Risk Factors for COVID-19 Mortality: Comorbidity Study
"Ministry of Health in Indonesia reported the first COVID-19 case in 2020. Elderly and comorbid individuals face higher risks. Diabetes Mellitus and Hypertension increase COVID-19 mortality. High-risk patients have increased ACE2 receptors, leading to severe outcomes. This study focuses on comorbidity and mortality patterns among confirmed COVID-19 cases in 2021. The analysis revealed 62% mortality rate among comorbid patients, with diabetes mellitus and hypertension being prevalent. Endothelial dysfunction and ACE2 enzyme play critical roles in COVID-19 complications."
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Presentation Transcript
WHO Ministry of Health Determines the occurrence of the COVID-19 PANDEMI on March 11, 2020 Health reported the first case of COVID 19 in Indonesia on March 2, 2020 2 people were confirmed
Ministry of Health Ministry of Health Covid 19 attacks all ages, and has different symptoms and levels of seriousness in each patient The elderly and people who have comorbidities are at high risk of COVID-19
Background cont Diabetes Mellitus and Hypertension comorbidity is one of the risk factors for coronavirus disease 2019 (COVID- 19) mortality. This study aimed to determined the comorbidity and mortality among COVID-19 convirmed cases during May to September, 2021.
Our process Increased endothelial vasoconstriction endothelial dysfunction make diabetic patients at high risk of endothelities vascular inflammation, associated lesions, Diabetic patients have an increase in ACE2 receptors in several tissues including the lungs, thereby increasing the SARS-CoV-2 viral load (Erener, 2020) and with ACE receptors are also expressed in the pancreas
Our process ACE2 enzymatically angiotensin (Ang) II to Ang (1-7) and Ang 1 to Ang (1-9) : CARDIOVARCULAR PROTECTING PEPTIDE( Nabila 2021) is able to convert Hypertensive number Converting Enzyme Type 2) (as SARS CoV2) (Rahayu L, 2021) patients ACE2 have an increased (Angiotensin of receptors Increased binding of SARS CoV2 to ACE2 results in ineffective vasodilators in COVID- 19 patients with comorbid (Alfhad et all, 2020) hypertension
Method The study was a retrospective cohort with secondary data from the COVID-19 with comorbidity in Hospital report from May to September, 2021, with a total sample of 89. We extracted demographic and clinical data, including hospital outcomes (discharge or death).
Result The result of the analysis showed of 89 patients with comorbidity, 62 % were died and 38 % were discharged. The most comorbidites were 67,4% diabetes mellitus, 33% hypertension. The Comorbidities, higher age, heavier weight, and d- dimer abnormality were significantly increased risk of mortality (p=0.000).
- 62% of patients with comorbidities died. This is due to comorbid factors Grippo's research (2020) - The high mortality rate in this study was related to age, body weight, and D-Dimer (p=0,000) Discussion
-38% respondents in this study had a younger age and normal d-dimer levels. Young people have not maximized cell mediated immunity . This is because corona-specific memory cells do not yet exist. so that the immune response to covid-19 is not too strong., (Ahmed, 2020) -D-dimer levels increase in COVID-19 patients due to endothelial dysfunction, (Sakka, et.al. 2019) Discussion
COVID-19 patients with comorbid DM have a mortality risk of 1.65 times higher (Albiltar, 2020) and even 22 times greater association (Choirunisa and Helda, 2021) Cases of death from confirmed COVID-19 patients in this study due to comorbid DM reached 67% and comorbid HT 33%. Discussion
Uncontrolled impaired immune response due to decreased mobilization of polymorphonuclear leukocytes, secretion and inhibition of TNF alpha on T cells.(Lestari, 2020) chronic hyperglycemic conditions result in chemotaxis, cytokine Discussion
Hypertension increases ACE2 as a regulator of reducing Angiotensin II to Angiotensin to reduce vasoconstriction and proliferative action. Homeostatic imbalance of blood results in high blood pressure Discussion
Dicussion cont ACE inhibitors and ARBs can also make it easier to get infected with SARS- CoV-2 because of increased expression ACE2 of these (Alfhad et all, 2020) the of drugs.
Conclusion We found that mortality was associated with comorbidity (pre- existing hypertention and diabetes), higher age, heavier weight and abnormal D-dimer
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