ABSTRACT
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the coronavirus disease 2019 (COVID-19) pandemic that has strained health care systems worldwide and resulted in high mortality. The current COVID-19 treatment is based on supportive and symptomatic care. Therefore, convalescent plasma (CP), which provides passive immunization against many infectious diseases, has been studied for COVID-19 management. To date, a large number of randomized and non-randomized clinical trials as well as many systematic reviews have revealed conflicting results. This article summarizes the basic principles of passive immunization, particularly addressing CP in COVID-19. It also evaluates the effectiveness of CP as a therapy in patients with COVID-19, clinical trial reports and systematic reviews, regulatory considerations and different protocols that are authorized in different countries to use it safely and effectively.An advanced search was carried out in major databases (PubMed, Cochrane Library, and MEDLINE) and Google Scholar using the following key words: SARS-CoV-2, COVID-19, convalescent plasma, and the applied query was “convalescent plasma” AND “COVID-19 OR SARS-CoV-2”. The results were filtered and duplicate data were removed.Collective evidence indicates that two cardinal players determine the effectiveness of CP use, time of infusion, and quality of CP. Early administration of CP with high neutralizing anti-spike IgG titer is hypothesized to be effective in improving clinical outcome, prevent progression, decrease the length of hospital stay, and reduce mortality. However, more reliable, high quality, well-controlled, double-blinded, randomized, international and multicenter collaborative trials are still needed.
ABSTRACT
There is accumulating evidence that leptin has a pleiotropic role in hematopoiesis, immune response, fibro-genesis, and hepatocarcinogenesis. The aim of this study was to determine the correlation between leptin levels and bone mineral density in HCV chronic liver disease patients. A medical history to retrieve information about health status, current medications and history of viral or toxic hepatitis; a physical examinations including height and weight; a fasting blood draw for the determination of liver profile and leptin. BMD values were measured by dual-energy X-ray absorptiometry [DEXA] at the L2-L4 lumbar spine and femoral neck. Fasting leptin was highly increased in HCV CLD patients with osteopenia than HCV CLD patients with normal hone mineral density [p<0.05]. Leptin showed a significant negative correlation with bone mineral density [BMD] in HCV CLD patients [r=-0.191, p=0.039] and significant positive correlation with age [r=0.331, p=0.041]. Serum concentrations of leptin is positively correlated in chronic liver disease patients with age and negatively correlated with BMD especially in patients with hepatitis C infection