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All Journal Althea Medical Journal Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia
Nanny Natalia Mulyani Soetedjo
Departemen Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Hasan Sadikin
Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology 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.
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 Ritonga, Ervita Susandi, Evan