Skip to main content Skip to main navigation menu Skip to site footer

Features of COVID-19 adult patients and the treatment in Indonesia: a retrospective cohort study


Background: Coronavirus disease of 2019 (COVID-19) is a new disease that causes clinical symptoms that vary from mild to severe. As a new disease, there is no standard treatment for the disease. Several drugs are used to treat COVID-19, most of which were previously used for other diseases, and the efficacy in COVID-19 is not yet known. This study aimed to evaluate COVID-19 therapy in the early phase of the pandemic.

Methods: In this study, we evaluate data on the characteristics of hospitalized COVID-19 patients in several hospitals in Indonesia from March until December 2020. We also evaluate the therapy given and the results of the therapy.

Results: Most hospitalized patients in this study were mild to moderate COVID-19 patients. The most common combination therapy was chloroquine/ hydroxychloroquine + Azithromycin (79.4%). A small number of patients received chloroquine/ hydroxychloroquine without Azithromycin (9.3%), and only a few did not get chloroquine/ hydroxychloroquine therapy (10.8%). The clinical outcome appeared to be better in the chloroquine/ hydroxychloroquine + azithromycin group than in the other groups. The mortality rate was lower in the chloroquine/ hydroxychloroquine + azithromycin group (2.6%) compared to those in the chloroquine/ hydroxychloroquine group (52%) and the group without chloroquine/ hydroxychloroquine (38%). However, the chloroquine/ hydroxychloroquine + azithromycin group had better baseline characteristics and received more additional medications, such as oseltamivir, corticosteroid, and levofloxacin, rather than levofloxacin, the other groups.

Conclusion: Hospitalized COVID-19 patients in Indonesia from March until December 2020 mostly had mild to moderate COVID-19. Most of them received treatment combinations consisting of chloroquine/ hydroxychloroquine and Azithromycin. The most common combination therapy for hospitalized COVID-19 patients was chloroquine/ hydroxychloroquine + Azithromycin. The clinical symptom improvement was seen mainly in this group.


  1. Zhu N, Zhang D, Wang W, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 2020;382(8):727-733. doi:10.1056/nejmoa2001017
  2. Ling Z, Xu X, Gan Q, et al. Asymptomatic SARS-CoV-2 infected patients with persistent negative CT findings. Eur J Radiol. 2020;126(January):108956. doi:10.1016/j.ejrad.2020.108956
  3. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-1062. doi:10.1016/S0140-6736(20)30566-3
  4. Wu Z, McGoogan JM. Characteristics of and Important Lessons from the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases from the Chinese Center for Disease Control and Prevention. JAMA - J Am Med Assoc. 2020;323(13):1239-1242. doi:10.1001/jama.2020.2648
  5. Mishra SK, Tripathi T. One year update on the COVID-19 pandemic: Where are we now? Acta Trop. 2021;214(September 2020):105778. doi:10.1016/j.actatropica.2020.105778
  6. Dong L, Hu S, Gao J. Discovering drugs to treat coronavirus disease 2019 (COVID-19). Drug Discov Ther. 2020;14(1):58-60. doi:10.5582/ddt.2020.01012
  7. China National Health Commission. Chinese Clinical Guidance for COVID-19 Pneumonia Diagnosis and Treatment (7 edition). Published 2020.
  8. Van Ierssel S, Dauby N, Bottineau E. Interim Clinical Guidance for Patients Suspected of / Confirmed with COVID-19 in Belgium. Published 2020.
  9. Focà E. Vademecum for the treatment of people with COVID-19. Edition 2.0, 13 March 2020. Le Infez Med. 2020;28(2):143-152.
  11. Popov GT, Baymakova M, Vasudeva V, Kundurzhiev T, Mutafchiyski V. Clinical Characteristics of Hospitalized Patients with COVID-19 in Sofia, Bulgaria. Vector-Borne Zoonotic Dis. 2020;20(12):910-915. doi:10.1089/vbz.2020.2679
  12. Sun L, Shen L, Fan J, et al. Clinical features of patients with coronavirus disease 2019 from a designated hospital in Beijing, China. J Med Virol. 2020;92(10):2055-2066. doi:10.1002/jmv.25966
  13. Liu K, Fang YY, Deng Y, et al. Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei Province. Chin Med J (Engl). 2020;133(9):1025-1031. doi:10.1097/CM9.0000000000000744
  14. Badan Pusat Statistik. Hasil SensusPenduduk 2020no 07/01/Th. XXIV. Sensus Penduduk 2020. Published 2020.
  15. Tim BPS Covid-19 Statistical Task Force. Hasil Survei Perilaku Masyarakat Di Masa Pandemi Covid-19 (7-14 September 2020). Vol 19.; 2020.
  16. Péreza M, Luque del Pinoa FJ, Jiménez Garcíaa N, et al. Comorbidity and prognostic factor on addmission in a COVID-19 cohort of a general hospital. Rev Clínica Española. 2020;accepted 2. doi:
  17. Paudel SS. A meta-analysis of 2019 novel corona virus patient clinical characteristics and comorbidities. 2020:1-16. doi:10.21203/
  18. Asai N, Takanashi D, Nakamura A, et al. Clinical manifestations and radiological features by chest computed tomographic findings of a novel coronavirus disease-19 pneumonia among 92 patients in Japan. J Microbiol Immunol Infect. 2020. doi:10.1016/j.jmii.2020.07.011
  19. Lamichhane PP, Samarasinghe AE. The Role of Innate Leukocytes during Influenza Virus Infection. J Immunol Res. 2019;2019. doi:10.1155/2019/8028725
  20. Barr FD, Ochsenbauer C, Wira CR, Rodriguez-Garcia M. Neutrophil extracellular traps prevent HIV infection in the female genital tract. Mucosal Immunol. 2018;11(5):1420-1428. doi:doi:10.1038/s41385-018-0045-0
  21. Lagunas-Rangel FA. Neutrophil-to-lymphocyte ratio and lymphocyte-to-C-reactive protein ratio in patients with severe coronavirus disease 2019 (COVID-19): A meta-analysis. J Med Virol. 2020;92(10):1733-1734. doi:10.1002/jmv.25819
  22. PDPI, PERKI, PAPDI, PERDATIN, IDAI. Pedoman Tatalaksana COVID-19 Edisi 3 Desember 2020. 3rd ed. (Burhan E, Susanto AD, Isbaniah F, et al., eds.). Jakarta; 2020.
  23. Gautret P, Lagier J, Parola P, Hoang VT. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID- 19 . The COVID-19 resource centre is hosted on Elsevier Connect , the company ’ s public news and information. Int J Antimicrob Agents. 2020;56(1).
  24. Molina, J.M; Delaugerre, C; Le Goff, J; Mela-Lima, B; Ponscarmea, D; Goldwirte, L; de Castro N. No evidence of rapid antiviral clearance or clinical benefit with the combination of hydroxychloroquine and Azithromycin in patients with severe COVID-19 infection. Médecine Mal Infect 50. 2020;50(January):382-387. doi:Https://
  25. Chen Z, Hu J, Zhang Z, et al. Efficacy of hydroxychloroquine in patients with COVID-19: results of a randomized clinical trial. medRxiv. 2020;preprint. doi:10.1101/2020.03.22.20040758
  26. Chen J, Liu D, Liu L, et al. A pilot study of hydroxychloroquine in treatment of patients with moderate COVID-19. J Zhejiang Univ Med Sci. 2020;49(2):215-219. doi:10.3785/j.issn.1008-9292.2020.03.03
  27. Tang, Wei; Cao, Zhujun; Han, Mingfeng; Wang, Zhengyan; Chen, Junwen; Sun, Wenjin; Wu, Yaojie; Xiao, Wei; Liu, Shengyong; Chen, Erzhen; Chen, Wei; Wang, Xiongbiao; Yang, Jiuyong; Lin, Jun; Zhao, Qingxia; Xie, Zhibin; Li, Dan; Yang, Yaofeng; Liu, Leshan; Qu Q. Hydroxychloroquine in patients mainly with mild to moderate COVID–19: an open-label, randomized, controlled trial Running. Routledge Libr Ed Epistemol. 2020;Preprint M:2718-2718. doi:10.4324/9781315694757-173
  28. Magagnoli J, Narendran S, Pereira F, et al. Outcomes of Hydroxychloroquine Usage in United States Veterans Hospitalized with COVID-19. Med. 2020;1(1):114-127.e3. doi:10.1016/j.medj.2020.06.001
  29. Borba MGS, Val FFA, Sampaio VS, et al. Effect of High vs Low Doses of Chloroquine Diphosphate as Adjunctive Therapy for Patients Hospitalized With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection: A Randomized Clinical Trial. JAMA Netw Open. 2020;3(4):e208857. doi:10.1001/jamanetworkopen.2020.8857
  30. Kanoh S, Rubin BK. Mechanisms of action and clinical application of macrolides as immunomodulatory medications. Clin Microbiol Rev. 2010;23(3):590-615. doi:10.1128/CMR.00078-09
  31. Li DQ, Zhou N, Zhang L, Ma P, Pflugfelder SC. Suppressive effects of Azithromycin on zymosan-induced production of proinflammatory mediators by human corneal epithelial cells. Investig Ophthalmol Vis Sci. 2010;51(11):5623-5629. doi:10.1167/iovs.09-4992
  32. Vrančić M, Banjanac M, Nujić K, et al. Azithromycin distinctively modulates classical activation of human monocytes in vitro. Br J Pharmacol. 2012;165(5):1348-1360. doi:10.1111/j.1476-5381.2011.01576.x
  33. Schögler A, Kopf BS, Edwards MR, et al. Novel antiviral properties of Azithromycin in cystic fibrosis airway epithelial cells. Eur Respir J. 2015;45(2):428-439. doi:10.1183/09031936.00102014
  34. Andreani J, Le M, Du I, Jardot P, Rolland C. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID- 19 . The COVID-19 resource centre is hosted on Elsevier Connect , the company ’ s public news and information. Microb Pathog. 2020;145(2020):104228.
  35. Galvez J, Zanni R, Galvez-Llompart M, Benlloch JM. Macrolides May Prevent Severe Acute Respiratory Syndrome Coronavirus 2 Entry into Cells: A Quantitative Structure-Activity Relationship Study and Experimental Validation. J Chem Inf Model. 2021;(iv). doi:10.1021/acs.jcim.0c01394
  36. Rosenberg ES, Dufort EM, Udo T, et al. Association of Treatment with Hydroxychloroquine or Azithromycin with In-Hospital Mortality in Patients with COVID-19 in New York State. JAMA - J Am Med Assoc. 2020;323(24):2493-2502. doi:10.1001/jama.2020.8630
  37. Furtado RHM, Berwanger O, Fonseca HA, et al. Azithromycin in addition to standard of care versus standard of care alone in the treatment of patients admitted to the hospital with severe COVID-19 in Brazil (COALITION II): a randomised clinical trial. Lancet. 2020;396(10256):959-967. doi:10.1016/S0140-6736(20)31862-6

How to Cite

Nugrahaningsih, D. A. A., Purnomo, E., Siswanto, Reviono, Yasmina, A., Prenggono, M. D., Fajari, N. M., Rudiansyah, M., Harsini, Syarif, R. A., & Sholikhah, E. N. (2022). Features of COVID-19 adult patients and the treatment in Indonesia: a retrospective cohort study. Bali Medical Journal, 11(1), 528–539.




Search Panel