BACKGROUND: Acute kidney injury (AKI) in coronavirus disease-19 (COVID-19) has high incidence and mortality. Risk factors for AKI in COVID-19 patients are not well explored. This systematic review provides a combination of available evidence regarding risk factors of AKI in COVID-19 patients. METHODS: A systematic research was performed in Medline, Cochrane Central Register of Controlled Trials, and ScienceDirect journal databases from 2019 to August 2020. The study selection process was plotted using a Preferred Reporting Items for Systematic Review and Meta-Analyses flow diagram. RESULTS: Out of 553 studies found, four full-text studies met the inclusion criteria and were included in qualitative analysis. There are 2205 COVID-19 patients with AKI (36.44%) from 6051 COVID-19 patients. Age was a risk factors for AKI in two studies (odds ratio [OR] 1.03 [p < 0.001], OR 1.03 [p < 0.007]). Critical condition of patient is risk factors for AKI (OR 8.155 [p = 0.006]). Hirsch et al. stated that diabetes mellitus (OR 1.74 [p < 0.001]), cardiovascular disease (OR 1.48 [p < 0.001]), and hypertension (OR 1.25 [p = 0.02]) are also risk factors. Laboratory results such as elevated procalcitonin (PCT) and estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2 showed positive association to AKI in COVID-19 patients (OR 4.822 [p = 0.037]; OR 13.451 [p = 0.016]). A higher sequential organ failure assessment (SOFA) score at admission is one of the risk factors (OR 1.498 [p = 0.027]). CONCLUSION: Demographics, clinical classification of COVID-19, comorbidities, SOFA score, PCT, and eGFR can help clinicians predict AKI in COVID-19 patients.

Physical activity is beneficial to modulate immune system function and has inverse relationship to ARDS linked with SARS-CoV-2. Physical activity consists of daily activity and physical training. Studies regarding effect of physical training on patients with COVID-19 are controversial. This systematic review aims to investigate physical training on muscle health and QOL in patients with COVID-19. The literature review was carried out using keywords: (Exercise) AND (COVID) AND (Muscle) AND (Observational Study) in several databases of PubMed and Cochrane Central Register of Controlled Trials (CENTRAL). All references were reviewed using critical appraisal Newcastle Ottawa Scale (NOS) and Centre for Evidence-Based Medicine (CEBM) checklist. The studies were subsequently screened for reporting exercise, muscle, and COVID-19. The descriptions of the extracted data are guided by Preferred Reporting Items for Systematic Reviews (PRISMA) statement with GRADE approach. This study is registered in PROSPERO: ID CRD42021295188. Six studies pooled and entered review synthesis. Studies were reviewed using critical appraisal by NOS and CEBM. Two clinical trial studies and four observational designs were selected. Our result showed physical training improved patients’ outcomes in the acute phase, critical phase, and post-COVID-19 phase. Multiple types of physical trainings were suggested by those studies, and most of them showed beneficial effects to patients with COVID-19 in different phases. The level of evidence by GRADE was downgraded, and further investigations are needed to establish guidelines and strong recommendation for a specific stage of COVID-19.

As age increases, adipose tissue infiltrates muscle tissue and leads to sarcopenia. When excessive accumulation of adipose tissue accompanied progressive decrease in lean body mass especially visceral fat, termed as sarcopenic obesity (SO) and related metabolic intermuscular adipose tissue (IMAT) is an ectopic tissue found between muscle groups, and is distinct from subcutaneous adipose tissue. Until now, the association between IMAT and metabolic health was not understood. This study is the first systematic review assessing the association between IMAT and metabolic health. The PubMed, Science Direct and Cochrane databases were searched for studies reporting IMAT and metabolic risk. The descriptions of the extracted data are guided by the Preferred Reporting Items for Systematic Reviews (PRISMA) statement with a Grading of Recommendations Assessment, Development and Evaluation approach. This study is registered at PROSPERO (identifier: CRD42022337518). Six studies were pooled and reviewed using critical appraisal by the Newcastle Ottawa Scale and Centre for Evidence-Based Medicine checklist. Two clinical trials and four observational trials were included. Our results reveal that IMAT is associated with metabolic risk, especially in older adults and patients with obesity. However, in a person with abdominal obesity, VAT has a more significant role in metabolic risk than IMAT. The largest decrease in IMAT was achieved by combining aerobic with resistance training.

Pendahuluan : Komplikasi dari fraktur tulang panggul seringkali berhubungan dengan mobilisasi, dimana semakin cepat mobilisasi postoperatif pasien, maka semakin rendah risiko komplikasi yang dialami pasien.Sekitar 50% fraktur tulang panggul adalah fraktur collum femur. Tujuan pembuatan laporan kasus ini adalah untuk meningkatkan pengetahuan mengenai mobilisasi pada pasien lansia dengan fraktur collum femur.Penting untuk mengontrol rasa nyeri dan menggunakan teknik anestesi yang mendukung mobilisasi dini pasien postoperatif.Perlu diperhatikan pula masalah psikologis dari pasien, seperti ketakutan untuk jatuh postoperatif yang menjadi penghambat utama dalam kasus ini bagi pasien untuk berjalan independen dan masih perlu ditentukan waktu mobilisasi postoperatif yang terbaik bagi pasien.Kasus : Pasien laki-laki berumur 73 tahun datang dengan keluhan nyeri pada paha kiri (Numeric Pain Rating Scale (NPRS) 5) setelah terjatuh empat hari sebelumnya dari anak tangga setinggi ± 50 cm. Pasien terjatuh terduduk dan semenjak itu pasien tidak dapat berdiri.Sebelum terjatuh, pasien dapat berjalan mandiri, merawat dirinya sendiri dan tinggal bersama dengan anak perempuannya.Ringkasan : Mobilisasi dini pada pasien lansia dengan fraktur collum femur dihubungkan dengan penurunan risiko komplikasi dan mortalitas.Penting bagi seorang dokter untuk mengontrol rasa nyeri dan menggunakan teknik anestesi yang mendukung mobilisasi pasien postoperatif.Perlu diperhatikan pula masalah psikologis dari pasien, seperti ketakutan untuk jatuh postoperatif dan masih perlu ditentukan waktu mobilisasi postoperatif yang terbaik bagi pasien.

The coronavirus Disease-19 (COVID-19) pandemic was announced in March 2020 by World Health Organization (WHO). Studies showed that the elderly had higher morbidity and mortality rates. Acute sarcopenia in the elderly with COVID-19 is an overlooked problem. Inflammation, malnutrition, immobilization, a side effect of COVID-19 treatment, depression, and hormonal dysregulation contributed to acute sarcopenia in COVID-19, especially in the elderly. Muscle quantity can be assessed with different techniques such as imaging or anthropometric measurements in diagnosing sarcopenia. Imaging such as CT scan was widely used in multiple studies. Still, anthropometric measurements are more fit in developing countries because they are widely available, safe, do not require special skills, and fit in low-resources facilities. Muscle strength can be assessed with grip strength. Acute sarcopenia was associated with immune dysregulation and cytokine storm, length of stay and readmission, and ICU admission and mechanical ventilation. These will contribute to high mortality in sarcopenic elderly with COVID-19.

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Background. Frailty was believed to reflect patients' prognosis better than age, but studies regarding the association between these factors are controversial. Moreover, studies highlighting the association of gender to mortality risk in frail patients are limited. Objectives. We aimed to investigate the association of frailty to mortality risk with the dose-response relationship of CFS and the association of gender to mortality risk in frail elderly with COVID-19. Material and methods. We performed a comprehensive literature search from several databases, such as europePMC, PubMed and DOAJ on 9 July 2021. We searched for studies investigating the association between frailty and mortality in COVID-19 patient. Results. A total of 16,438 patients from 15 studies were included. Frailty was found in 52.67% of the patients. the lowest mean age was 65.4 ± 15.8 years. Pre-frailty (OR 2.07 [1.53-2.79]; p < 0.00001; I 2 : 72%), mild frailty ; p = 0.00001; I 2 : 80%), moderate frailty ; p < 0.00001; I 2 : 79%) and severe frailty ; p < 0.00001; I 2 : 83%) increase the mortality risk in elderly with COVID-19. Each 1-point increase in CFS increases the mortality risk by 1.4 [1.3-1.5]; p = 0.000; I 2 : 98.6%. Men had a lower risk of frailty ; p = 0.0004; I 2 =36%) but higher mortality risk. Conclusions. This meta-analysis showed that pre-frailty and frailty increase the mortality risk in elderly with COVID-19. Each 1-point increase in CFS increased the mortality risk by 1.4. Men had a lower risk of frailty but higher mortality risk.

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