Leonardo Helasti Simanjuntak’s research while affiliated with Siloam Hospitals and other places

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Publications (3)


Pneumothorax in critically COVID-19 patients with mechanical ventilation
  • Article
  • Full-text available

May 2021

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41 Reads

Medical Journal of Indonesia

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Titis Dewi Wahyuni

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Leonardo Helasti Simanjuntak

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[...]

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Coronavirus disease 2019 (COVID-19) is a public health emergency caused by SARS-CoV-2. A few studies reported pneumothorax in patients with COVID-19. Pneumothorax is associated with an increased morbidity and mortality. Hence, it should be considered during the treatment and follow-up of patients with COVID-19. Herein, we reported four cases of pneumothorax in critical COVID-19 patients hospitalized in the ICU and treated with a mechanical ventilation. All patients were diagnosed with COVID-19, type 1 respiratory failure, and acute respiratory distress syndrome. All patients developed pneumothorax during mechanical ventilation, although the ventilator settings were set to lung-protective strategy.

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Ecchymosis in critical coronavirus disease 2019 (COVID-19) patient in Tangerang, Indonesia: a case report

November 2020

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45 Reads

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6 Citations

Journal of Thrombosis and Thrombolysis

We have read with great interest the articles regarding cutaneous manifestations in Coronavirus Disease 2019 (COVID-19) infection. Studies showed 20.4% of COVID-19 patients developed cutaneous manifestations. COVID-19 causes vascular endothelial injury, vasculitis and prothrombotic state which might be the underlying cause of hemorrhagic cutaneous manifestations, disseminated intravascular coagulation (DIC), and multiple organ failures. To date, hemorrhagic cutaneous manifestations reported are chilblain-like lesion, purpura to ecchymosis, livedo reticularis, and dry gangrene. We present a case of ecchymosis in COVID-19-positive ICU hospitalized patient.


(a b) Coronal and axial slices of chest CT scan on admission showed ground‐glass opacity and multifocal crazy paving patterns involving both lungs, predominantly in peripheral, and paraseptal emphysema on first left lung segment; (c) chest X‐ray on April 10 showed right lung hydropneumothorax and atelectasis, bilateral lung opacities on perihilar and middle to inferior lung fields, cardiothoracic ratio 54% with elongation and calcification of aorta, ETT, and CVP; (d) chest X‐ray post first bronchoscopy, water seal drainage (WSD), and tracheostomy on April 11: Remaining pneumothorax on superior region of right lung, WSD installed with distal tip as high as 10th thoracic vertebra on right lung side
(a, b) Coronal and axial slices of thorax CT scan on April 22 showed ground‐glass opacity with a multifocal fibrotic band with improvement on left lung segment; Pneumothorax on superolateral right lung with right lung collapse; within right lung collapse, was seen ground‐glass opacity, consolidation, thick‐walled cavity with fibrosis, and emphysematous bullae with partially septated with medial and inferior segments of the right lung; minimal pleural effusion on the posterobasal of the right lung; paraseptal emphysema on 1st segment of the left lung. (c) The latest chest X‐ray before hospital discharge showed improvement of right lung pneumothorax and massive right lung fibrosis, and right pleura thickening, (d) chest X‐ray 2 weeks after hospital discharge showed residual but improved massive right lung fibrosis and right pleura thickening
Happy hypoxia in critical COVID‐19 patient: A case report in Tangerang, Indonesia

October 2020

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501 Reads

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25 Citations

Coronavirus Disease 2019 (COVID-19) is a public health emergency of international concern with increasing cases globally, including in Indonesia. COVID-19 clinical manifestations ranging from asymptomatic, acute respiratory illness, respiratory failure that necessitate mechanical ventilation and support in an intensive care unit (ICU), to multiple organ dysfunction syndromes. Some patients might present with happy hypoxia, a condition where patients have low oxygen saturations (SpO2 < 90%), but are not in significant respiratory distress and often appear clinically well, which is confusing for the doctors and treatment strategies. Most infections are mild in nature and have a relatively low case fatality rate (CFR); however, critical COVID-19 patients who need support in ICU have high CFR. We would like to report a case of happy hypoxia in a critical COVID-19-positive ICU hospitalized patient who survived from Indonesia. © 2020 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society

Citations (2)


... Globally, cutaneous manifestations of COVID-19 were reported in cases from Asia including China, 9,36,47, Thailand, 76,77 Iran, 12,61,[78][79][80][81] Indonesia, 19,46,60,67,82,142 Malaysia, 60 Qatar, 77 India, 83 Turkey, 14,[84][85][86] and Kuwait; 87 from Africa including Morocco 20,88 Tunisia, 88 and Egypt; 89 from Europe including Austria, 90 Italy, 10,12,15,18,21,24,25,[32][33][34][35]43,52,53,57,65,69,75,[91][92][93][94][95][96][97][98][99][100][101][102][103][104] France, 12,26,31,[105][106][107][108][109][110][111][112][113][114] Spain, 8,11,16,17,22,27,28,[41][42][43][44][45]48,51,55,68,70,40,127 Ireland, 62 Germany, 128 The Netherlands 12 Poland, 13,62,66,77,90 United Kingdom, 12,58 Switzerland, 58 and Russia; 54 from North America including USA, 12,29,30,[37][38][39]50,63,[129][130][131][132][133]12 Mexico; 12,23,49,56 and from South America including Brazil. 134 The majority of the studies reported no correlation between COVID-19 severity and skin lesions. ...

Reference:

Cutaneous Manifestation in COVID-19: A Lesson Over 2 Years Into the Pandemic
Ecchymosis in critical coronavirus disease 2019 (COVID-19) patient in Tangerang, Indonesia: a case report
  • Citing Article
  • November 2020

Journal of Thrombosis and Thrombolysis

... It is not possible to definitively conclude that either the seizure disorder alone or the interstitial pneumonitis alone caused the death. The fact that the child was mildly symptomatic lies within the clinical spectrum of interstitial pneumonia, with walking pneumonia and happy hypoxia being well described [53,54]. Subsequently, the mild symptoms the patient experienced days prior to death could also be due to DS. ...

Happy hypoxia in critical COVID‐19 patient: A case report in Tangerang, Indonesia