Clinical determinants of oxygen saturation and length of hospitalisation of COVID-19 patients: A cross-sectional study in Indonesia

Aims

Indonesia was one of the countries with the highest COVID-19 positive cases. Understanding the length of hospitalisation is critical for anticipating bed demand and resource allocation, such as oxygen. This study aims to examine the determinants of oxygen saturation and the length of hospitalisation in Hermina Mekarsari Hospital, West Java, Indonesia.

Methods

This cross-sectional study uses medical records from June to August 2021. The inclusion criteria were: COVID-19 patients aged between18 and 65, fully conscious, and not using mechanical ventilation. Participants who passed away during hospital stay were excluded. We used demographic information, laboratory data, and the clinician's assessments of the patients admitted to the hospital. Linear regression was performed for oxygen saturation on day seven, while logistic regression analysis was conducted to predict the length of hospital stay.

Results

In total, 371 participants with an average age of 47.2 (standard deviation 15.8) years were included. Most participants were female (57.7%) and smoking (78.4%). The results indicated that decreasing oxygen saturation was reported in vomiting patients (β = 1.63, p-value = .001), hypertensive patients (β 1.18 with, p-value = .034), and patients with the increased respiratory rate (β = 0.28, p-value = .000). In the logistic regression, we found that respondents who experienced dyspnoea, headache, fever, an increasing number of D-Dimer and blood glucose, and those with diabetes mellitus were more likely to stay more than 14 days.

Conclusions

Oxygen saturation was influenced by vomiting, hypertension, and increasing respiratory rate. Length of hospitalisation of more than 14 days was influenced by dyspnoea, headache, fever, increased number of D-Dimer, blood glucose, and diabetes mellitus. Identifying the determinants of oxygen saturation and length of stay can inform health professionals in designing a suitable intervention to reduce mortality and length of stay among COVID-19 patients in Indonesia.

Educational counselling of patients with combined TB and diabetes mellitus: a randomised trial

SETTING

Newly diagnosed pulmonary TB with diabetes mellitus (DM) comorbidity attending clinics in Bandung City, Indonesia.

OBJECTIVE

To describe the effect of educational counselling on patients' knowledge about TB (transmission, treatment, risk factors) and DM (symptoms, treatment, complications, healthy lifestyle), adherence to medication, and to assess characteristics associated with knowledge.

DESIGN

All patients received counselling and were then randomised to either structured education on TB-DM, combined with clinical monitoring and medication adjustment (intervention arm), or routine care (control arm). Knowledge and adherence were assessed using a questionnaire.

RESULTS

Baseline and 6-month questionnaires were available for 108 of 150 patients randomised (60/76 in the intervention arm and 48/74 in the control arm). Patients knew less about DM than about TB. There was no significant difference in the proportion with knowledge improvement at 6 months, both for TB (difference of differences 14%; P = 0.20) or for DM (10%; P = 0.39) between arms. Intervention arm patients were more likely to adhere to taking DM medication, with fewer patients reporting ever missing oral DM drugs than those in the control arm (23% vs. 48%; P = 0.03). Higher education level was associated with good knowledge of both TB and DM.

CONCLUSIONS

Structured education did not clearly improve patients' knowledge. It was associated with better adherence to DM medication, but this could not be attributed to education alone. More efforts are needed to improve patients' knowledge, especially regarding DM.