FAIZ ZAKIYA YAHYA

33101700018

1. How is the pathophysiology of covid 19? (Febi)

Covid19 enters body cell through the s protein (spike) and then binds to the ACE2
receptor located in the lungs. Other journals mention that ACE2 is also expressed in all
endothelial and smooth muscle cells in each of our organs. In endothelial cells there are
AT receptors, which are sites that bind to viral protein spikes then the virus replicates and
triggers the T cells to release cytokine storms in respins in the human body
( Sohrabi, C., etc. 2020. World Health Organization declares global emergency: A
review of the 2019 novel coronavirus (COVID-19). International Journal of Surgery. 76 :
71 – 76. )
2. What the risk factors of covid-19? (Fatika)
 Factor resiko : pada penderita diabetes dan hipertensi dapat meningkatkan resiko covid-
19. Karena pasien penyakit jantung, hipertensi dan diabetes terapinya diberikan obat
ACE2. Maka dari itu harus dipantau modulasi ACE2 nya, apakah perlu menggunakan
ACE inhibitor atau ARB

Fang,Lei.2020. Are patients with hypertension and diabetes mellitus at increased risk for
COVID-19 infection?. Lancet Respir Med

3. What are the clinic manifestations of covid 19? (Faiz)

Symptoms:
- common symptoms: fever, dry cough, fatigue

- symptoms are rarely found: headache, nasal congestion, sore throat, cough with phlegm, shortness of
breath, muscle / joint pain, chills, nausea, vomiting, diarrhea

- severe symptoms: high fever, decreased white blood cells, kidney failure

Gejala :

- gejala umum : demam, batuk kering, kelelahan

- gejala jarang ditemukan : sakit kepala, hidung tersumbat, sakit tenggorokan, batuk
berdahak, sesak nafas, nyeri otot/sendi, menggigil, mual muntah, diare

- gejala berat : demam tinggi, penurunan sel darah putih, gagal ginjal

Sumber : Perhimpunan Dokter Paru Indonesia (PDPI).2020.PNEUMONIA COVID-19 DIAGNOSIS &

PENATALAKSANAAN DI INDONESIA. Jakarta

4. how to prevent corona virus? (Nurita)

Prevention:

- Stay at home

- Avoid traveling / activities in public places

- often washing hands with soap and water

- Do not touch the eyes, nose or mouth with unwashed hands

- the use of masks is only recommended for people who are coughing or sneezing or who are
handling patients
Pencegahan :

- Tetap berada dirumah

- Menghindari berpergian / aktivitas di tempat umum

- sering mencuci tangan dengan sabun dan air

- tidak menyentuh mata, hidung, atau mulut dengan tangan yang tidak dicuci

- penggunaan masker hanya direkomendasikan untuk orang yang sedang batuk atau bersin
atau yang sedang menangani pasien

Sumber : Perhimpunan Dokter Paru Indonesia (PDPI).2020.PNEUMONIA COVID-19 DIAGNOSIS &

PENATALAKSANAAN DI INDONESIA. Jakarta

5. what is the etiology of covid-19 (lailatul)

6. how pharmacological and non pharmacological therapies covid 19? (novi)

Management

 If you feel unwell with criteria:

- Fever 38 degrees Celsius

- Cough and cold

- c. has a history of travel to coold-19 Countries

- d. feel in contact with covid-19 patients, immediately go to a health facility for examination:

 Use a mask
  If you don't have a mask, follow the correct ethics of coughing / sneezing by covering your
mouth and nose with a tissue or the back of your arm

 Try not to use mass transportation

 health workers will screen suspect COVID-19:

- If you meet the suspect COVID-19 criteria, you will be referred to one of the referral hospitals
(hospitals) who are ready for COVID19 treatment.

- If you do not meet the criteria of suspect COVID-19, you will be hospitalized or outpatient
depending on the diagnosis

 If you meet the COVID-19 Suspect criteria, you will be delivered to the referral hospital using an
ambulance accompanied by health workers who use personal protective equipment (PPE).

 At the referral hospital, specimens will be collected for laboratory tests and treated in isolation
rooms.

Treatment

 No antiviral treatment for Coronavirus infection has been proven effective. In the study of SARS-
CoV, the combination of lopinavir and ritonavir was associated with providing clinical benefits.
Currently the use of lopinavir and ritonavir is still being investigated regarding the effectiveness
and safety of COVID-19 infection.

 Symptomatic therapy: Symptomatic therapy is given as an antipyretic, cough medicine and

others if needed.

 Isolation in all cases: In accordance with clinical symptoms that appear, both mild and
moderate. Patients are bed-rested and avoid moving rooms or patients.

Implementation of infection prevention and control (PPI):

- Chest X-ray series to assess disease progression

- Oxygen supplementation: Provision of oxygen therapy immediately to patients with SARI, respiratory
distress, hypoxemia or shock. The first oxygen therapy is around 5L / min with a SpO2 target of ≥90% in
nonpregnant patients and ≥ 92-95% in pregnant patients.

- Systemic corticosteroid administration is not routinely given in the treatment of viral pneumonia or
ARDS other than there are other indications.

Management :

 Jika Anda merasa tidak sehat dengan kriteria:

- Demam 38 derajat Celcius

 - Batuk/pilek

- mempunyai riwayat perjalanan ke Negara terjangkir covid-19

- merasa melakukan kontak dengan pasien covid-19

segera pergi ke fasilitas kesehatan untuk pemeriksaan :

- Gunakan masker

- Apabila tidak memiliki masker, ikuti etika batuk/bersin yang benar dengan cara menutup mulut
dan hidung dengan tisu atau punggung lengan

- Usahakan tidak menggunakan transportasi massal

 tenaga kesehatan akan melakukan screening suspect COVID-19:

- Jika memenuhi kriteria suspect COVID-19, maka Anda akan dirujuk ke salah satu rumah sakit
(RS) rujukan yang siap untuk penanganan COVID19.

- Jika tidak memenuhi kriteria suspect COVID-19, maka Anda akan dirawat inap atau rawat jalan
tergantung diagnosa

 Jika anda memenuhi kriteria Suspect COVID-19 akan diantar ke RS rujukan menggunakan
ambulan didampingi oleh nakes yang menggunakan alat pelindung diri (APD).

 Di RS rujukan, akan dilakukan pengambilan spesimen untuk pemeriksaan laboratorium dan

dirawat di ruang isolasi.

Treatment

 Belum ada tatalaksana antiviral untuk infeksi Coronavirus yang terbukti efektif. Pada studi
terhadap SARS-CoV, kombinasi lopinavir dan ritonavir dikaitkan dengan memberi manfaat klinis.
Saat ini penggunaan lopinavir dan ritonavir masih diteliti terkait efektivitas dan keamanan pada
infeksi COVID-19.

 Terapi simptomatik : Terapi simptomatik diberikan seperti antipiretik, obat batuk dan lainnya
jika memang diperlukan.

 Isolasi pada semua kasus : Sesuai dengan gejala klinis yang muncul,baik ringan maupun sedang.
Pasien bed-rest dan hindari perpindahan ruangan atau pasien.

Implementasi pencegahan dan pengendalian infeksi (PPI):

- Serial foto toraks untuk menilai perkembangan penyakit

- Suplementasi oksigen : Pemberian terapi oksigen segera kepada pasien dengan SARI,
distress napas, hipoksemia atau syok. Terapi oksigen pertama sekitar 5L/menit dengan
target SpO2 ≥90% pada pasien tidak hamil dan ≥ 92-95% pada pasien hamil.
 - Pemberian kortikosteroid sistemik tidak rutin diberikan pada tatalaksana pneumonia
viral atau ARDS selain ada indikasi lain.

Sumber : Smith, tim. Etc. 2020. COVID-19 Drug Therapy – Potential Options. Elsevier

7. How to the purpose of the therapy for covid 19 (Nawang)

8. how to monitor patients have been exposed to covid-19? (amelia)

Monitoring

- Do not forget the patient's family must always be informed, provide support, informed consent and
prognosis information.

- Tight observation

The patient's condition needs to be observed closely with signs of clinical deterioration, rapid
progressive respiratory failure, and sepsis so that supportive intervention can be carried out quickly

Monitoring

-Jangan lupa keluarga pasien harus selalu diinformasikan, memberi dukungan, informed consent serta
informasi prognosis.

-Observasi ketat

Kondisi pasien perlu diobservasi ketat terkait tanda-tanda perburukan klinis, kegagalan respirasi
progresif yang cepat, dan sepsis sehingga penanganan intervensi suportif dapat dilakukan dengan cepat

Sumber : Smith, tim. Etc. 2020. COVID-19 Drug Therapy – Potential Options. Elsevier