Author
Sherly Lawrensia
Bio: Sherly Lawrensia is an academic researcher from Atma Jaya Catholic University of Indonesia. The author has contributed to research in topics: Disease & Medicine. The author has an hindex of 6, co-authored 12 publications receiving 163 citations.
Topics: Disease, Medicine, Type 2 diabetes, Diabetes mellitus, Meta-analysis
Papers
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TL;DR: CCI score should be utilized for risk stratifications of hospitalized COVID-19 patients and is prognostically associated with mortality and associated with a composite of poor outcomes.
Abstract: Background and aims The ongoing COVID-19 pandemic is disproportionately affecting patients with comorbidities. Therefore, thorough comorbidities assessment can help establish risk stratification of patients with COVID-19, upon hospital admission. Charlson Comorbidity Index (CCI) is a validated, simple, and readily applicable method of estimating the risk of death from comorbid disease and has been widely used as a predictor of long-term prognosis and survival. Methods We performed a systematic review and meta-analysis of CCI score and a composite of poor outcomes through several databases. Results Compared to a CCI score of 0, a CCI score of 1–2 and CCI score of ≥3 was prognostically associated with mortality and associated with a composite of poor outcomes. Per point increase of CCI score also increased mortality risk by 16%. Moreover, a higher mean CCI score also significantly associated with mortality and disease severity. Conclusion CCI score should be utilized for risk stratifications of hospitalized COVID-19 patients.
160 citations
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TL;DR: In this paper, the authors performed a systematic literature search from several electronic databases up until 8 September 2020 and reported that increase in CFS was associated with increase in mortality in a linear fashion, and the potential for a nonlinear relationship based on ORs of each quantitative clinical frailty scale was examined using restricted cubic splines with a three-knots model.
123 citations
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TL;DR: Preliminary findings showed that mortality was lowered in those who consume metformin vs who did not, and given its low cost and widespread availability, met formin is an attractive and potential regimen for mitigating excessive risk in diabetic populations.
Abstract: Background and aims Diabetes is one of the most common comorbidities, and it is associated with poorer outcomes in patients with coronavirus disease 2019 (COVID-19). Preliminary findings showed that mortality was reduced in those who consume metformin compared to those who did not, and given its low cost and widespread availability; metformin is an attractive and potential agent to mitigate excessive risk in diabetic populations. Methods Several medical databases (Pubmed, EuropePMC, EBSCOhost, Proquest, Cochrane library) and two health-science preprint servers ( preprint.org and Medrxiv) were systematically searched for relevant literature. Results Nine studies with 10,233 subjects were included in the qualitative and quantitative synthesis. Meta-analysis showed that metformin is associated with lower mortality in pooled non-adjusted model (OR 0.45 [0.25, 0.81], p = 0.008; I2: 63.9%, p = 0.026) and pooled adjusted model (OR 0.64 [0.43, 0.97], p = 0.035; I2: 52.1%, p = 0.064). Conclusion The analysis showed that metformin consumption was associated with lower mortality. Randomized controlled trials are needed to confirm this finding.
69 citations
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TL;DR: In this paper, the authors proposed that patients with type 1 or type 2 diabetes should be prioritized for vaccination, since they are a high-risk population, and the prevalence of non-communicable diseases is expected to rise due to lifestyle changes and medical issues encountered during the pandemic.
Abstract: Diabetes, one of the most prevalent chronic diseases in the world, is strongly associated with a poor prognosis in COVID-19. Scrupulous blood sugar management is crucial, since the worse outcomes are closely associated with higher blood sugar levels in COVID-19 infection. Although recent observational studies showed that insulin was associated with mortality, it should not deter insulin use in hospitalized patients requiring tight glucose control. Back and forth dilemma in the past with regards to continue/discontinue certain medications used in diabetes have been mostly resolved. The initial fears of consequences related to continuing certain medications have been largely dispelled. COVID-19 also necessitates the transformation in diabetes care through the integration of technologies. Recent advances in health-related technologies, notably telemedicine and remote continuous glucose monitoring, have become essential in the management of diabetes during the pandemic. Today, these technologies have changed the landscape of medicine and become more important than ever. Being a high-risk population, patients with type 1 or type 2 diabetes, should be prioritized for vaccination. In the future, as the pandemic fades, the prevalence of non-communicable diseases is expected to rise due to lifestyle changes and medical issues/dilemma encountered during the pandemic.
42 citations
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13 Jul 2020TL;DR: The importance of knowing similar clinical presentations of both coronavirus diseases and why excluding COVID-19 in the differentials in the setting of a pandemic is imprudent are emphasized.
Abstract: At the beginning of 2020, the national health system and medical communities are faced with unprecedented public health challenges. A novel strain of coronavirus, later identified as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread globally, marking another pandemic of coronaviruses. This viral disease is responsible for devastating pneumonia, named coronavirus disease of 2019 (COVID-19), and projected to persist until the end of the year. In tropical countries, however, concerns arise regarding the similarities of COVID-19 with other infectious diseases due to the same chief complaint, which is fever. One of the infectious disease of a primary concern is dengue infection, which its peak season is approaching. Others report that there are cases of serological cross-reaction of COVID-19 and dengue infection. In this comprehensive review, we underscore the importance of knowing similar clinical presentations of both diseases and emphasize why excluding COVID-19 in the differentials in the setting of a pandemic is imprudent.
35 citations
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01 Jan 2020
TL;DR: Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future.
Abstract: Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.
4,408 citations
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TL;DR: In this paper, the authors performed a systematic literature search from several electronic databases up until 8 September 2020 and reported that increase in CFS was associated with increase in mortality in a linear fashion, and the potential for a nonlinear relationship based on ORs of each quantitative clinical frailty scale was examined using restricted cubic splines with a three-knots model.
123 citations
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TL;DR: This study reported three cases of suspected COVID-19-dengue co-infection in hospitals of Bali, Indonesia and revealed possible cross-reactivity between SARS-CoV-2 and DENV antibodies based on rapid serological tests.
87 citations
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01 Aug 2021TL;DR: In this paper, the authors explore how age-related damage and decline in repair result in cellular and molecular deficits that scale up to tissue, organ and system levels, where they are jointly expressed as frailty.
Abstract: Frailty is a multiply determined, age-related state of increased risk for adverse health outcomes. We review how the degree of frailty conditions the development of late-life diseases and modifies their expression. The risks for frailty range from subcellular damage to social determinants. These risks are often synergistic—circumstances that favor damage also make repair less likely. We explore how age-related damage and decline in repair result in cellular and molecular deficits that scale up to tissue, organ and system levels, where they are jointly expressed as frailty. The degree of frailty can help to explain the distinction between carrying damage and expressing its usual clinical manifestations. Studying people—and animals—who live with frailty, including them in clinical trials and measuring the impact of the degree of frailty are ways to better understand the diseases of old age and to establish best practices for the care of older adults. Rockwood and colleagues discuss how measuring the degree of frailty helps us understand how aging gives rise to the diseases of aging, and aids translation from comprehensive geriatric assessment and individual care plans to geroscience and back.
68 citations