Evaluating COVID-19 Treatment Among Infected COVID-19

Patients at a Private Hospital in North Jakarta in 2021

Dini Permata Sari and Siti Saidatus S.

Faculty of Pharmacy, Universitas 17 Agustus 1945, Jakarta, Indonesia

Keywords: COVID-19, COVID-19 Treatment, Evaluation.

Abstract: Coronavirus Disease 2019 (COVID-19) is a newly discovered infectious respiratory disease caused by severe

acute respiratory syndrome, coronavirus 2 (SARS CoV-2). This study purpose evaluation of handling on the

treatment of COVID-19 patients at a private hospital in North Jakarta. This study an observational method

with a sample of 109 people selected using purposive sampling. The instrument of this study used patient

medical record data. The result of this study was from 109 patients, 58.45% of them w male with 78.90%

without comorbidities in the study. The treatment were given antiviral (oseltamivir, favipiravir, remdesivir),

antibiotics (azithromycin, levofloxacin), symptomatic drugs (mucolytics/expectorants, fever, pain, etc.),

comorbidity drugs (such as DM drugs, hypertension drugs, and other comorbidities drugs), and therapeutic

additives such as heparin. Most of those patient received oseltamivir and azitromycin for COVID-19 treatment

at the private hospital in north Jakarta.

1 INTRODUCTION

The coronavirus disease 2019 (COVID-19) is a major

health concern today. COVID-19 was caused by the

SARS-CoV-2 virus. An outbreak of viral pneumonia

of unknown etiology was found introduced in Wuhan,

China on December 12, 2019 (Ji et al, 2020).

Indonesia has announced a case of COVID-19 to

be precise in March 2020 (WHO,2020). The data on

March 31, 2020, showed that there were 1,528

confirmed cases and 136 deaths ((Ministry of Health,

2021).

Infection occurs when particles containing the

virus exhaled by an infected person, either as

respiratory droplets or aerosols, enter the mouth,

nose, or eyes of another person who is in close contact

(Zhai et al., 2020)

Symptoms of coronavirus disease often vary, but

most people experience fever, cough, difficulty

breathing, fatigue, and loss of smell and taste. In

severe cases of renal failure, high fever, organ failure,

dyspnea, and hypoxia, are observed (Lata et al.,

2021).

No specific treatment for coronavirus infection

has been prescribed to date, except for careful

supportive care. Management of the source of

infection, minimizing personal protective procedures,

risk of transmission, and early identification,

isolation, and supportive care for infected patients are

the solutions to this disease. There is no adequate

antibacterial agent (Rahmatillah &Isnaini, 2021).

Based on the references above, an exploration

about the treatment given among COVID-19 patients

was needed to be conducted.

2 METHODS

This study used observational methods. Using

retrospective cohort studies, by collecting secondary

data on patient medical records in 2021. The sample

used was 109 people who were COVID-19 patients at

A Private Hospital in North Jakarta, which was

selected using Purposive sampling in accordance with

existing inclusion criteria. Data collection using

tables created in excel. Inclusion Criteria:

a. Confirmed positive for COVID-19 based on

Swab or Antigen.

b. Patients over 18 years of age.

c. Completed medical records.

d. COVID-19- positive patients with and without

comorbidities.

Sari, D. and S., S.

Evaluating COVID-19 Treatment Among Infected COVID-19 Patients at a Private Hospital in North Jakarta in 2021.

DOI: 10.5220/0011979000003582

In Proceedings of the 3rd International Seminar and Call for Paper (ISCP) UTA â

Z45 Jakarta (ISCP UTA’45 Jakarta 2022), pages 219-224

ISBN: 978-989-758-654-5; ISSN: 2828-853X

 2023 by SCITEPRESS – Science and Technology Publications, Lda. Under CC license (CC BY-NC-ND 4.0)

219

3 RESULT AND DISCUSSION

Based on research that has been carried out at a

Private Hospital in North Jakarta, COVID-19 among

patients hospitalized during the 2021 period who met

the inclusion and exclusion criteria, was 109 patients.

Medical records with complete data based on patient

characteristics including gender, age, weight,

comorbid diseases, and patient treatment therapy.

3.1 Profile Based on Patient

Characteristics

3.1.1 Gender

Table 1: Percentage of COVID-19 patients based on

gender.

No Type Sex Amount Percentage

1 Man 64 58,71%

2 Woman 45 41,29%

Total 109 100%

Based on table 1, it can be seen that the number of

patients diagnosed positive for COVID-19 with or

without comorbid diseases among patients at a

Private Hospital in North Jakarta, was 109 patients

based on gender with male 64 patients with a

percentage of 58.71%, while female patients were 45

patients with a percentage of 41.29% (Table 1). The

research data obtained, it shows that the COVID-19

disease in Private Hospitals in North Jakarta occurs

more in males.

There are more male patients than females

infected with COVID-19 (Zhai et al., 2020). Found

that, due to the patient's weak immune function,

SARS-CoV-2 was more likely to infect older adult

males with chronic comorbidities (Zhai et al., 2020).

Gender has been shown to be is a risk factor for

mortality in COVID-19 patients, where males die

more than women. This is due to fundamental

differences in the immunological systems of males

and women, differences in lifestyle, and the

prevalence of smoking (Wenham, et al. 2020).

Fewer males recovered than the group who died.

Higher mortality rates are associated with higher

chronic comorbidities in males, cardiovascular

disease, hypertension, pulmonary disease, and

smoking (Jean et al., 2020).

3.1.2 Age

From the results of research that has been carried out

based on the age characteristics of among patient

COVID-19 patients at a Private Hospital in North

Jakarta, it can be seen in table 2, as follows:

Table 2: Percentage of COVID-19 patients based on age.

No Age Category Amount Percentage %

1 17-25 Late Teen 10 9.17%

2 26-35 Early Adult 17 16.00%

3 36-45 Late Adult 28 25.69%

4 46-55

Early

Elderl

26 23.85%

5 56-65

Late

Elderl

16 14.67%

6 >65 seniors 12 11.00%

TOTAL 109 100%

Based on table 2, it can be seen that the number of

patients diagnosed as positive for COVID-19 with or

without comorbid diseases at a Private Hospital in

North Jakarta was 109 patients. Based on the age

characteristics of COVID-19-positive patients, most

in the late adult category with ages 36-45 years as

many as 28 patients with a percentage of 25.68%

(Table 2).

Elderly patients have long-term health problems

so they are more at risk when exposed to the virus, a

person's immune system decreases when they reach

old age, making it difficult to fight infection.

These results are reinforced by research, which

shows data that Covid-19 mortality increases with age

with a percentage of CFR of 1.3% in patients aged 50-

59 years, 3.6% in patients aged 60-69 years, 8% in

patients aged 70-79 years, and 14.8% in patients aged

≥80 years (Wiliam et al, 2021).

The percentage of COVID-19 mortality is

increasing due to age increase, with the youngest

patients aged 5% to the oldest at 55% ((Zhou et al,

2020).

3.1.3 Patients with or without Comorbidities

Table 3: Percentage of COVID-19 patients based on with

or without comorbid

No Disease

Comorbidities

Amount Percentage %

1 With comorbid 23 21,10%

2 Without comorbid 86 78.90 %

TOTAL 109 100

Based on table 3, it can be seen that the number of

patients diagnosed as positive for COVID-19 who

ISCP UTA’45 Jakarta 2022 - International Seminar and Call for Paper Universitas 17 Agustus 1945 Jakarta

220

underwent hospitalization at A Private Hospital in

North Jakarta in 2021 as many as 109 patients based

on the characteristics of patients with or without

comorbidities, namely patients with comorbidities.

patients with comorbidities were 23 patients with a

percentage of 21.10%, and patients without

comorbidities 86 patients with a percentage of

78.90% (Table 3).

The presence of comorbidities can determine the

prognosis of COVID-19 patients. This is presumably

because previous health conditions affect the severity

of COVID-19 sufferers. Thus, the presence of

comorbidities will exacerbate COVID-19 infection

and can even become the pathogenesis of COVID-19

infection.

3.1.4 Patients by Type of Comorbid Disease

Table 4: Percentage of COVID-19 Patients based on the

type of comorbid disease.

Type Disease

Participant

Amount Percentage %

Hypertension &

4 17.40%

2 DM 3 13.04 %

3 Kidne

/ CKD 3 13.04 %

4 Hypertension 6 26.08%

5 Broncho

neumonia 1 4.35%

Pulmonary TB &

Anemia

1 4.35%

Hypertension &

Thrombocytopenia

1 4.35%

Post Stroke &

ertension

1 4.35%

9 Dyspepsia 1 4.35%

Hypertension &

Kidne

2 8.69%

TOTAL 23 100%

Based on table 4, it can be seen that the number of

patients diagnosed as positive for COVID-19 patients

at a Private Hospital in North Jakarta in 2021 was 109

patients. Characteristics of patients based on the type

of comorbidities as many as 23 patients. Patients who

had the most comorbidities were hypertension as

many as 6 patients with a percentage of 26.08%, and

comorbid complications of hypertension & diabetes

mellitus as many as 4 patients with a percentage of

17.40% (Table 4).

The most common comorbidities reported in

COVID-19 patients are hypertension, cardiovascular

diseases, and diabetes (Jarahzadeh et al., 2021).

Chronic heart and metabolic disease, the

presence of acute inflammation, and decreased organ

function (heart, kidney, liver, and hematology)

experienced by patients at the beginning of treatment

can increase the risk of death due to COVID-19

infection (Yang & Yan, 2020).

Meanwhile, a UK study showed that patients

with heart, kidney and lung disease, cancer, dementia,

and obesity, had a higher risk of death (Docherty et

al., 2020).

3.2 Therapeutic Profile of COVID-19

Patients Treatment

The data obtained were classified into descriptions of

the treatment of COVID-19 patients including all

drugs (whether single or combination drug use) used

for the treatment of hospitalized COVID-19 patients

with a total sample of 109. The use of drugs for the

treatment of hospitalized suspected Covid-19 patients

in private Hospitals in North Jakarta includes

antibiotics, antiviral drugs, vitamins, multivitamins

and supplements, symptomatic drugs to reduce

symptoms, and comorbid drugs to treat comorbidities

in confirmed COVID-19 patients. Then it is analyzed

trough numbers and percentages and presented in the

form of a table.

3.2.1 The Use of Drugs as the Main Therapy

for Covid-19

Table 5: Percentage of the use of drugs as the main therapy

for Covid-19.

group Type Drug

Amount

use

Percentage

Antiviral

Oseltamivir

Remdesivir

favipirafir

Iso

rinosine

43.83%

7.40%

9.88%

38.89%

Antibiotics

Azithromycin

Levofloxacin

Fradiomicin -

Gramicidin

Metronidazole

Ceftriaxone

Cefotaxime

cefadroxil

54.25%

40.52%

1.31%

0.65%

1.31%

0.65%

Multivitamins/

Supplements

Vit C

Vit D

Zink

Vit K

Mecobalamin

Folic Aci

108

107

35.18%

34.85%

28.01%

0.33%

0.98%

0.65%

Based on table 1, it shows the use of drugs used as

main therapy in COVID-19 patients among patients

at a Private Hospital in, North Jakarta in 2021,

including multivitamins / supplements, antivirals, and

antibiotics.

Evaluating COVID-19 Treatment Among Infected COVID-19 Patients at a Private Hospital in North Jakarta in 2021

221

Drug use therapy as the main therapy used is with

antiviral drugs such as oseltamivir, isoprinosine,

remdesivir, and favipiravir. In the study data, patients

were given more oseltamivir antivirals as many as 71

with a presentase 3,83% (Table 1).

Oseltamivir has also been used in clinical trials in

various combinations with chloroquine and

favipiravir, nucleoside analogues known as broad-

spectrum antiviral drug that have follow-up in male,

those in the older age groups with chronic kidney

disease, and those whose therapy is Oseltamivir +

Chloroquine, 16 people (57.1%) recovered clinically.

Four were shown EC50 61.88 M against SARS-CoV-

2 and low toxicity (CC50>400 M) ((Zhai et al., 2020).

Furthermore, drug therapy as the main therapy

used was Multivitamins/Supplements. In this study,

the most widely used multivitamins/supplements

were vitamin D, vitamin C, and zinc. The use of

Vitamin C either orally or intravenously is effective

in reducing the severity, reducing the risk of

complications, overcoming symptoms and improving

the prognosis of COVID-19 patients.

The administration of vitamin C can significantly

reduce pneumonia caused by coronavirus by

increasing the expression of IFR 3 (Interferon

regulatory factor 3) which functions to cause an

innate antiviral response, inhibit nuclear factor kappa-

B (NFkB), and play an important role in immunity by

regulating chemokines, cytokines, adhesion

molecules, inflammatory mediators and inhibiting

apoptosis (Cai et al., 2015).

In this study, vitamins were prescribed to all

patients. The number of studies also shows the same

pattern. Vitamins other than to restore the deficiency

has a role as an antioxidant. Most studies also show

the same pattern ((Lata et al., 2021)).

COVID-19 disease is characterized by

pneumonia, so the use of antibiotics is needed to be

able to prevent bacterial co-infection. The most

widely used antibiotics in this study are levofloxacin

and azithromycin. Azithromycin can strengthen the

effect of hydroxychloroquine in lowering viral load in

COVID-19 patients. Azithromycin, in addition to its

macrolide antibacterial activity, also has antiviral and

immunomodulating properties. This action makes

azithromycin often an option in the management of

inflammatory manifestations of coronavirus

involving the lungs ((Lata et al., 2021).

3.2.2 The Use of Drugs as Symptomatic

Therapy of COVID-19

Table 6: Percentage of the use of drugs as symptomatic

therapy of COVID-19.

group Type of

medicine

Total

Usage

Percentage

Gastrointestina

l drugs (gastric

ulcers, gastritis

and

antiemetics)

Histamine H2

Receptor

Antagonists

(Ranitidine)

Proton Pump

Inhibitor PPI

(Omeprazole,

lansoprazole)

Antacids and

Antireflux

(Sucralfate,

strocaine, and

rebamipide)

Antiemetics

(ondancentron

and

domperidone)

33.63%

15.93%

15.04%

35.40%

Mucolytic &

expectorant

Ambroxol

Acetyl cysteine

Loratadine &

pseudoephedrine

OBH

1.12%

78.65%

2.25%

17.98%

Antidiarrhea

and

consti

ation

Attapulgit

Loperamide

Laxadine

30.77%

38.46%

30.77%

NSAID Paracetamol

Dexamethasone

US. Mefenamate

Ketorolac

60.68%

37.08%

1.12%

Antihistamines Betahistine

Flunarizine

CTM

70%

10%

20%

Based on table 2, it shows that the use of drugs used

as symptomatic therapy in COVID-19 patients treated

at a Private Hospital in North Jakarta in 2021. The

administration of these drugs aims to overcome the

clinical symptoms experienced by COVID-19

patients. that can worsen the situation, condition and

support the success of therapy. The use of

symptomatic therapy drugs is intended to reduce the

symptoms felt by the patient, such as fever, cough,

sore throat, nausea, diarrhea, and so on.

Based on research conducted on treatment for

symptomatic therapy in COVID-19 patients at A

Private Hospital in North Jakarta in accordance with

the guildelines for the management of COVID-19

patients according to the Indonesian Lung Doctors

Association (PDPI) and the Ministry of Health.

Symptomatic therapy is given according to the

ISCP UTA’45 Jakarta 2022 - International Seminar and Call for Paper Universitas 17 Agustus 1945 Jakarta

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symptoms experienced by COVID-19 patients to

reduce the symptoms experienced.

3.2.3 The Use of Drugs by Type of

Comorbid Disease Class

Table 7: Percentage of the use of drugs by type of comorbid

disease class.

group Amount

use

Percentage %

Drug Comorbid

Hypertension :

Amlodipine

Losartan

Captropil

Bisoprolol

Simvastatin

Kandesartan

78.58%

Drug CKD

comorbid :

Furosemide

1 2.38%

Dru

Heart : ISDN 4 9.52%

Drug Comorbid

DM:

Metformin

Insulin Lispro

9.52%

TOTAL 42 100%

Based on table 3, it shows the use of comorbid disease

drug classes in COVID-19 patients who are

hospitalized at A Private Hospital in North Jakarta in

2021. The table above shows data on 42 patients

confirmed COVID-19 patients, there are 33 patients

with comorbid hypertension who use hypertension

drug therapy with a percentage of 78.90%. With the

most use of hypertension drugs, namely amlodipine

by 50% (Table 3).

Patients with cardiac comorbidities were patients,

and the drug used was ISDN with a percentage of

2.38%. Patients with the use of diuretic drug classes

for patients with comorbid renal failure and heart

failure with a percentage of 2.38% using furosemide.

The use of comorbid DM drugs was 4 patients with a

percentage of 9.52%. The most widely used drug use

in COVID-19 patients with comorbid DM is

metforfin with a percentage of 7.15% (Table 3).

3.2.4 The Use of Drugs as Adjunctive

Therapy

Table 8: Percentage of the use of drugs as adjunctive

therapy.

No group

Drug

Type

Usage

amount

Percentage

1 Anticoagulants Heparin 53 48.62%

Based on table 4, it shows the use of drugs as

additional therapy for Covid-19 among patient at A

Private Hospital in North Jakarta in 2021. The

provision of additional therapy for Covid-19 aims to

support the success of the therapy carried out.

Additional therapy used for Covid-19 patients is an

anticoagulant drug class, the type of drug used is

heparin. Giving anticoagulants aims to prevent

coagulation which can result in thrombosis and

thromboembolism.

Therapeutic use of anticoagulant drugs in Covid-

19 patients provides a good prognosis. Coagulation

disorders, especially increased values of D-dimer and

Fibrinogen-degradation product (FDP) were found in

high levels in pneumonia patients due to Covid-19

who died. Based on the guidelines for the treatment

of Covid-19, the provision of anticoagulants is seen

based on the evaluation of the DPJP (see explanation

on severe / critical degrees) (Ministry of Health,

2021).

4 CONCLUSION

The average age among those patients was 36-45 with

only less than 25,69% of them had hypertension and

diabetic. Most of those patients oseltamivir as an

antiviral and azitromycin as an antibiotic.

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