E-Journal Faculty of Medicine Universitas Padjadjaran / E-Jurnal Fakultas Kedokteran Universitas Padjadjaran
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Characteristics of In-Hospital Mortality among Patients with Acute Coronary Syndrome: A Single-Center Study in West Java, Indonesia
Get PDFBackground: Acute Coronary Syndrome (ACS) is a severe manifestation of coronary artery disease, classified into unstable angina (UA), non-ST-segment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI). In-hospital mortality in patients with ACS remains high despite the advancement of therapy. This study aimed to evaluate the characteristics of in-hospital mortality among ACS patients in West Java, Indonesia.Methods: This descriptive cross-sectional study analyzed retrospective secondary data of ACS patients who died during hospitalization in the period of July 2018 to June 2019 that were recorded in the ACS registry.Results: A total of 17 patients died during hospitalization in the study period. The mean age was 64.1 years, predominantly female (n=10). The prevalent diagnoses were STEMI (n=11) and NSTEMI (n=6). Interestingly, no patients had died from UA. Hypertension was the most frequent risk factor (11 of 17). Mortality among Killip Class I, II, III, and IV were 7, 5, 1, and 4 patients, respectively. The number of patients who died after underwent Percutaneous Coronary Intervention (PCI) was lower (n=6) than those who did not undergo PCI or those without revascularization (n=11).Conclusions: The incidence of in-hospital mortality with acute coronary syndrome is high in females, STEMI diagnosis, Killip Class I, and no revascularization
Perioperative Management of a Giant Ovarian Tumour in an Adolescence with Severe Scoliosis and Unilateral Diaphragmatic Dysfunction: A Case Report
Get PDFThough giant ovarian tumor are rare but due to the limitations in oncology surgery during the COVID-19 pandemic, many oncology patients are presented with a more severe stage and giant ovarian tumors may be more commonly seen during this period. The aim of this case report study was to describe the perioperative management of an adolescent patient with a giant ovarian tumor, severe scoliosis, and unilateral diaphragm dysfunction. An 18-years-old girl weighing 28 kgBW came with a giant abdominal mass that extended to her thoracic and back areas. The patient had a history of severe scoliosis since childhood. She had signs of respiratory distress and was not comfortable lying down. Preoperatively, the surgeon used ultrasonography to guide cyst puncture using a thoracic tube and 6,500 cc of mucinous fluid was drained. Inhalational induction with preservation of spontaneous breathing was performed. Two massive masses filled the entire abdominal area, adhering to the peritoneum while pushing and tenting the diaphragm cranially and laterally to the right and bilateral salpingo-oophorectomy was conducted. Serial radiological examinations showed unilateral diaphragmatic dysfunction and a progressing ventilator associated pneumonia. Improving post-operative outcome of patients with giant intraabdominal masses must include preoperative assessment of potential peri-operative respiratory complications, preparation of intraoperative hemodynamic, and ventilatory disturbances with gentle weaning and multidisciplinary approach during the post-operative care to assess readiness of ventilator weaning. Manajemen Perioperatif Pasien dengan Tumor Ovarium Permagna pada Remaja dengan Skoliosis Berat dan Gangguan Diafragma UnilateralTumor ovarium berukuran masif pada anak jarang ditemukan di masa moderen karena perbaikan sistem pelayanan kesehatan namun di masa COVID-19, kasus dapat ditemukan karena hambatan pelayanan pembedahan onkologi. Laporan kasus ini bertujuan melaporkan manajemen perioperatif pada pasien remaja dengan tumor ovarium massif, skoliosis berat dan disfungsi diafragma. Remaja berusia 18 tahun dengan berat 35 kilogran datang dengan massa abdomen sangat besar disertai riwayat skoliosis. Pasien memiliki tanda ancaman gagal napas dan tidak nyaman pada posisi berbaring dan hanya dapat beristirahat dalam posisi duduk. Sebelum induksi, dokter bedah melakukan punksi massa dan didapatkan 6.500 cc cairan musin. Pasien diinduksi dengan napas spontan menggunakan gas anestesi. Bilateral salfingoofarektomi dilakukan dan pascaoperasi pasien dirawat di ruang intensif. Selama masa pemulihan pasien sulit disapih dari ventilator dan hasil pemeriksaan radiologis berulang menunjukkan tanda disfungsi diafragma dan pneumonia. Simpulan, meningkatkan hasil keluaran pada pasien dengan massa intraabdomen massif harus meliputi pemeriksaan preoperatif yang cermat mengenai komplikasi pernafasan perioperative, persiapan permasalahan hemodinamik intraoperative dan strategi penyapihan dari ventilator yang efektif dengan melibatkan pendekatan multidisiplin
Readiness of Health Workers to Provide Pregnancy Planning Program for Women Infected with Human Immunodeficiency Virus: A Case Study in Surabaya, East Java, Indonesia
Get PDFBackground: The prevalence of human immunodeficiency virus (HIV) mother-to-child infection, or vertical transmission of HIV, in Indonesia is about 90%. Ministry of Health of the Republic of Indonesia Regulation No. 21 of 2013 stated that HIV infection in sexual productive age needs integrative professional help to lower the transmissions, including voluntary counseling and testing for pregnant women as well as all people at risk. This study aimed to determine the readiness of health workers to provide pregnancy planning program service for women with HIV.Methods: This study was a descriptive study involving 30 obstetricians and 30 residents of Obstetrics and Gynecology specialist education in Surabaya, Indonesia. The respondents’ knowledge on pregnancy planning for HIV-infected women based on based on guidance released by the Ministry of Health of Indonesia in 2017 and Regulation of Ministry of Health no. 52 the year 2017, as well as their attitude and readiness to provide pregnancy planning services, was explored. Questionnaires were distributed from August to December 2019 and the data collected were analyzed using Statistical Package for the Social Science (SPSS) version 17.0 and results were described in percentage.Results: Most health workers (80%) had good knowledge on providing pregnancy planning program for HIV positive women; however, only 63.3% had good attitude towards it. The majority of respondents (90%) were ready to help HIV patients in planning their pregnancy. Conclusion: Health workers in Surabaya are ready to provide services related to pregnancy planning for women infected with HIV
Rare Case of Periampullary Duodenal Carcinoma
Get PDFPeriampullary carcinoma is a malignancy that appears around the vatteri ampulla. This malignancy can originate from the pancreas, duodenum, and distal choledochal duct. Duodenal cancer is a very rare case, only about 0.3% of the gastrointestinal malignancies. Reported cases are increasing with the increasing use of esophagogastroduodenoscopy. The most frequently found carcinomas of the duodenum include adenocarcinoma, carcinoid, lymphoma, and leiomyosarcoma. The symptoms of these carcinomas are often not specific so the diagnosis is often late, leading to a poor prognosis. Early diagnosis and proper therapy provide a good prognosis. The case reported here representeda 52-year-old woman presented with hematemesis melena, anemia, jaundice, epigastric mass, right hypochondrial pain, and weight loss. From the esophagogastroduodenoscopy, the mass was found to obstruct half of the duodenum lumen and bleeding, which was easily triggered, was observed in the second part of the duodenum. CT scan revealed a mass in the head of the pancreas with gall bladder hydrops and obstruction of the intra and extra-hepatic billier system. After a Whipple operation Laparotomy, the histology showed papillary adenocarcinoma duodenum. Patients then underwen chemotherapy with 5 fluorouracil regimen. Patient's clinical condition is currently improving and no complaint is conveyed by the patient
Analisis Syndecan-1 Laktat dan Profil Lipid Sebagai Faktor Risiko Keparahan dan Mortalitas Sepsis
Get PDFPada sepsis, endothelial glycocalyx (EG), dapat rusak dan luruh melepaskan syndecan-1 ke dalam plasma. Kerusakan EG akan mengganggu mikrosirkulasi, menimbulkan hipoperfusi jaringan, dan meningkatkan kadar laktat. Gangguan profil lipid pada sepsis terjadi karena gangguan metabolisme dan kerusakan langsung hepatosit akibat meluruhnya EG. Penelitian ini bermaksud menganalisis syndecan-1, laktat, dan profil lipid sebagai faktor risiko keparahan dan mortalitas pada pasien sepsis. Penelitian ini adalah penelitian analitik observasional pada 39 pasien dewasa yang memenuhi kritera sepsis-3. Keparahan sepsis diklasifikasikan menjadi sepsis dan syok septik dan ditentukan dalam 6 jam setelah time zero berdasarkan penggunaan vasopresor, kecukupan resusitasi cairan, dan nilai laktat ulangan. Kematian 7 hari dihitung sejak time zero sepsis. Syndecan-1, laktat, dan profil lipid diambil dalam jam pertama setelah time zero dianalisis sebagai faktor risiko keparahan dan mortalitas 7 hari. Analisis data dilakukan dengan uji logistik regresi bivariat dan multivariat. Pada penelitian ini didapatkan 20 pasien dengan sepsis, 19 pasien dengan syok septik. Berdasar atas mortalitas 7 hari, 10 pasien meninggal dan 29 pasien bertahan hidup. Laktat dan syndecan-1 merupakan prediktor keparahan pada sepsis. Laktat merupakan variabel yang lebih superior dibanding dengan syndecan-1 sebagai prediktor keparahan sepsis. Laktat merupakan prediktor untuk mortalitas 7 hari pada pasien sepsis. Simpulan penelitian ini adalah laktat dan syndecan-1 merupakan prediktor keparahan pada sepsis. Laktat merupakan prediktor kematian 7 hari pada sepsis. Syndecan-1 Lactate and Lipid Profiles as Risk Factors for Severity and Mortality in SepsisIn sepsis, endothelial glycocalyx (EG) may experience damages and decay, releasing syndecan-1 into plasma. EG damages will disrupt microcirculation, causing tissue hypoperfusion and increasing lactate levels. Disorders of the lipid profile in sepsis occur due to metabolic disorders and direct hepatocyte damages due to EG shedding. This study intended to analyze the Syndecan-1, lactate, and lipid profiles as risk factors for severity and mortality in septic patients. This was an observational analytic study on 39 adult patients who met the criteria for sepsis-3. Sepsis severity was classified into sepsis and septic shock and was determined within 6 hours after time zero based on the vasopressor use, adequacy of fluid resuscitation, and repeat lactate values. The 7-day mortality was counted from time zero sepsis. Syndecan-1, Lactate, and Lipid Profiles were assessed within the first hour after time zero and analyzed as risk factors for severity and 7-day mortality. Data analysis was performed using bivariate and multivariate logistic regression tests. In this study, there were 20 patients with sepsis, 19 patients with septic shock. Based on the 7-day mortality, 10 patients died and 29 patients survived. Lactate and Syndecan-1 are predictors of severity in sepsis. Lactate is superior than Syndecan-1 as a predictor of sepsis severity and is a predictor of 7-day mortality in septic patients. Nonetheless, both lactate and Syndecan-1 are predictors of severity in sepsis.Pada sepsis, endothelial glycocalyx (EG), akan rusak dan luruh, melepaskan syndecan-1 ke dalam plasma. Kerusakan EG akan mengganggu mikrosirkulasi, menimbulkan hipoperfusi jaringan dan meningkatkan kadar laktat. Gangguan profil lipid pada sepsis terjadi karena gangguan metabolism dan kerusakan langsung hepatosit akibat meluruhnya EG. Tujuan: Menganalisis Syndecan-1, Laktat dan Profil Lipid sebagai faktor risiko keparahan dan mortalitas pada pasien sepsis. Metode: Penelitian ini adalah penelitian analitik observasional pada 39 pasien dewasa yang memenuhi kritera sepsis-3. Keparahan sepsis diklasifikasikan menjadi sepsis dan syok septik dan ditentukan dalam 6 jam setelah time zero berdasarkan penggunaan vasopressor, kecukupan resusitasi cairan dan nilai laktat ulangan. Kematian 7 hari dihitung sejak time zero sepsis. Syndecan-1, Laktat dan Profil Lipid diambil dalam jam pertama setelah time zero dianalisis sebagai faktor risiko keparahan dan mortalitas 7 hari. Digunakan analisis normalitas data, uji logistik regresi bivariat dan multivariat. Hasil: Pada penelitian ini didapatkan 20 pasien dengan sepsis, 19 pasien dengan syok septik. Berdasarkan mortalitas 7 hari, 10 pasien meninggal dan 29 pasien bertahan hidup. Laktat dan Syndecan-1 merupakan prediktor keparahan pada sepsis. Laktat (RR 3,597 CI 95% 1,373 – 9,421 p 0,009) merupakan variabel yang lebih superior dibandingkan Syndecan-1 (RR 1,009 CI 95% 1,002 – 1,016 p 0,018) sebagai prediktor keparahan sepsis. Laktat (RR 2,369 CI 95% 1,021 – 5,495 p 0,045) merupakan prediktor untuk mortalitas 7 hari pada pasien sepsis. Simpulan: Laktat dan Syndecan-1 merupakan prediktor keparahan pada sepsis. Laktat merupakan prediktor kematian 7 hari pada sepsis
Perbandingan Pemberian Ketorolak dengan Parecoxib Intravena Terhadap Kadar Trombosit, Aggregasi Trombosit dan Profil Koagulasi pada Operasi Seksio Sesarea
Get PDFPengelolaan nyeri pascabedah bertujuan menghasilkan analgesia yang optimal serta menghambat respons stres akibat pembedahan. Pengaruh OAINS baik COX 1 dan COX 2 terhadap trombosit baik jumlah maupun aggregasinya perlu dinilai untuk menentukan obat terpilih yang aman dalam mengatasi nyeri pascabedah. Penelitian ini bertujuan membandingkan pemberian ketorolak dengan parecoxib intravena terhadap jumlah trombosit, aggregasi trombosit, dan profil koagulasi pada operasi seksio sesarea. Penelitian ini menggunakan uji klinis acak tersamar ganda. Penelitian dilakukan di RSUP Wahidin Sudirohusodo Makassar pada bulan Oktober 2020–Maret 2021. Pengukuran dilakukan di awal dan setelah perlakuan dengan jumlah sampel masing-masing 11 orang. Data dianalisis menggunakan uji statistik Independen T-Test. Tidak berbeda bermakna perubahan kadar trombosit pada pemberian ketorolak dengan parecoxib sebagai analgesia pascabedah seksio pasca 24 jam dan pasca 48 jam (p>0,05). Berbeda bermakna perubahan agregasi trombosit pada pemberian ketorolak dengan parecoxib sebagai analgesia pascabedah seksio pasca 48 jam (p0.05). There was a significant difference in platelet aggregation between ketorolac and parecoxib group after 48 hours of post cesarean section surgery (p 0.05). There was a significant difference in platelet aggregation between ketorolac and parecoxib group after 48 hours of post cesarean section surgery at concentration of 1uM, 2uM, 5uM, and 10uM reagents respectively (p 0.05).Conclusion: Parecoxib does not cause a decrease in platelet aggregation therefore it can be used as an alternative for post-surgical analgesics, especially for patients with hemostatic disorders. Parecoxib does not cause hemostatic physiological disorders compared to ketorolac. Both parecoxib and ketorolac do not affect the platelet count Keywords: Coagulation Profile, Ketorolac, Parecoxib, Platelet Aggregation. ABSTRAKLatar Belakang: Pengelolaan nyeri pasca bedah, bertujuan menghasilkan analgesia yang optimal serta menghambat respon stres akibat pembedahan. Pengaruh OAINS baik COX 1 dan COX 2 terhadap tromobosit baik jumlah maupun aggregasinya perlu dinilai untuk menentukan obat terpilih yang aman dalam mengatasi nyeri pasca bedah yang aman.Tujuan: Membandingkan pemberian ketorolak dengan parecoxib intravena terhadap jumlah trombosit, aggregasi trombosit dan profil koagulasi pada operasi seksio sesarea.Metode: Desain yang digunakan pada penelitian ini adalah uji klinis acak tersamar ganda (Randomized double blind clinical trial). Dalam rancangan eksperimental, pengukuran atau observasi dilakukan diawal dan setelah perlakuan dengan jumlah sampel masing-masing 11 orang. Data dianalisis menggunakan uji statistik Independen T Test.Hasil Penelitian: Tidak ada perbedaan yang bermakna perubahan kadar trombosit pada pemberian ketorolak dan parecoxib sebagai analgesia pasca bedah seksio post 24 jam dan post 48 jam (p> 0.05). Ada perbedaan yang bermakna perubahan agregasi trombosit pada pemberian ketorolak dan parecoxib sebagai analgesia pasca bedah seksio post 48 jam pada reagen concentrate 1uM, 2uM, 5uM, dan 10uM (p 0.05).Simpulan: Parecoxib tidak menyebabkan penurunan agregasi trombosit sehingga dapat digunakan sebagai alternatif untuk analgetik pasca bedah terutama untuk pasien yg mengalami gangguan hemostatis. Parecoxib tidak menyebabkan gangguan faal hemostasis dibandingkan ketorolak. Parecoxib dan ketorolak tidak mempengaruhi jumlah trombositKata kunci: Ketorolak, Parecoxib, Aggregasi trombosit, Profil koagulas
Positive Lateral Flow Urine Lipoarabinomannan Assay (LF-LAM) Result in Detection of Active Tuberculosis
Get PDFLipoarabinomannan (LAM) is the main component of M. tuberculosis (MTB) wall as result of MTB degradation by macrophages in the human body. In patients with active TB and HIV co-infection, a decrease in antibody responses may be apparent that some of LAM may not be bound with antibodies. In this condition, LAM can pass through the normal glomerular basement membrane and can be detected in the urine. One laboratory examination for detecting LAM is the Lateral Flow Urine Lipoarabinomannan (LF-LAM) assay that uses urine as the sample. The purpose of this cross-sectional observational descriptive comparative study was to compare the positivity rate of LF-LAM examination results in active TB patients with and without HIV infection. Random urine samples were collected from patients diagnosed with active TB with and without HIV infection who visited Dr. Hasan Sadikin General Hospital Bandung from August to October 2020. The proportion between the group with HIV and group without HIV was analyzed with the Chi-Square test. Subjects were 52 patients, consisting of 25 (48%) subjects with HIV infection and 27 (52%) subjects without HIV infection. The positive LF-LAM results were found in 11 (21%) subjects, consisting of 9 (36%) subjects with HIV infection and 2 (7%) subjects without HIV infection, with p=0.012. In conclusion, the positivity rate of LF-LAM results is higher in active TB patients with HIV infection compared to those without HIV infection.
Characteristics of Enterovesical Fistula Patients Visiting the Urology Department of Dr. Hasan Sadikin General Hospital Bandung, Indonesia, from 2015 to 2019
Get PDFEnterovesical fistula (EVF) represents an abnormal channel between the intestine and the bladder. The EVF is a complication of inflammatory or neoplastic diseases and injuries. Diagnosis of EVF can be challenging and often delayed up to several months after the onset of the symptoms. This study aimed to determine the characteristics of patients with enterovesical fistula visiting Dr. Hasan Sadikin General Hospital Bandung, Indonesia. This retrospective descriptive study used the medical records of EVF patients treated in the urology department of Dr. Hasan Sadikin General Hospital from 2015 to 2019 as the secondary data to be analyzed. A total of 58 patients with EVF were enrolled in this study. By gender, that more than half of the patients were male patients (n=30, 51.7%) and 45% of patients were between 41 and 50 years old. The most common symptoms of EVF were pneumaturia and fecaluria which were seen in 30 (51.7%) and 20 (34.5%) patients, respectively. Twenty-nine (50%) patients experienced malnutrition and 18 (31.1%) patients had diabetes mellitus as a comorbid. The most common type of fistula was rectovesical fistula (n=45, 77.6%) and 26 (66.6%) patients suffered from rectosigmoid cancer and malignancy (68.95) had become the most predominant etiology. Escherichia coli was found in 42 (72.4%) urine cultures collected from the patients and cystoscopy with fistula biopsy was found in 43.1% of cases, followed by fistula repair (29.3%) and urethral catheter drainage (15.5%). Hence, malignancy and rectosigmoid cancer become the most common etiology of EVF while cystoscopy with fistula biopsy is the most frequently performed procedure.
Efektifitas Pemberian EMLA 5 % Dibandingkan dengan Etil Klorida Spray untuk Mengurangi Nyeri pada Suntikan Jarum Epidural
No full textNyeri pada saat penyuntikan jarum epidural menjadi kekurangan terhadap aplikasi tindakan epidural. Tujuan penelitian ini adalah mengetahui perbedaan efektivitas pemberian EMLA 5% dibanding dengan etil klorida spray untuk mengurangi nyeri pada suntikan jarum epidural dengan skor visual analoge scale (VAS). Penelitian ini merupakan jenis penelitian eksperimental dengan pendekatan uji klinis dengan teknik single blind. Terdapat 30 subjek penelitian menjalani tindakan epidural di RSUD Dr. Moewardi Surakarta dengan status fisik ASA I dan II berusia 20–65 tahun. Sampel meliputi 10 subjek dengan pemberian EMLA 5%, 10 subjek etil klorida spray dan 10 subjek lidokain 2%. Setelah dilakukan randomisasi dilakukan pengukuran intensitas nyeri dengan skor VAS pada kedalaman jarum epidural 0,5–1 cm dan 1–4 cm. Hasil pemberian EMLA 5% memberikan hasil yang lebih baik terhadap nilai VAS saat penyuntikan jarum epidural dibanding dengan etil klorida spray, perbedaan tingkat nyeri ditunjukkan pada kedalaman jarum epidural 0,5–1 cm (p=0,006) dan 1–4 cm p=0,000 (p<0,05). Simpulan, pemberian EMLA 5% efektif mengurangi rasa nyeri pada suntikan epidural.Effectiveness of EMLA 5% Administration Compared to Ethyl Chloride Spray to Reduce Pain in Epidural Needle InjectionsPain at the time of injection of the epidural needle becomes a drawback to applying epidural action. This study aimed to determine the difference in the effectiveness of administrating EMLA 5% compared to ethyl chloride spray to reduce pain on epidural needle injections with a visual analog scale (VAS) score. This study was experimental research with a clinical trial approach with a single-blind technique. There were 30 research subjects undergoing an epidural at Dr. Moewardi Hospital Surakarta with the physical status of ASA I and II, aged between 20–65 years. The samples included ten subjects with 5% EMLA administration, ten subjects with ethyl chloride spray, and ten with 2% lidocaine. After randomization, pain intensity was measured with a VAS score at an epidural needle depth of 0.5–1 cm and 1–4 cm. The administration of EMLA 5% gave better results on the VAS value when injecting the epidural needle compared to ethyl chloride spray; the difference in pain level was shown at the epidural needle depth of 0.5–1 cm (p=0.006) and 1–4 cm p=0.000. In conclusion, administration of 5% EMLA is effective in reducing pain on epidural injections.Nyeri pada saat penyuntikan jarum epidural menjadi kekurangan terhadap aplikasi tindakan epidural. Berkembangnya ilmu pengetahuan dibidang anestesia, khususnya penanganan nyeri, dikembangkan konsep penanganan nyeri yang dilakukan sebelum nyeri muncul. Tujuan penelitian ini adalah Mengetahui perbedaan efektifitas pemberian EMLA 5 % dibanding dengan Ethil klorida Spray untuk mengurangi nyeri pada suntikan jarum epidural dengan skor VAS (Visual Analoge Scale). Penelitian ini merupakan jenis penelitian eksperimental dengan pendekatan uji klinis dengan teknik single blind. Terdapat 30 subjek penelitian menjalani tindakan epidural di RSUD Dr. Moewardi Surakarta dengan status fisik ASA I dan II berumur antara 20-65 tahun. Sampel meliputi 10 subyek dengan pemberian EMLA 5 %, 10 subyek Ethil Klorida Spray dan 10 subyek Lidokain 2%. Setelah dilakukan randomisasi dilakukan pengukuran intensitas nyeri dengan skor VAS pada kedalaman jarum epidural 0,5-1cm dan 1-4 cm. Hasil Pemberian EMLA 5 % memberikan hasil yang lebih baik terhadap nilai VAS (Visual Analoge Scale) saat penyuntikan jarum epidural dibandingkan Ethil klorida spray, perbedaan tingkat nyeri ditunjukkan pada kedalaman jarum epidural 0,5-1 cm p=0,006 (p<0,05) dan 1-4 cm p=0,000 (p<0,05). Sehingga dapat disimpulkan pemberian EMLA 5% efektif mengurangi rasa nyeri pada suntikan epidural
Mutation and Phylogenetic Analysis of Spike Glycoprotein of Indonesian Isolates of Severe-Acute-Respiratory-Syndrome-Coronavirus-2 (SARS-CoV-2)
Get PDFCoronavirus disease-2019 (COVID-19) is an infectious acute respiratory disease caused by SARS-CoV-2. The protein that plays a role in the entry of SARS-CoV-2 into human cells is the surface protein, or the Spike, which is thought to be the effective vaccine target to prevent SARS-CoV-2 infection. Until December 2020, Indonesia has reported 106 SARS-CoV-2 genome sequences identified from COVID-19 positive patients. The purpose of this study was to analyze the phylogenetic relationship of the Spike protein of the Indonesian isolates of SARS-CoV-2 Indonesian, as well as the virus mutations and their effects on changes in the amino acid. The 106 Indonesian SARS-CoV-2 genomes were downloaded from GISAID and the Spike nucleotide and amino acid sequences were analyzed by multiple sequence alignment (MSA) and mutation analysis using the ClustalW method. Phylogenetic trees were created using the Neighbor-Joining method in MEGA-X software. The results showed that 30 of the 106 Indonesian isolate SARS-CoV-2 Spike were 100% identical to the Wuhan-Hu-1, while the remaining 76 had experienced mutations at 1-4 sites. There were 43-point mutations in the Spike gene, 27 of which led to amino acid changes and four had not been reported in other countries. The global mutation D614G was found in 60 Indonesian isolates , of which West Java was the province with the most reports. The phylogenetic of Spike showed that the Indonesian samples have been divided into several branches that are far from Wuhan-Hu-1. This study indicates the possibility of differences in the protein structure of Indonesian isolate SARS-CoV-2 Spike that need to be further studied to manufacture a vaccine against the Indonesian strain of SARS-CoV-2