Acute kidney injury (AKI) is associated with a worse prognosis in coronavirus disease 2019 (COVID-19) patients. Identification of AKI, particularly in COVID-19 patients, is important for improving patients’ management. The study aims to assess risk factors and comorbidities of AKI in COVID-19 patients. We systematically searched PubMed and DOAJ databases for relevant studies involving confirmed COVID-19 patients with data on risk factors and comorbidities of AKI. The risk factors and comorbidities were compared between AKI and non-AKI patients. A total of 30 studies involving 22385 confirmed COVID-19 patients were included. Male (OR: 1.74 (1.47, 2.05)), diabetes (OR: 1.65 (1.54, 1.76)), hypertension (OR: 1.82 (1.12, 2.95)), ischemic cardiac disease (OR: 1.70 (1.48, 1.95)), heart failure (OR: 2.29 (2.01, 2.59)), chronic kidney disease (CKD) (OR: 3.24 (2.20, 4.79)), chronic obstructive pulmonary disease (COPD) (OR: 1.86 (1.35, 2.57)), peripheral vascular disease (OR: 2.34 (1.20, 4.56)), and history of nonsteroidal anti-inflammatory drugs (NSAID) (OR: 1.59 (1.29, 1.98)) were independent risk factors associated with COVID-19 patients with AKI. Patients with AKI presented with proteinuria (OR: 3.31 (2.59, 4.23)), hematuria (OR: 3.25 (2.59, 4.08)), and invasive mechanical ventilation (OR: 13.88 (8.23, 23.40)). For COVID-19 patients, male gender, diabetes, hypertension, ischemic cardiac disease, heart failure, CKD, COPD, peripheral vascular disease, and history of use of NSAIDs are associated with a higher risk of AKI.

Introduction: Diabetes mellitus is a degenerative disease characterized by chronic hyperglycemia conditions in the body. Various complications of diabetes mellitus are caused by oxidative stress condition. Petiveria alliacea (P. alliacea) is a potential plant and easy to grow in hot regions. Leaf extracts of P. alliacea contain flavonoids and tannins which work as antidiabetic and antioxidant. In addition, other compounds found in P. alliacea leaf extracts like linoleic acid and allantoin show an increase in insulin secretion. Therefore, this study aimed to determine the antidiabetic activity of ethanolic extract of P. alliacea. Methods: We investigated the hypoglycemic and antioxidant effect of P. alliacea on STZ-induced diabetic rats. Rats were randomly divided into six groups named normal control, diabetes control, metformin (150 mg/kg/d), low dose of P. alliacea (90 mg/kg/d), intermediate dose (180 mg/kg/d), and high dose (360 mg/kg/d). Rats were orally given the treatment daily in the morning for fourteen days. At the end of the study, blood glucose level was measured and rats were sacrificed to measure blood malondialdehyde level.malondialdehydeResults: P. alliacea extract dose of 90 mg/kg and 360 mg/kg, and also metformin significantly decrease blood glucose levels. P. alliacea extract dose of 360 mg/kg was able to lower blood malondialdehyde level significantly which were not obtained on metformin. Conclusion: This finding suggests that ethanolic extract of P. alliacea possess antidiabetic effect at least on rats.

Excessive release of interleukin-6 (IL-6) during the progression of coronavirus disease 2019 (COVID-19) induces cytokine storms, resulting in multi-organ damages including liver injury, similar in nature with mechanism of viral hepatitis. Systemic IL-6 has been associated with the incidence of liver injury among COVID-19 patients; however, studies on IL-6 expression in the liver tissue are completely lacking. The aim of this study was to measure the IL-6 expression in the liver tissues and to determine its correlation with the degree of liver injury in fatal COVID-19 patients. Through this first cross-sectional study, IL-6 expression was measured through immunohistochemical staining and the degree of liver injury was identified based on level of serum alanine aminotransferase (ALT). The Spearman correlation test was used to identify the correlation between IL-6 expression and the degree of liver injury. A total of 47 deceased COVID-19 patients were included and IL-6 expression was observed in all post-mortem liver specimens, ranging from mild to strong expression. Liver injury at various degrees (mild to severe) was found in more than half (59.5%) of the cases. The Spearman correlation analysis suggested a statistically insignificant correlation between liver IL-6 expression and the degree of liver injury (r=0.152; p=0.309). In conclusion, even IL-6 expression was observed in all post-mortem liver specimens, there was an insignificant correlation between IL-6 expression in the liver tissue with the degree of liver injury among fatal COVID-19 patients, suggesting that IL-6 was not the only main factor contributing to liver damage in COVID-19 patients.

COVID-19 pneumonia is a communicable disease with no definite therapy. Therapeutic recommendations are still evolving based on ongoing studies and clinical trials. Patients with comorbidities, such as obesity and diabetes, are at risk for developing more severe diseases with higher mortality rates. A number of antivirals, such as oseltamivir, favipiravir, and remdesivir, have been proposed as a treatment for COVID-19, especially in severe diseases. However, the World Health Organization (WHO) initially does not recommend any antiviral therapy.

Small intestinal bacterial overgrowth (SIBO) is a condition that is characterized by an increased number of bacteria in the small intestine or an existence of bacteria type that generally should not be in the small intestine. In SIBO, the number of bacteria found in culture was more than 10⁵ CFU (Colony-Forming unit) per ml. The fundamental problem in which SIBO occurred was the disruption in defensive mechanisms to prevent bacteria from overgrowing, including gastric acid juice, intestine motility, competent immune function, and intact anatomy. Disruption of this defensive mechanism will lead to SIBO, which furthermore will result in not only mild complications, such as abdominal complaints, but also severe complications, such as maldigestion/malabsorption, nutrient deficiency, or even systemic infection and acidosis. The manifestations of SIBO were often unclear so that it is hard to distinguish with other diseases, which much lead to misdiagnosis or underdiagnosis. Diagnosis of SIBO should be conducted very meticulously regarding underlying diseases that resulted in gastrointestinal defensive mechanism disturbance and malassimilation syndrome. Additional examinations for SIBO currently were jejunal aspiration and breath test, but both of them had their limitations in sensitivity and specificity. Therapeutical management consisted of treating the underlying diseases, eradicating bacteria with the antibiotic, particularly rifaximin, and improving nutritional deficiency.

Background: Malignancy is the most common cause of non-inflammatory pericardial effusion that is usually neglected. Metastatic involvement of the pericardium is reflecting the advanced stage of the disease and generally associated with poor outcomes.