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IntroductionThe potential role of medical students in raising awareness during public health emergencies has been acknowledged. To further explore their potentials as public educators and role models for the communities during the coronavirus disease 2019 (COVID-19) pandemic, a study is conducted to assess the knowledge, attitude, and practice of these students toward COVID-19. MethodsAn online cross-sectional survey was conducted among undergraduate medical students in Indonesia. Socio-demographical characteristics, social interaction history, information-seeking behavior, as well as knowledge, attitude, and practice toward COVID-19 were collected through a self-reported questionnaire. A p-value of <0.05 indicated statistical significance. ResultsOut of 4870 respondents, 64.9% and 51.5% had positive attitude and practice toward COVID-19 while only 29.8% had adequate knowledge. Knowledge was slightly positively correlated with attitude and practice ({rho}=0.074 and {rho}=0.054, respectively; both p<0.001), while attitude was weakly correlated with practice ({rho}=0.234, p<0.001). Several factors including age, sex, place of residence, institution type, academic level, family income, history of chronic illness, prior volunteering experience, and perceptual awareness on COVID-19 were significantly associated with either knowledge, attitude, and/or practice toward COVID-19. Furthermore, health institutions and the governments press releases, as well as health expert opinions were deemed as the most reliable sources of COVID-19-related information - yet trivially none of these sources were associated with knowledge, attitude, and practice in the study population. ConclusionMany undergraduate medical students in Indonesia had positive attitude and practice against COVID-19, yet only a few had adequate knowledge. This warrants further interventions to keep them updated with COVID-19 evidence to maximize their potentials in raising public awareness on COVID-19.
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AimsTo investigate the prognostic value of admission blood glucose (BG) in predicting COVID-19 outcomes, including poor composite outcomes (mortality/severity), mortality, and severity. Materials and methodsEligible studies evaluating the prognostic value of fasting BG (FBG) and random BG (RBG) levels in predicting COVID-19 outcomes were included and assessed for risk of bias with the Quality in Prognosis Studies tool. Random-effects high-vs-low meta-analysis followed by dose-response analysis using generalized least squares model in a two-stage random-effects meta-analysis were conducted. Potential non-linear association was explored using restricted cubic splines and pooled using restricted maximum likelihood model in a multivariate meta-analysis. ResultsThe search yielded 35 studies involving a total of 14,502 patients. We discovered independent association between admission FBG and poor prognosis in COVID-19 patients. Furthermore, we demonstrated non-linear relationship between admission FBG and severity (Pnon-linearity<0.001), where each 1 mmol/L increase augmented the risk of COVID-19 severity by 33% (risk ratio 1.33 [95% CI: 1.26-1.40]). Albeit exhibiting similar trends, study scarcity limited the strength of evidence on the independent prognostic value of admission RBG. GRADE assessment yielded high-quality evidence for the association between admission FBG and COVID-19 severity, and moderate-quality evidence for its association with mortality and poor outcomes, while the other assessments yielded very low-to-low quality. ConclusionHigh level of FBG at admission was independently associated with poor prognosis in COVID-19 patients. Further researches to confirm the observed prognostic value of admission RBG and to ascertain the estimated dose-response risk between admission FBG and on COVID-19 severity are required.
