Background: Coronavirus disease-2019 (COVID-19) is a global pandemic and high mortality rate among severe or critical COVID-19 is linked with SARS-CoV-2 infection-induced hyperinflammation of the innate and adaptive immune systems and the resulting cytokine storm. This paper attempts to conduct a systematic review and metaanalysis of published articles, to evaluate the association of inflammatory parameters with the severity and mortality in COVID-19 patients. Methods: A comprehensive systematic literature search of medical electronic databases including Pubmed/ Medline, Europe PMC, and Google Scholar was performed for relevant data published from January 1, 2020 to June 26, 2020. Observational studies reporting clear extractable data on inflammatory parameters in laboratoryconfirmed COVID-19 patients were included. Screening of articles, data extraction and quality assessment were carried out by two authors independently. Standardized mean difference (SMD)/mean difference (MD/WMD) and 95% confidence intervals (CIs) were calculated using random or fixed-effects models. Results: A total of 83 studies were included in the meta-analysis. Of which, 54 studies were grouped by severity, 25 studies were grouped by mortality, and 04 studies were grouped by both severity and mortality. Random effect model results demonstrated that patients with severe COVID-19 group had significantly higher levels of Creactive protein (CRP), erythrocyte sedimentation rate (ESR), procalcitonin (PCT), interleukin-6 (IL-6), interleukin-10 (IL-10), interleukin-2R (IL-2R), serum amyloid A (SAA) and neutrophil-to-lymphocyte ratio (NLR) compared to those in the non-severe group. Similarly, the fixed-effect model revealed significant higher ferritin level in the severe group when compared with the non-severe group. Furthermore, the random effect model results demonstrated that the non-survivor group had significantly higher levels of CRP, PCT, IL-6, ferritin, and NLR when compared with the survivor group. Conclusion:In conclusion, the measurement of these inflammatory parameters could help the physicians to rapidly identify severe COVID-19 patients, hence facilitating the early initiation of effective treatment. Prospero registration number: CRD42020193169.

Background Coronavirus disease-2019 (COVID-19) is now becoming a global threat. Studies reported dyslipidemia in patients with COVID-19. Herein, we conducted a systematic review and meta-analysis of published articles to evaluate the association of lipid profile with the severity and mortality in COVID-19 patients. Methods PubMed/Medline, Europe PMC, and Google Scholar were searched for studies published between January 1, 2020 and January 13, 2021. Random or Fixed effects models were used to calculate the mean difference (MD) and 95% confidence intervals (CIs). Statistical heterogeneity was assessed using Cochran’s Q test and I 2 statistics. Results This meta-analysis included 19 studies. Of which, 12 studies were categorized by severity, 04 studies by mortality, and 03 studies by both severity and mortality. Our findings revealed significantly decreased levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) in the severe group when compared with the non-severe group in a random effect model. Similarly, random effect model results demonstrated significantly lower levels of HDL-C and LDL-C in the non-survivor group when compared with the survivor group. The level of TC was also found to be decreased in the non-survivor group when compared to the survivor group in a fixed-effect model. Conclusion In conclusion, lipid profile is associated with both the severity and mortality in COVID-19 patients. Hence, a lipid profile may be used for assessing the severity and prognosis of COVID-19. PROSPERO registration Number CRD42021216316 .

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Prediabetes is the precursor stage of diabetes mellitus and is also considered to be a risk factor for the development of cardiovascular disease. Atherogenic indices have been used for assessment of risk for cardiovascular disease development. To date, there is no data on evaluating the relationship between atherogenic indices (cardiac risk ratio (CRR), atherogenic coefficient (AC), and atherogenic index of plasma (AIP)) and carotid intima-media thickness (CIMT) in prediabetes. Hence, we aimed to determine atherogenic indices (CRR, AC, and AIP) and CIMT in prediabetic subjects and then sought to evaluate the relationship between them. A total of 400 human subjects were included in the present study, out of which 200 were prediabetic subjects and 200 were normal healthy control subjects. For each subject, CRR, AC, and AIP were calculated from routine lipid parameters and carotid intima-media thickness was measured as well. Atherogenic indices, that is, CRR, AC, and AIP, were significantly increased in prediabetic subjects as compared to the controls (5.87 ± 0.87 vs. 4.23 ± 0.50, p < 0.001; 4.87 ± 0.87 vs. 3.23 ± 0.50, p < 0.001; and 0.29 ± 0.07 vs. 0.09 ± 0.09, p < 0.001, respectively). Moreover, a significant and positive correlation was observed between CIMT and AIP (r = 0.529, p < 0.01), CRR (r = 0.495, p < 0.01), and AC (r = 0.495, p < 0.01). Prediabetic subjects present abnormalities in atherogenic indices and CIMT, which indicate a greater propensity of prediabetes for the development of cardiovascular disease. Hence, atherogenic indices can be used in addition to routine lipid parameters for the better assessment of subclinical atherosclerosis in prediabetic subjects.

Cardiac markers are used to evaluate functions of heart. However, there are no satisfactory cardiac biomarkers for the diagnosis of acute myocardial infarction (AMI) within 4 h of onset of chest pain. Among novel cardiac markers, glycogen phosphorylase BB (GPBB) is of particular interest as it is increased in the early hours after AMI. The present study was conducted with the objective to find out the sensitivity and specificity of GPBB over other cardiac markers i.e. myoglobin and CKMB in patients of AMI within 4 h after the onset of chest pain. The study includes 100 AMI patients and 100 normal healthy individuals as controls. In all the cases and controls, serum GPBB and myoglobin concentrations were measured by ELISA where as CK-MB was measured by diagnostic kit supplied by ERBA. The sensitivity and specificity of glycogen phosphorylase BB (GPBB) were greater than CK-MB and myoglobin in patients of AMI within 4 h after the onset of chest pain. Hence, glycogen phosphorylase BB (GPBB) can be used as additional biomarker for the early diagnosis of AMI.

Background: Hypothyroidism is a clinical entity resulting from a deficiency of thyroid hormones or, more rarely, from their impaired activity at the tissue level. Several mineral and trace elements are essential for normal thyroid hormone metabolism and co-existing deficiencies of these elements can impair thyroid function. The present study was conducted with the aim to find out the concentrations of zinc and copper in hypothyroidism and to determine the possible correlations between trace elements and thyroid hormones. Material and Methods:Our study included 40 patients with hypothyroidism and 40 normal control subjects. In all the subjects, T3, T4, and TSH were measured by ELISA whereas trace elements zinc and copper were measured colorimetrically.Results: Both zinc and copper were significantly reduced in patients of hypothyroidism as compared to controls (57.05±7.54 µg/dl vs. 98.02±7.77 µg/dl, p<0.001 and 73.86±6.22 µg/dl vs. 114.97±18.18 µg/dl, p<0.001, respectively). Zinc was significantly and positively correlated with T3 (r=0.326; p<0.05) in hypothyroidism patients but there was no significant correlation of zinc with rest of the hormones i.e, T4 (r=0.078; p>0.05) and TSH (r=-0.026; p>0.05) levels. With regard to copper, we did not find any significant correlation of copper with T3 (r=0.076; p>0.05), T4 (r=0.171; p>0.05) and TSH (r=0.167; p>0.05). Conclusion:In conclusion, hypothyroid patients had significantly decreased concentration of zinc and copper. Hence, diet rich in trace elements, viz. zinc and copper should be supplied to patients of hypothyroidism in order to maintain normal thyroid hormone function.

Background: Psoriasis is a common recurrent disease of skin characterised by excessive cell proliferation and incomplete differentiation in lesional epidermis. Aim: The present study was aimed to determine lipid parameters and paraoxonase activity in psoriatic patients. Methods: The study included 100 subjects of age group 30-60 years, out of which 50 were patients of psoriasis (Case group) and rest 50 were normal healthy individuals of same age group (Control group). Result: Our study showed significant increase (p<0.001) in the levels of Cholesterol, Triglyceride, LDL and VLDL in patients of psoriasis as compared to control group. Also, we found significant decreased levels of serum HDL and PON-1 in psoriatic patients as compared to control group. Conclusion: Our study concludes that altered lipid profile and paraoxonase may be responsible for the higher prevalence of systemic complication such as metabolic and cardiovascular diseases.