The high mortality rate in Coronavirus Disease (COVID-19) patients is associated with their comorbid conditions. Therefore, it is important to identify risk factors associated with poor outcomes among COVID-19 patients. The aims of this study were to find out the comorbidities in case of death due to COVID-19. The design of this study was a retrospective descriptive method with a confirmed COVID-19 patient on hospitalized at Dr. Wahidin Sudirohusodo Hospital from March to September 2020. Ethics Council recommendation number: 357/UN4.6.4.5.31/PP36/2020. A total of 454 patients were included of this study. 78 (17.18%) patients death due to COVID-19, consisting of 52 (66.67%) male and 26 (33.33%) female. Range of ages between 18 and 85 years. The highest mortality rate occurred in the age group ≥60 years (35; 51.47%), followed by the age group of 45–59 years (33; 48.53%), and the age group of <45 years (10; 12%). The prevalent comorbidity was hypertension (42.31%), cardiovascular disease (30.77%), diabetes (28.21%), chronic kidney disease (23.08%), malignancy (15.38%), obesity (15.38%), chronic liver disease (7.69%), chronic respiratory disease (6.41%), immune related disease (3.85%), and non-traumatic cerebral infarction (3.85%). 41 (52.56%) patients reported having two or more comorbidities, and 37 (47.44%) only has one comorbidity. Elevated neutrophil-to-lymphocyte ratio (NLR) ≥3.13 was seen in the majority of patients (68; 87.18%). The mean value of NLR was 20.94. Hypertension, cardiovascular disease, and diabetes were the most common comorbidity in patients death due to COVID-19. More than half of the patients had two or more comorbidities.

Coronavirus disease 2019 (COVID-19) has emerged as a pandemic and public health crisis across the world. With its high infectivity and rapid spread, the severity of the disease is escalating in certain populations, especially in patients with pre-existing cardiovascular disease. In developing countries, infective endocarditis remains a problem in patients with rheumatic heart disease. We report the case of a patient with a diagnosis of infective endocarditis concomitant with COVID-19, including the diagnosis, management, and main outcomes.

Characteristics and Prevalence of Premature Ventricular Complex: A Telemedicine Study

The burden of antimicrobial-resistant (AMR) infections in low and middle-income countries (LMICs) is largely unknown. Here, we evaluate attributable mortality of AMR infections in Indonesia. We used routine databases of the microbiology laboratory and hospital admission at Dr. Wahidin Sudirohusodo Hospital, a tertiary-care hospital in South Sulawesi from 2015 to 2018. Of 77,752 hospitalized patients, 8,341 (10.7%) had at least one blood culture taken. Among patients with bacteriologically confirmed bloodstream infections (BSI), the proportions of patients with AMR BSI were 78% (81/104) for third-generation cephalosporin-resistant (3GCR) Escherichia coli, 4% (4/104) for 3GCR plus carbapenem-resistant E. coli, 56% (96/171) for 3GCR Klebsiella pneumoniae, 25% (43/171) for 3GCR plus carbapenem-resistant K. pneumoniae, 51% (124/245) for methicillin-resistant Staphylococcus aureus, 48% (82/171) for carbapenem-resistant Acinetobacter spp., and 19% (13/68) for carbapenem-resistant Pseudomonas aeruginosa. Observed in-hospital mortality of patients with AMR BSI was 49.7% (220/443). Compared with patients with antimicrobial-susceptible BSI and adjusted for potential confounders, the excess mortality attributable to AMR BSI was -0.01 (95% CI: -15.4, 15.4) percentage points. Compared with patients without a BSI with a target pathogen and adjusted for potential confounders, the excess mortality attributable to AMR BSI was 29.7 (95%CI: 26.1, 33.2) percentage points. This suggests that if all the AMR BSI were replaced by no infection, 130 (95%CI: 114, 145) deaths among 443 patients with AMR BSI might have been prevented. In conclusion, the burden of AMR infections in Indonesian hospitals is likely high. Similar large-scale evaluations should be performed across LMICs to inform interventions to mitigate AMR-associated mortality.

Background: The global burden of tuberculosis (TB) and cardiovascular disease (CVD) is overt, and the prevalence of this double burden disease remains steadily rising, particularly in low- and middle-income countries. This review aims to explore the association between latent tuberculosis infection (LTBI) and the development of cardiovascular diseases and risk factors. Furthermore, we elucidated the underlying pathophysiological mechanisms that contribute to this relationship. Main body: Approximately 25% of the global population carries a dormant form of tuberculosis (TB) infection. During this latent stage, certain subsets of mycobacteria actively reproduce, and recent research suggests that latent TB infection (LTBI) is connected to persistent, long-term low-grade inflammation that can potentially contribute to the development of atherosclerosis and cardiovascular disease (CVD). The presence of LTBI can be confirmed through a positive result on either a tuberculin skin test (TST) or an interferon-gamma release assay (IGRA). Several plausible explanations for the association between LTBI and CVD include increased inflammation, autoimmunity related to heat shock proteins (HSP), and the presence of pathogens within the developing atherosclerotic plaque. The most commonly observed cardiovascular events and risk factors associated with LTBI are acute myocardial infarction, coronary artery stenosis, diabetes mellitus, and hypertension. Conclusions: This article highlights the critical role of LTBI in perpetuating the tuberculosis disease cycle and its association with cardiovascular risk factors. Chronic and persistent low inflammation underlined the association. Identifying high-risk LTBI patients and providing targeted preventive medication are crucial strategies for global TB eradication and interrupting transmission chains.

: As Indonesia’s rifampin resistance testing rates are lower than global testing rates per the 2020 WHO global tuberculosis (TB) report, prevalence of multidrug-resistant TB may be underestimated. Our study aimed to evaluate prevalence and patterns of TB drug resistance (DR) within Indonesia. We conducted a cross-sectional analysis of baseline data collected from 2017–2018 as part of a cohort study of adults with presumed pulmonary TB at 7 DR-TB referral hospitals in Indonesia. Bacteriological examinations (acid-fast bacilli, GeneXpert, sputum culture) and drug-susceptibility testing were performed following the guidelines of the National TB Program. Of 447 participants with complete bacteriological examinations, 312 (69.8%) had positive sputum cultures for Mycobacterium tuberculosis. The proportion of MDR and pre-extensively drug-resistant was higher in previously treated compared with newly diagnosed participants (52.5% [73/139] versus 15% [26/173]). Compared with drug-sensitive case, drug-resistant TB was associated with cavities. Given the difference between rates of DR in TB referral hospitals from our study compared with the WHO survey in 2019 that showed 17.7% and 3.3% DR among previously treated and newly diagnosed participants globally, further characterization of Indonesia’s TB epidemiology in the general population is needed. Strategies, including public policies to optimize case finding, strengthen capacity for resistance testing, and prevent loss to follow-up will be critical to reduce the burden of TB in Indonesia.