COVID-19 is caused by a novel coronavirus known as SARS-CoV-2, a single chain RNA virus with a particle size of 120-160 nm. Covid-19 can affect almost all age groups, despite, the elderly and people who have records of chronic disease (co-morbid) have the risk to be affected more often and with worse complications from this disease. Diabetes mellitus (DM) is one of the risk factors for enhancing the severity of COVID-19 infection. A 26 years old man, was referred to the hospital with symptoms of shortness of breath, fever, and cough. The patient has no history of comorbidities, but his father has newly type-2 diabetes mellitus (T2DM). The patient was examined, with ad random blood sugar of 220 mg/dL and a chest radiograph suggesting bronchopneumonia. The patient was then examined for fasting and postprandial glucose, HbA1c, and diagnosed with DM, the patient's throat swab showed a positive COVID-19 result. Patients were then treated with antiviral, antibiotic, regulated insulin, and his blood sugar was monitored. The patient's blood sugar is stable and the patient discharge after 34 days of hospitalization.
Background. Lipids play a central role in viral infection, as they represent the structural foundations of cellular and viral membranes. The study aimed to examine the relationship between the D-dimer of T2DM patients with the lipid profile parameters of newly diagnosed COVID-19 patients. Method. This study uses secondary data, which is obtained from medical records of H. Adam Malik Medan Hospital between 2020-2021. The population of this study was all inpatients confirmed COVID-19 through RT-PCR SARS-CoV-2 swab examination. Results. There are 163 participants in this study. HbA1c values were high in T2DM patients with Covid-19, while lipid, and D-dimer profile values were still normal. Parameter of HbA1c, lipid and D-dimer profiles between men and women do not differ significantly. D-dimer is not correlated with HbA1c parameters and lipid profiles Conclusion. In this study, HbA1c values were high in T2DM patients with Covid-19, while D-dimer is not correlated with HbA1c parameters and lipid profiles
ABSTRACT: Background: Fournier gangrene (FG) is a rare but life-threatening necrotizing fasciitis of the external genitalia, perineal area, or perianal caused by a combination of aerobic and anaerobic bacterial infection. It has a higher incidence in men with risk factors including diabetes, HIV, alcoholism, and other immunocompromised states Case presentation: A man, aged 62, was admitted to the hospital complaining of ulcers on his testicles. The patient feels that his testicles are getting swollen, painful, and red. Ulcers appear black, accompanied by pus and accompanied by a foul smell. The patient was hematoligic examination, radiologic and blood cultur and diagnosed with Fournier's gangrene on scrotal area and T2DM. The patient is subjected to immediate debridement and is given broad-spectrum antibiotic therapy, administration of insulin, and monitoring of blood sugar. Conclusion: We reported a case of Fournier gangrene being comprehensive management, causing the prognosis to good improvement Keyword: Fournier gangrene, T2DM ABSTRAK: Latar belakang: Fournier Gangrene (FG) merupakan suatu fasciitis nekrotikans langka namun mengancam nyawa pada genitalia eksterna, daerah perineal, atau perianal yang disebabkan oleh gabungan infeksi bakteri aerob dan anaerobik. Penyakit ini memiliki insiden yang lebih tinggi pada laki-laki dengan faktor risiko termasuk diabetes, HIV, alkoholisme, dan keadaan imunokompromise lainnya. Presentasi Kasus: Seorang pria, berusia 62 tahun, dirujuk ke rumah sakit dengan keluhan luka borok pada buah zakarnya. Pasien merasakan buah zakarnya semakin membengkak, nyeri dan memerah. Luka borok tampak menghitam, disertai nanah dan disertai bau busuk. Pasien dilakukan pemeriksaan darah dan radiologi di diagnosis dengan Fournier gangrene scrotal area dan DMT2. Selanjunya pasien dilakukan debridemen segera, dan diberikan terapi antibiotik spektrum luas, pemberian insulin, dan dilakukan pemantauan gula darah Kesimpulan: Dilaporkan seorang kasus Fournier gangrene yang ditangani secara komprehensif, menyebabkan perbaikan prognosa. Kata Kunci: Fournier gangrene; DMT2
Introduction: Diabetes can cause secondary hyperlipidemia. In COVID-19, dyslipidemia is thought to be the result of biological and pathological processes triggered by SARS-CoV-2. Altered lipid profiles have been reported since the beginning of the COVID-19 pandemic, where the alteration of lipid profile and the severity of SARS-CoV-2 infection were positively correlated. This study aims to analyze the lipid profile in confirmed COVID-19 patients with T2DM at H. Adam Malik General Hospital Medan. Method: This was a descriptive study with a cross-sectional design using a total sampling technique by collecting secondary data on inpatients with confirmed COVID-19 with T2DM at H. Adam Malik General Hospital from 2020 to 2021 which was then analyzed using the SPSS version 25 application. Results: Of the 372 subjects, the most common sex was male (57.3%), 193 people had a BMI of 18.5 - 24.9kg/m2 (51.9%), the mean overall age was 57.5 ± 10.4 years, and the median length of stay was 8 days. The most common comorbid was hypertension (n=189, 50.8%), 176 people had severe COVID-19 (47.3%), and 225 patients were discharged (60.5%). Based on laboratory data, 327 people had dyslipidemia (87.9%), 31 people had mild acute liver impairments (8.3%), the average of HbA1c was 9.0±2.5%, the average fasting blood glucose was 221.7±122.2 mg/L, the average 2 hours post-prandial blood glucose was 261.7±125.8 mg/L, an average of total cholesterol was 151.2±52.2 mg/L, an average of triglycerides was 147.5±99.1 mg/L, an average of HDL was 33.1±14.6 mg/L, an average of LDL was 97.4±44.5 mg/L, the median of ALT was 25 μ/L, and an average of AST was 30.45±27.42 μ/L. Conclusion: Total cholesterol, triglyceride, and LDL were lower in T2DM patients with a critical illness of COVID-19 and patients who died.
Background and aim: Acute kidney injury (AKI) is a common complication in hospitalized patients. The incidence of AKI in COVID-19 ranges from 0.5% to 56.9% in various case series. AKI in COVID-19 is also associated with a higher risk of death. Some risk factors reported to confer a poor prognosis in COVID-19 such as increased age, male gender, patients with comorbidities such as hypertension or diabetes and higher BMI. The aim of this study was to identify the prevalence and risk factor of AKI among COVID-19 patients. Material and methods:We conducted a cross sectional analysis from moderate, severe, and critical COVID-19 patients that developed to AKI at RSUP Haji Adam Malik Medan during 2020. The data was collected during July to September 2021.Results: Form 465 hospitalized COVID-19 patients, there were 64 people with inclusion and exclusion criteria suffered from AKI during the COVID-19 treatment period (13.8%). 71.9% of the patients were men, 70.3% had more than 1 comorbidities, and 60.9% had hypertension as comorbid. Among patients with comorbid hypertension, 12 patients had stage 1 AKI (30.8%), 2 patients had stage 2 AKI (5.1%), and 25 had stage 3 AKI (64.1%). Although bivariate analysis showed no signifi cant relationship between hypertension and AKI stadium (p 0.155), multivariate analyses showed that hypertension has an OR of 4.24 (p 0.049; CI 95% 1.01 -17.9) which means that in patients with hypertension, the incidence rate for stage 3 AKI is 4.24 times greater and statistically signifi cant. Conclusion:Hypertension is proven as a risk factor of AKI in COVID-19 patients.
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