Since the beginning of 2020 there has been an increase in the number COVID-19 virus infection, previously known as 2019-nCov. It is known that up to February 2020, more than 70,000 positive cases of COVID-19 infection have been confirmed. COVID-19 is known to be a virus from the coronaviridae family, which is also a family of the SARS-CoV and MERS-CoV viruses that caused an outbreak in 2002 and 2012. The exact pathogenesis of COVID-19 is not clearly known, but is thought to be similar to the pathogenesis of SARS-CoV and MERS-CoV. The average COVID-19 mortality was 2.3%, lower than the SARS-CoV and MERS-CoV mortality. The COVID-19 outbreak was also thought to have started from a local seafood sales market in winter, an environment that was almost the same as the SARS virus outbreak. This scientific article will discuss in depth the operational definitions that can be used in the management of patients with suspected COVID-19 infection. It will also discuss clinical manifestations and management in patients with suspected and confirmed COVID-19 infection.

Background: A significant complication among post-tuberculosis patients is chronic pulmonary aspergillosis (CPA), with prevalence and outcomes varying by region. This study aimed to explore the epidemiology, clinical characteristics, and microbiological profiles of 219 post-tuberculosis patients with persistent respiratory symptoms and lung cavities in Indonesia. Methods: The patients were divided into CPA (n = 144) and non-CPA (n = 75) groups. This cross-sectional study diagnosed CPA in post-tuberculosis patients using ERS/ESCMID criteria, integrating clinical, radiological, and fungal assessments. Serological tests for Aspergillus-specific IgG were conducted using immunochromatographic (ICT) and ELISA on serum samples. Sputum specimens were used in parallel for fungal culture, and radiological evaluations (e.g., chest X-rays or CT scans) were performed to identify typical CPA features such as cavitation and fibrosis. Results: Persistent cough was significantly more common in CPA patients (83.3%, p = 0.015), highlighting its role as a clinical indicator for CPA. Radiological infiltrates were found in 165 patients (75.3%); critical diagnostic markers of CPA were cavitation and pericavitary fibrosis. Aspergillus-specific IgG testing demonstrated high diagnostic utility, with positivity rates of 69.4% for ICT and 63.2% for ELISA among CPA patients. Among those with infiltrates, a positive Aspergillus culture was not more common (p > 0.05), whereas Aspergillus IgG was more often raised (p = 0.037), as was a positive ICT (p = 0.021). Regional analysis revealed a higher CPA burden in Region 1 (75%) compared to Region 2 (56%, p = 0.003), with Aspergillus fumigatus and Aspergillus niger predominating in Region 1. Conclusions: These findings highlight the importance of comprehensive approaches and region-specific CPA management strategies in Indonesia.