ABSTRACT
Background: Diabetic ketoacidosis (DKA) is an acute life-threatening complication of diabetes mellitus. This study aimed to evaluate the clinical characteristics and the burden of DKA cases during the period of the COVID-19 outbreak in Ethiopia. Methods: An institutional-based retrospective chart review study was conducted. 178 randomly selected patients’ medical charts were included. Data were collected from medical records in the period between October 2020 to July 2022. To investigate the association between the dependent and independent variable, binary and multivariable logistic regression were done with statistically significant at P ≤0.05. Results: A total of 178 medical records were reviewed. The mean (±SD) age of the patients was 41.3 (±13.2) years and 45% of patients had type 2 diabetes. Acute diabetic complications were documented in 25.8% of patients where DKA was the commonest (16.3%). Nearly half of the DKA patients (n=13, 44.8%) were presented with poly-symptoms at the time of diagnosis. Furthermore, missing drug (31%) was the most frequent precipitating factor followed by community-acquired pneumonia (21%), and multiple factors (17%). Besides, patients in the DKA group had a higher mean length of hospital stay (3 days versus 2.6 days). Conclusion: The poly-symptoms were the common clinical features of DKA at the time of presentation. Pneumonia and a history of missing drugs were identified as leading precipitating factors of DKA. Even though the DKA complication is low in this research, diabetes health education at the community and institutional level, routine screening for diabetes at health centers, and treating the infections early are strongly recommended.
Subject(s)
Diabetic Ketoacidosis , Diabetes Mellitus, Type 2 , Pneumonia , Diabetes Mellitus , COVID-19ABSTRACT
Background: COVID-19 is a viral infection spreading at a great speed and has quickly caused an extensive burden to individuals, families, countries, and the world. No intervention has yet been proven highly effective for the treatment of COVID-19. Different drugs were being evaluated and reported through randomized clinical trials, and more are currently under trial. This review aimed to compare the efficacy of anti-infectious drugs with a comparator of the standard of care or placebo in patients with COVID-19.Methods: Two independent review authors will extract data and assess a risk of bias using RoB2. Randomized controlled trials (RCT) that evaluate single and/or combined antiviral drugs recommended by WHO latest guideline for the treatment of COVID-19 will be included. We will search for Pub Med, the Cochrane Center for Clinical Trial database (CENTRAL), clinicaltrials.gov, etc. databases for articles published in the English language between December 2019 to April 2021. We will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) involving Network Meta-analysis guidelines to design and report of the results. The primary endpoints will be time to clinical recovery and time to RNA negativity. The certainty of evidence will be evaluated using the GRADE extension of NMA. Data analysis will be performed using the frequentist NMA approach with the netmeta package implemented in R.Discussion: This review will reveal the best antiviral drug treatment for covid-19 and show the hierarchy of those drugs.Systematic review registration: The protocol was registered on PROSPERO with ID number CRD42021230919
Subject(s)
COVID-19ABSTRACT
ABSTRACT Background COVID-19 is a viral infection spreading at a great speed and has quickly caused an extensive burden to individuals, families, countries, and the world. No intervention has yet been proven highly effective for the treatment of COVID-19. Different drugs were being evaluated and reported through randomized clinical trials, and more are currently under trial. This review aimed to compare the efficacy of anti-infectious drugs with a comparator of the standard of care or placebo in patients with COVID-19. Methods and analysis Two independent review authors will extract data and assess a risk of bias using RoB2. Randomized controlled trials (RCT) that evaluate single and/or combined antiviral drugs recommended by WHO latest guideline for the treatment of COVID-19 will be included. We will search for Pub Med, the Cochrane Center for Clinical Trial database (CENTRAL), clinicaltrials.gov, etc. databases for articles published in the English language between December 2019 to April 2021. We will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) involving Network Meta-analysis guidelines for the design and reporting of the results. The primary endpoints will be time to clinical recovery and time to RNA negativity. The certainty of evidence will be evaluated using the GRADE extension of NMA. Data analysis will be performed using the frequentist NMA approach with netmeta package implemented in R. Ethics and dissemination There are no ethical considerations associated with this study as we will use publicly available data from previously published studies. We plan to publish results in open access peer-reviewed journals. PROSPERO registration number ID=CRD42021230919. Strengths and limitations of this study This will be the first systematic review and network meta-analysis to assess the efficacy specific to anti-infectious drugs category for for mild to severe patients of COVID-19. Its compliance with the Preferred Reporting Items for Systematic Review and Meta-Analysis for Protocols (PRISMA-P) involving network meta-analysis(NMA) will ensure the quality of reporting. Doing both pairwise meta-analysis and network meta-analysis (NMA) can comprehensively analyse direct and indirect comparison results of different anti-infectious drugs for COVID 19 will give more reliable conclusions aswell as the rank of those drugs. There is risk of heterogeneity and inconsistency, given the different anti-infectious drugs that will be included; however, we try to control intransitivity by carefully identifying the eligibility criteria depending on PICOS strategy and assess inconsistency using local as well as global approaches. The limitation of this study is it will not explore the economic benefits of these drugs.