Characteristics and outcomes of patients with severe COVID-19 in Indonesia: Lessons from the first wave
Erlina Burhan, Keibun Liu, Eva M Marwali, Samuel Huth, Navy G H M L Wulung, Dafsah A Juzar, Muhammad A Taufik, Surya O Wijaya, Dyah K Wati, Neurinda P Kusumastuti, Saptadi Yuliarto, Bhirowo Y Pratomo, Erwin Pradian, Dadang H Somasetia, Desy Rusmawatiningtyas, Arie Z Fatoni, Jose M Mandei, Eka Y Lantang, Fajar Perdhana, Bambang P Semedi, Muhammad Rayhan, Tiffany R S Tarigan, Nicole White, Gianluigi L Bassi, Jacky Y Suen, John F Fraser
PLOS ONE, doi:10.1371/journal.pone.0290964
Background Indonesia's national response to COVID-19 evolved rapidly throughout 2020. Understanding pandemic response and outcomes is crucial for better mitigation strategies ahead. This study describes the characteristics and outcomes of patients admitted to ICU during the early stages of the pandemic.
Methods This is a multi-centre prospective observational study including patients from twelve collaborating hospitals in Indonesia. All patients were clinically suspected or laboratory-confirmed COVID-19 cases admitted to ICU between January 2020 and March 2021. The primary outcome was monthly ICU mortality. Descriptive statistics of patient characteristics and treatment were generated as secondary outcomes.
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'abstract': '<jats:sec id="sec001">\n'
'<jats:title>Background</jats:title>\n'
'<jats:p>Indonesia’s national response to COVID-19 evolved rapidly throughout 2020. '
'Understanding pandemic response and outcomes is crucial for better mitigation strategies '
'ahead. This study describes the characteristics and outcomes of patients admitted to ICU '
'during the early stages of the pandemic.</jats:p>\n'
'</jats:sec>\n'
'<jats:sec id="sec002">\n'
'<jats:title>Methods</jats:title>\n'
'<jats:p>This is a multi-centre prospective observational study including patients from twelve '
'collaborating hospitals in Indonesia. All patients were clinically suspected or '
'laboratory-confirmed COVID-19 cases admitted to ICU between January 2020 and March 2021. The '
'primary outcome was monthly ICU mortality. Descriptive statistics of patient characteristics '
'and treatment were generated as secondary outcomes.</jats:p>\n'
'</jats:sec>\n'
'<jats:sec id="sec003">\n'
'<jats:title>Results</jats:title>\n'
'<jats:p>From 559 subjects, the overall mortality was 68% and decreased over the study period, '
'while the mortality of patients that received mechanical ventilation was 92%, consistently '
'high over the study period. Fatal cases showed 2- and 4-day delays from symptoms onset to '
'hospital admissions and ICU admissions, respectively. Evidence-backed approaches which could '
'influence patient outcome, such as extracorporeal membrane oxygenation, prone positioning, '
'renal replacement therapy, and neuromuscular blockade were scarcely administered.</jats:p>\n'
'</jats:sec>\n'
'<jats:sec id="sec004">\n'
'<jats:title>Conclusions</jats:title>\n'
'<jats:p>The mortality rate of COVID-19 patients in Indonesia was extremely high during the '
'first major outbreak of disease, particularly in those mechanically ventilated. Delayed '
'admission and unavailability of evidence-based approaches due to high burden on health '
'facility during COVID-19 crisis could be addressed by efficient public health measures and '
'enhancing health infrastructure to improve the future pandemic response.</jats:p>\n'
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