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COVID-19 cases can lead to pneumonia, acute respiratory distress syndrome, acute kidney failure, and death. The presence of comorbidities are tought to worsen that condition. This study aimed to investigate impact of hypertension, diabetes mellitus, and chronic obstructive pulmonary disease to admission to intensive care unit (ICU) among COVID-19 patients in DKI Jakarta. This cross sectional study utilize COVID-19 patients registry data owned by DKI Jakarta Provincial Health Office from March to June 2020. Inclusion criteria are aged 18 years old or older, confirmed by positive PCR swab test result, and hospitalized in DKI Jakarta. Exclusion criteria are patients with immunodeficiency condition (HIV, malignancy, in chemotherapy or radiation therapy). Data were analyzed in bivariate and multivariate analysis using multiple logistic regression by considering covariates (age, sex, working status, number of symptoms, and duration of symptoms). Among 12 699 patients, 6 359 were included. Approximately 623 (9,8%) had hypetension, 421 (6,62%) had diabetes mellitus, and 133 (2,09%) had COPD. Among them, 166 (2,61%) were admitted to ICU. After controlling for covariates, those comorbidities are independently increase risk of ICU admission. The highest risk are found among hypertension patients without diabetes melitus and had more than two symptoms OR 23,98 (95%CI 12,83-44,83) followed by hypertension patients with diabetes melitus and had more than two symptoms OR 16,53 (95%CI 8,76-31,17). COPD patients had risk OR 1,80 (95%CI 0,95-3,40) for ICU admission. In conclusion, hypertension, diabetes mellitus, and COPD increase risk of ICU admission among COVID-19 patients in DKI Jakarta.
The high cost of using insulin and increasing the prevalence of people with type 2 DM who use insulin can be a burden on hospitals and the government, for this reason it is necessary to have policies that will encourage the effectiveness and efficiency of treatment of type 2 DM patients. financing of type 2 DM patients in the hospital before and after insulin restriction. This research is an economic evaluation research with cross sectional design with a hospital perspective. Data were collected retrospectively from medical records, documents / receipts from hospital pharmaceutical installations, finance departments, laboratory sections and documents from the data management department. Subjects were outpatient type 2 DM patients with a total sample of 26 for the group before restriction and 31 for the group after restriction. The results of the study in the groups before and after the restriction for HbA1c decrease were 53.85% and 61.29% with an average decrease of 0.05 and 0.06. The average total cost of one type 2 DM patient per episode of outpatient treatment is Rp. 1,180,620 and Rp. 837,705, with a total average cost of medicine is Rp. 1,000,620 and Rp. 657,705. The group after the retrieval can be said to be more efficient in spending the cost of drug type 2 DM patients with a difference of Rp.342,915 per treatment episode
As of January 30 2020, the World Health Organization (WHO) deemed Covid-19 as a Public Health Emergency of International Concern (PHEIC) due to a significant increase of cases and confirmed cases in several countries (World Health Organization, 2020a). In April 2021, the mortality rate of COVID-19 in Indonesia reached 4.68%, which is higher than the global average mortality rate of 3.79%. Previous studies have shown that there is a relationship between hypertension and diabetes mellitus on the survival of Covid-19 patients. This study aims to determine the relationship between hypertension and diabetes mellitus on the survival of Covid-19 patients at RSJPD Harapan Kita Jakarta March 2020 - April 2021. This retrospective cohort study was conducted using cox regression analysis to determine survival. This study uses secondary data provided by the infection prevention and control division of Harapan Kita and medical record tracing. The study involved a total of 433 confirmed Covid-19 patients who were selected using random sampling technique. The results of the analysis show that hypertension and diabetes mellitus were significantly related to the incidence of death in Covid-19 patients at RSJPD Harapan Kita March 2020 - April 2021 after being controlled for confounding factor namely chronic lung disease with an adjusted hazard ratio of 1.727 (95% CI: 1.012 – 2.499), p-value 0.045. Proper triage of patients is needed, as well as rigorous monitoring and adequate treatment for Covid-19 patients who suffer from hypertension and diabetes mellitus to prevent further mortality and morbidity.
