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All Journal Journal of Epidemiology and Public Health Indonesian Journal of Medicine
Zainal, Dwi Trisnawati
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Medicine & Pharmacology Public Health

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The Effect of Metformin Use on Mortality of COVID-19 Patients with Diabetes Mellitus Hapsari, Dini; Zainal, Dwi Trisnawati
Journal of Epidemiology and Public Health Vol. 7 No. 2 (2022)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2022.07.02.07

Abstract

Background: COVID-19 is a disease caused by infection with the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). COVID-19 is still a worldwide threat because of its high morbidity and mortality. This is influenced by the occurrence of hypertension, obesity, age and diabetes mellitus. However, currently there is still controversy in the results of research regarding the use of metformin in COVID-19 with type 2 diabetes mellitus (type 2 DM). This study was aimed to analyze the effect of metformin in COVID-19 patients with diabetes mellitus on mortality rates.Subjects and Method: This study was a systematic review and meta-analysis with the following PICO. P: COVID-19 patient with type-2 diabetes mellitus. I: administration of metformin therapy. C: therapy other than metformin and O: mortality. The articles used in this study were obtained from several databases, namely PubMed, Science Direct, Proquest, SpringerLink, Google Scholar and Scopus. The article search keywords were: “COVID-19” OR “coronavirus” AND “diabetes” AND “metformin” AND “mortality.” Articles included are full-text English using a cohort study design from 2020 to 2021 and reporting the Odds Ratio in multivariate analysis. The selection of articles was carried out using the PRISMA flow chart. The articles were analyzed using the Review Manager 5.3 application.Results: A total of 7 cohort studies involving 136,321 COVID-19 patients from the Americas (USA and Alabama United States), Europe (France and Spain), and Asia (China and South Korea) were selected for systematic review and meta-analysis. The data collected showed that COVID-19 patients with diabetes mellitus who were given metformin reduced the risk of death by 0.90 times higher compared to COVID-19 patients with diabetes mellitus who were not given metformin therapy (aOR= 0.90; CI 95%= 0.68 to 1.19; p=0.450).Conclusion: Metformin can reduce the risk of death in COVID-19 patients with diabetes mellitus. Keywords: Diabetes, COVID-19, SARS-CoV-2, metformin, mortality Correspondence:Dwi Trisnawati Zainal. Masters Program of Public Health Science, Universitas Sebelas Maret. Jl. Ir. Sutami 36A Surakarta 57126, Central Java. Email: dwitrisnawatiz@gmail.com. Mobile: +62-8133-1282-009.
Effect of ACE Inhibitor Therapy on Mortality in COVID-19 Patients with Hypertension: Meta-Analysis Zainal, Dwi Trisnawati
Journal of Epidemiology and Public Health Vol. 7 No. 3 (2022)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2022.07.03.06

Abstract

Background: Acute respiratory syndrome Corona Virus 2 (SARS-CoV-2) can trigger the occurrence of respiratory infectious disease Coronavirus Disease 2019 (COVID-19). Patients who have comorbid health problems such as hypertension, chronic liver, cardiovascular and diabetes mellitus are more likely to experience deterioration and death. ACE inhibitor therapy in patients with hypertension has a therapeutic effect in lowering blood pressure and is able to reduce mortality rates in COVID-19 patients, but the benefits of ACE inhibitors in patients with COVID-19 are still uncertain. This study aims to determine how much influence ACE inhibitors have on COVID-19 patients with hypertension on mortality rates.Subjects and Method: This study is a systematic review and meta-analysis with the following PICO, population: COVID-19 patients with hypertension. Intervention: administration of ACE inhibitor therapy. Comparison: therapy other than ACE inhibitors. Outcome: mortality. The articles used in this study were obtained from several online databases, including Science Direct, PubMed and Google Scholar. The keywords used in the article search were: “ACE inhibitor” AND “COVID-19” AND “Hypertension” AND “mortality”. The articles included are full-text English with a cohort study design from 2020 to 2021 and report the odds ratio in multivariate analysis. The selection of articles was carried out using the PRISMA flow chart. The articles were analyzed using the Review Manager 5.4. application.Results: A total of 4 cohort studies involving 4,998 COVID-19 patients from America, China and Italy were selected for systematic review and meta-analysis. The data collected yielded information that COVID-19 patients with hypertension who were given ACE inhibitors reduced the risk of mortality 0.67 times compared to COVID-19 patients with hypertension who were not treated with ACE inhibitors (aOR= 0.67; 95% CI= 0.36 to 1.26; p= 0.210).Conclusion: ACE inhibitors can reduce the risk of mortality in COVID-19 patients with hypertension. Keywords: COVID-19, hypertension, ACE inhibitors, mortality. Correspondence:Dwi Trisnawati Zainal. Social Security Administrator for Health, Madiun, East Java. Jl. Timor 6 Madiun, East Java, Indonesia. Email: dwitrisnawatiz@gmail.com. Mobile: 081331282009.
Correlation between the Characteristics of Chronic Kidney Disease Patients Undergoing Hemodialysis and Erythropoietin Stimulating Agent Therapy and Hemoglobin Levels Zainal, Dwi Trisnawati; Tamtomo, Didik Gunawan; Murti, Bhisma
Indonesian Journal of Medicine Vol. 9 No. 2 (2024)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/theijmed.2024.09.02.02

Abstract

Background: Chronic Kidney Disease is one of the deadliest diseases in the world with a high prevalence. Hemodialysis is believed to increase the survival of chronic kidney disease patients. This study aims to analyze the relationship between condition factors in patients with chronic kidney disease undergoing hemodialysis and erythropoietin stimulating agent therapy with hemoglobin levels. Subjects and Method: This research is a quantitative study with a cross-sectional study design carried out at the Madiun City Regional Hospital. Data was taken from June 1, 2022 to June 30, 2022. The population in this study were patients who received hemodialysis services and erythropoietin stimulating agent therapy. The sample was 101 patients with total sampling technique. The independent variables in this study are age, gender, duration of hemodialysis, while the dependent variable is hemoglobin level. Data collection techniques were carried out using patient medical record data. Data analysis used multiple linear regression with Stata 17. Results: The results of multiple linear regression analysis of the relationship between duration of hemodialysis, gender, age, hemoglobin levels before and hemoglobin levels after chronic kidney disease patients undergoing hemodialysis with erythropoietin stimulating agent therapy show that every 1 month increase in hemodialysis will be followed by an increase in hemoglobin of 0.02g/dL (b =0.02 CI95% 0.01 to 0.03 p=0.018). Every 1g/dL increase in hemoglobin levels before hemodialysis will be followed by hemoglobin levels after hemodialysis of 0.7 g/dL (b=0.7 CI 95% 0.6 to 0.8 p<0.001). Gender (b=-0.06 CI 95% -0.7 to 0.6 p=0.857). Age (b=-0.01 CI 95% -0.03 to 0.03 p=0.833). Conclusion: There is a positive relationship between the duration of hemodialysis and hemoglobin levels after chronic kidney disease patients undergo hemodialysis with erythropoietin stimulating agent therapy. There is no statistically significant difference between men and women, age in hemoglobin levels after undergoing hemodialysis with erythropoietin stimulating agent therapy in patients with chronic renal failure. Keywords: chronic kidney disease, hemodialysis, erythropoietin stimulating agent, hemoglobin
Co-Authors Bhisma Murti Didik Gunawan Tamtomo Hapsari, Dini