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All Journal Althea Medical Journal Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Indonesian Journal of Global Health research
Nanny Natalia Mulyani Soetedjo
Departemen Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Hasan Sadikin
Biochemistry, Genetics & Molecular Biology Education Health Professions Languange, Linguistic, Communication & Media Medicine & Pharmacology Nursing Public Health

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Characteristics and Clinical Outcomes of COVID-19 Patients with Hyperglycemia: Retrospective Cohort Study from a COVID-19 Referral Hospital, Bandung, Indonesia Permana, Hikmat; Ikhsanawati, Annisa; Susandi, Evan; Soetedjo, Nanny Natalia Mulyani; Alisjahbana, Bachti
Althea Medical Journal Vol 10, No 4 (2023)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v10n4.3111

Abstract

Background: COVID-19 often causes severe complications in patients with metabolic disorders such as diabetes mellitus. Conversely, inflammation caused by infection may also trigger insulin resistance, resulting in hyperglycemia and is related to the disease severity. This study aimed to describe the characteristics and clinical outcomes of COVID-19 patients with hyperglycemia at one of the COVID-19 referral hospitals in Bandung, Indonesia.Methods: This retrospective cohort study used secondary data from medical records of COVID-19 patients admitted to Dr. Hasan Sadikin General Hospital Bandung, Indonesia from March 2020 to March 2021. This study included all patients with confirmed COVID-19, aged >18 years, and had at least one blood glucose test at admission. Patients were grouped based on three possible types of hyperglycemia, namely diabetes mellitus, reactive hyperglycemia, and steroid-induced hyperglycemia; then their characteristics and disease outcomes were compared. Results: This study identified 1,114 patients’ medical records and included 1,013 data in the analysis. Hyperglycemia occurred in 45.1% of COVID-19 patients. The most common hyperglycemia types were diabetes mellitus (55.7%), reactive hyperglycemia (37.4%), and steroid-induced hyperglycemia (7%). The steroid-induced hyperglycemia group had similar characteristics as the diabetes group. The reactive hyperglycemia group exhibited a metabolic syndrome pattern resembling pre-diabetic conditions. The highest rates of severe disease and mortality were seen in the steroid-induced hyperglycemia group, followed by the diabetes group.Conclusions: There is an elevated prevalence of hyperglycemia in COVID-19 patients with diabetes. The steroid-induced hyperglycemia group has the most unfavorable outcomes. These observations emphasize the importance of identifying hyperglycemic conditions to improve management and outcomes.
Perbedaan Parameter Hematologi Neutrophil to Lymphocyte Ratio (NLR) Antara Pasien Diabetes Melitus dan Tanpa Diabetes Melitus berdasarkn Derajat Keparahan Sakit Covid-19 Loe, Luse; Soetedjo, Nanny Natalia Mulyani; Permana, Hikmat; Alisjahbana, Bachti
Majalah Kedokteran Indonesia Vol 75 No 1 (2025): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.75.1-2025-1125

Abstract

Background: Patients with diabetes mellitus (DM) have higher risk of complications caused by coronavirus 2019 (COVID-19). COVID-19 virus causes leukopenia and lymphopenia. The neutrophil to lymphocyte ratio (NLR) is a parameter in the complete blood count routinely performed on admission. Method: This study aims to evaluate the difference between NLR in diabetic and non-diabetic patients based on COVID-19 severity. This is a cross-sectional, retrospective, descriptive-analytical study, and the analysis was performed using the comparison test in COVID-19 patients admitted to Hasan Sadikin Hospital from March 2020 to March 2021 using secondary data collected from medical records. There were 612 subjects included in this study. Result: We found a higher NLR median in diabetic (4.1, IQR 2.3-6.2) than non-diabetic (2.9, IQR 2.0-4.0) subjects, with p<0.001. Increased NLR was seen in diabetic COVID-19 subjects with mild to moderate severity, median NLR in diabetic group 4.1 (IQR: 2.3-6.2) vs 2.9 (IQR: 2.0-4.0) in non-diabetic group (p=<0.001). The median NLR was significantly higher in severe-critical diabetic subjects (4.8, IQR 3.0-6.8) than in mild-moderate non-diabetic subjects (2.9, iQR 2.0-4.0). Conclusion: NLR differs between the diabetic and non-diabetic groups depending on the severity of the disease. The NLR is an important parameter in assessing the severity of disease in COVID-19.
Nutriepigenetic Modulation of Hypertension Risk: A Review of the Literature Iryaningrum, Maria Riastuti; Soetedjo, Nanny Natalia Mulyani; Indraswari, Noormarina; Supriyadi, Rudi
Indonesian Journal of Global Health Research Vol 7 No 2 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i2.4774

Abstract

This review aimed to investigate the interplay between dietary components and epigenetic modulation in the pathogenesis of hypertension. A comprehensive literature search encompassing all published primary and secondary research dating up to March 2024 was carried out on several electronic databases, including MEDLINE, EBSCO-Host, Science Direct, ProQuest, and Google Scholar. Individual genomes and dietary intake exhibit a bidirectional relationship, influencing the hypertension risk. Unhealthy dietary patterns can compromise DNA integrity through DNA methylation and histone acetylation, ultimately affecting both systolic and diastolic blood pressure. Dietary macronutrient composition (carbohydrates, lipids, and proteins) significantly alters the expression of specific microRNAs (miRNAs) known to regulate endothelial function and blood pressure homeostasis. Moreover, micronutrients (vitamin A, D, E, Zinc, Iodine, and Sodium) can exert epigenetic effects on blood pressure via receptor interactions, potentially modifying cardiovascular disease risk. Dietary imbalances in macro and micronutrients can epigenetically influence hypertension development. Addressing these deficiencies through targeted interventions may offer a complementary approach to hypertension treatment.
Rhabdomyolysis in Thyroid Crisis Soetedjo, Nanny Natalia Mulyani; Loe, Luse; Kusumawati, Maya; Ritonga, Ervita; Permana, Hikmat
Majalah Kedokteran Indonesia Vol 72 No 5 (2022): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.72.5-2022-829

Abstract

Introduction: Hyperthyroidism might lead to rhabdomyolysis. Rhabdomyolysis in thyroid crisis is very rare, currently there are only 7 cases in the world. This is the eight cases in the world that had been reported.Cases: We reported a case of a 46-year-old man with Graves’ Disease who presented with thyroid crisis and rhabdomyolysis.Discussion: The patient came with shortness of breath and palpitations for 10 hours before admission. Tachycardia, tachypnea, thyroid enlargement, motoric weakness, and bilateral lung crackles were noted. The Burch-Wartofsky Point Scale was 60 and the Japan Thyroid Association grade was TS2 first combination. Laboratory showed hyperkalemia (7.7 meq/L), increase in urea (144 mg/dl), creatinine (1.92 mg/dl), fT4 ( greater than 5.0), TSHs (0.06 uIU/ml) creatine kinase (3645 U/L), positive TRAb and Anti-TPO. The patient was treated with thyroid crisis management (propylthiouracil, lugol, dexamethasone) and supportive treatment (dobutamine, digoxin, furosemide, antibiotics, hyperkalemia therapy). After hospitalized for 11 days, the patient was discharged with resolution clinical symptom and levels of CK, urea, and creatinine. Conclusion: Hyperthyroidism might lead to rhabdomyolysis. This condition needs to be recognized and becomes a differential diagnosis in non-traumatic rhabdomyolysis accompanied by acute kidney injury. Therefore, can lead to appropriate and prompt management.
Co-Authors Annisa Ikhsanawati, Annisa Bachti Alisjahbana Hikmat Permana Kusumawati, Maya Loe, Luse Maria Riastuti Iryaningrum Noormarina Indraswari Ritonga, Ervita Rudi Supriyadi Susandi, Evan