reactive protein, D-dimer, and Glomerular Filtration Rate with clinical outcomes of COVID-19 patients with Diabetes Mellitus.
Introduction: Gastrointestinal tuberculosis (GI TB) is quite rare with 3% incidence of all extrapulmonary involvement. Appendicular TB may occur in 0.1 - 3% of cases. Diagnosis is often difficult because the patient usually complains about chronic abdominal pain and fever. A definite diagnosis is based on histopathological examination of resected specimens from the appendectomy procedure.Case: We present a 37-year-old male patient admitted to the hospital with chronic abdominal pain, fever, nausea, and loss of body weight. The patient never had a persistent cough, hemoptysis, or night sweating. Physical examination showed pain and muscular rigidity in the right iliac area during palpation with Blumberg's sign and Rovsing's sign positive. Abdomen ultrasound imaging showed an appendicular abscess. The patient underwent appendectomy afterwards with histopathology result showing TB. The patient was treated with first category anti-tuberculosis drugs (ATD).Discussion: Diagnosis of appendicular TB is difficult due to unspecific clinical presentations. Appendicular TB patients often complain of signs and symptoms which are similar to acute appendicitis. These conditions can delay ATD treatment because the definitive diagnosis could be made after histopathological examination.Summary: Appendicular TB is a rare case of extrapulmonary TB. It can present as acute appendicitis. The definitive diagnosis is based on the histopathological examination. It is recommended to check the appendicectomy specimens histopathologically to exclude TB or other diseases.
Background: Data on the prevalence of bacterial co-infections among COVID-19 patients are limited, especially in our country, Indonesia. We aimed to assess the rate of bacterial co-infections in hospitalized COVID-19 patients and report the most common microorganisms involved and the antibiotic use in these patients.Methods: This study is a retrospective cohort study, among COVID-19 adult patients admitted to Universitas Airlangga Hospital Surabaya from 14 March-30 September 2020. The bacterial infection is defined based on clinical assessment, laboratory parameters, and microbiology results.Results: A total of 218 patients with moderate to critical illness and confirmed COVID-19 were included in this study. Bacterial infection was confirmed in 43 patients (19.7%). COVID-19 patients with bacterial infections had longer hospital length of stay (17.6 ± 6.62 vs 13.31±7.12), a higher proportion of respiratory failure, intensive care treatment, and ventilator use. COVID-19 patients with bacterial infection had a worse prognosis than those without bacterial infection (p<0.04). The empirical antibiotic was given to 75.2% of the patients. Gram-negative bacteria were commonly found as causative agents in this study (n = 39; 70.37%).Conclusion: COVID-19 patients with bacterial infection have a longer length of stay and worse outcomes. Healthcare-associated infections during intensive care treatment for COVID-19 patients must be carefully prevented.
This article provides an in-depth review of the correlation between radiological features and mortality in pulmonary tuberculosis (TB) patients presenting with respiratory distress, highlighting the interplay between diagnostic imaging and clinical outcomes. It examines key aspects such as the pathophysiological mechanisms underlying respiratory distress in TB, predictors of adverse outcomes, and the critical role of diagnostic imaging in identifying disease severity. Radiological findings, including cavitation, infiltrates, consolidations, and pleural effusions, are explored for their prognostic implications and their role in guiding treatment strategies for high-risk patients. By synthesizing evidence from recent studies, the review underscores the importance of integrating radiological assessments with clinical, biochemical, and laboratory data to improve risk stratification and optimize management. These insights aim to enhance understanding of how severe radiological patterns influence mortality and provide actionable guidance for improving therapeutic approaches in TB patients, particularly those in critical care settings.
