Clinical, Radiological Features and Outcome of COVID-19 patients in a Secondary Hospital in Jakarta, Indonesia

Abstract

Introduction: The numbers of people infected with SARS-CoV-2 in Indonesia especially in Jakarta as the epicenter continue to rise. Limited published clinical data, scarcity and long turn over time of diagnostic testing put clinician in dilemma to make diagnosis.

Methodology: This is an observational case series study from confirmed COVID-19 patient in our hospital from first case admission on 17 March 30 April, 2020. We collected patient's demography, symptoms, comorbidities, therapy, laboratory, chest x-ray and ECG consecutively.

Results: Between 17 March 2020 and 30 April 2020, there were 30 confirmed COVID-19 cases, 16 (53.3%) were male. Clinical symptoms were dyspnea in 22 (73.3%) and dry cough 16 (53.3%). Comorbidities were diabetes in 14 (46.6%), hypertension 10 (33.3%) and Coronary Artery Disease (CAD) in 10 (33.3%) patients respectively. Laboratory findings showed lymphopenia in 21 (70%) patients, increased inflammation marker in Erythrocyte Sedimentation Rate (ESR), C-Reactive Protein (CRP) and Lactate Dehydrogenase (LDH) 21 (70%), 23 (76.6%) and 12 (40%) patients respectively. Twenty-seven (90%) cases had abnormal Chest X-Ray (CXR) and mostly severe 18 (60%). Descriptive finding for images included consolidation 16 (53.3%) and Ground Glass Opacities (GGO) in 10 (33.3%) patients.

Conclusions: Based on our findings, most cases of COVID-19 admitted in secondary referral hospital were already in moderate to severe stages. This is most likely due to late referral from primary care and unspecific clinical features resemblance of other infectious diseases. Inflammation marker and CXR are cost effective findings and can be used as marker to determine further referral.

Keywords: COVID-19; Diagnosis; Limited resources.