Chronic Hepatitis C virus (HCV) infection in chronic kidney disease (CKD) patients can accelerate the decline of kidney function, increase the risk of kidney failure, and increase mortality in CKD patients on hemodialysis (HD). Chronic HCV infection is also a risk factor of mortality in kidney transplant patients. Effective detection, evaluation and treatment for HCV infection can improve kidney and cardiovascular outcomes. In the subsequent 10 years, direct-acting antivirals (DAAs) has become available. DAAs enabled a greater rate of HCV eradication in CKD populations. Patients with stage 1-3b CKD (G1-G3b) can be treated with any licensed DAA regimens. The recommended DAA treatment regimens for CKD stage 4-5, including those undergoing HD (G4-G5D) are the sofosbuvir-free combination therapies (grazoprevir/elbasvir and glecaprevir/pibrentasvir). While sofosbuvir-based regimens are much more accessible, data showed that some countries have a limited access (due to drug availability and high cost) to sofosbuvir-free regimens. Because of this phenomenon, some countries have had difficulty providing sofosbuvir-free treatment to CKD G4-G5D patients. As an alternative to those conditions, some clinicians have approved the usage of sofosbuvir-based regimens in CKD G4-G5D, but this decision is still debatable. Kidney Disease: Improving Global Outcomes (KDIGO) 2018 did not approve sofosbuvir-based regimens for CKD G4-G5D. On the contrary, 0ther studies and guidelines have approved sofosbuvir-based regimen for CKD G4-G5D patients.
Background: Obesity and hyperglycemia are common in patients with COVID-19 and are associated with an aggravating risk of COVID-19. This study assesses hyperglycemia and obesity as risk factors for developing severe COVID-19. Method: Analytical observational research with the design used is a matched case-control study. This study divided subjects into two groups according to the dependent variable category of severe COVID-19 as a case and not as severe as a control group. In each group, a history of hyperglycemia and obesity was traced. The analysis includes descriptive tests, bivariate with Chi-Square and multivariate with linear logistic regression using Statistical Product and Service Solutions (SPSS) 26. Result: 126 subjects divided into two groups with 63 subjects each. By age, the COVID-19 group was found to be severe, with an average of 57.9±12.731, and the COVID-19 group was not severe, with an average of 57.53±12.589. Hyperglycemia was associated with severe COVID-19 with a p-result of 0.000 (OR 11.8; CI 95% 3.819-36.456). Obesity was associated with severe COVID-19 with a result of p 0.001 (OR 4.6; CI 95% 1.8 – 11.756). Another covariant factor related to the severity of COVID-19 is Diabetes mellitus (OR: 4.6; CI 95% 2.148–10.137; p=0.028)cardiovascular disease (OR:4.7; 95% CI 1.258-17600; P=0.013),chronic lung disease(OR: 14.5; CI 95% 1.835-115.999).The results of multivariate analysis of Adj Odd Ratio10.038 (95% CI 2.447 – 41.172; P<0.001)and the association with obesity with the Adj Odd Ratio 4.846 (95% CI 1.187 – 19.789; P=0.028). Conclusion: Hyperglycemia and obesity are risk factors for severe COVID-19.
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