UNS – The Coronavirus Disease 2019 (Covid-19), which designated as a pandemic for the several past months, shows a symptom related to respiratory tract such as coughing, shortness of breath, sneezing, and coupled with a high fever. These were included in guidelines issued by the Ministry of Health of the Republic of Indonesia also in an Early Warning Score that currently widely implemented.
However, according to Prof. Dr. Reviono, dr., Sp.P(K), Pulmonologist from the Universitas Sebelas Maret (UNS) Surakarta, the symptoms can no longer hold onto. Because the symptom for COVID-19 is varied, no longer similar to the typical viral infection in the respiratory tract. There are many positive cases with no respiratory infection symptoms and fever, as mentioned earlier.
“Therefore, currently there are many opinions on People Without Symptom (Orang Tanpa Gejala-OTG), which complicates detection for Covid-19 cases. This can be explained as follow, there are many receptors for the COVID-19 virus (SARS CoV2) in various organs such as the nose, lungs, intestine, eyes, and many others, with different amounts receptors in each organ,” he explains during his inauguration as Professor in Pulmonology and Respiratory Medicine UNS, Wednesday (20/5/2020).
Moreover, as Prof. Reviono adds, there is a COVID-19 case that does not show general Acute Respiratory Distress Syndrome (ARDS). Namely feeling anxious and decreased consciousness despite having a chest X-ray picture showing extensive white shades and severe hypoxemia.
Not only the symptom of COVID-19, Prof. Reviono adds that variation also found in patients’ radiological and blood examination. During the radiology examination, the existence of infiltrates or thin white ‘fog’ on lungs x-ray result, is believed as a sign of COVID-19. In reality, this is not always the case. There was a case with an evident sign of infiltrates, but it actually a symptom of leptospirosis. On the other hand, there was a case where the x-ray examination shows a normal lung condition, but the PCR COVID-19 test shows a positive result.
“Based on the variation of the symptom and clinical signs, laboratory, radiological, and also pathogenesis, there are various treatment methods. At least there are 30 different therapies that have been investigated for Covid-19 cases. However, there is no single therapy that recommended globally and is proven to be effective for handling the COVID-19,” he adds.
Responding to this matter, Prof. Reviono suggests the clinician and researchers in Indonesia actively investigate a wide range of therapies available for a certain region. Therefore, in the future, Indonesia will have baseline data with the characteristics of the population of Indonesia, which can help clinicians to have strong references. Moreover, if similar outbreaks happen in the future, then researchers will be able to develop therapies that have been previously investigated.
Further, Prof. Reviono recommends the importance of established service system research. As long as there is no definitive treatment for handling the Coronavirus, then, using the drugs that are considered to cure is necessary.
“But there is regulation, not just any drugs can be given. Therefore, a special regulation on health service research, which aims to provide proper supervision. Moreover, a service system in this research should be developed in all education center or the Faculty of Medical Study that has Education Hospital or network,” he explains.
Meanwhile, in service research, Prof. Reviono suggests that related parties should have a priority to consider the clinical condition of COVID-19 patients. There are two types of immediate therapy needed, the causative therapy where drugs that are designed as antivirals must be prioritized and another special therapy for severe cases that cause death.
Another thing that is no less important, according to Prof. Reviono is continuous special research, not only during a pandemic but also to anticipate similar pandemic to occur. Moreover, with the news on the possibility of the second wind of COVID-19.
Prof. Reviono considered that during this time when several outbreaks occurred, globally there is still confusion in determining the cure for each disease that causes the plague. While the development of medicine for SARS is not finished, the MERS outbreak occurred. While the medicine for MERS is not yet found, the COVID-19 outbreak occurred and have a global impact.
“Generally, anticipating an outbreak, epidemic, or pandemic should be done in each country. Hopefully, there will be antibiotics that can be re-synthesized and adjusted according to the targeted bacteria in diseases caused by bacteria, such as tuberculosis and pneumonia, and it can be used for viral infection,” he explains.
Concluding his recommendation, he also mentioned the confusing information regarding the COVID-19 variation, therapies, and medication. Therefore, Prof. Reviono emphasizes the importance of familiarizing the public with Evidence-Based Medicine (EBM).
“This will be strategic measures to ensure that the public gets the valid medication information and free from the hoax,” he concludes. Humas UNS/Kaffa