ABSTRACT
Background: The COVID-19 vaccine has become the utmost protection against the pandemic, with billions of doses has been used across the globe. Immunosuppression has been one of the leading issues in the vaccination program, one of which should not be handled lightly is the use of the steroid. Thus, this systematic review is aimed to explore the Impact of steroid use on the efficacy and safety of the COVID-19 vaccine. Methods: The systematic review is conducted based on the PRISMA guideline by conducting a literature search and screening process through several databases (PubMed, ScienceDirect, Scopus, and EBSCOHost) based on the predetermined PICO criteria. Original articles (Controlled trial or cohort) on the use of steroids in healthy or non-immunocompromised or autoimmune patients were included. The included articles were then assessed for risk of bias using the ROBINS-I tool. Results: 6,857 articles were screened, with two articles included for the final analysis. The results show a non-significant Impact of steroid use on the vaccine efficacy based on seropositivity and antibody count. However, steroid use is related to milder adverse effects and symptoms. Conclusion: Steroid is not associated with lower response to the COVID-19 vaccine. Further research on the dose-dependent response to steroid use should be conducted. © 2023, Sanglah General Hospital. All rights reserved.
ABSTRACT
SARS-CoV-2 was found in Wuhan, China and has become a global pandemic until now. To achieve control of COVID-19, we need accurate and rapid diagnostic tests. There are two kinds of diagnostic: molecular tests to detect viral RNA and serological tests to detect anti-SARSCoV-2 immunoglobulins. Serological tests become an alternative or a complement to RT-PCR as it might be cheaper and easier. Combining IgM and IgG detection resulted in higher sensitivity than detecting either isotype alone. However, the tests have some limitations to measure IgM or IgG antibodies. Therefore, using merely such tests to diagnose COVID-19 will miss any infections. Consequently, the diagnosis or screening for COVID-19 using antibody test needs to be evaluated. We aim to decrease the risk of false-negative or false-positive in the tests. © 2021 UPM Press. All rights reserved.
ABSTRACT
A brand new virus that is known as Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is the cause of this new disease called Coronavirus Disease 2019 (COVID-19). This new disease may lead to severe illnesses and eventually become fatal due to many complications related to cytokine storms. Cytokine storm could be described as pro-inflammatory cytokine response that is not controlled due to infection and other stimuli. The increase in cytokine levels can cause multiple organ systems damages. To protect the patient from tissue damage caused by the pro-inflammatory cytokine, a balanced immune response is needed. Many efforts have been tested to manipulate or prevent the cytokine storm. One of the potential targets is IL-10. IL-10 is a key role cytokine. The information regarding IL-10 that is currently available will be reviewed in this article, its role in the cytokine storm, and its potential as a curative agent in COVID-19. © 2021 UPM Press. All rights reserved.
ABSTRACT
COVID-19 continues to become a global threat. The development of COVID-19 vaccine has a potential to induce long-lasting cellular and humoral immunity and ending this pandemic. Currently, there are 213 vaccines in development, with 66 in clinical trials and 9 in phase III. In one hand the vaccines are developed using novel vaccine platforms including DNA and mRNA based, antigen-presenting cell, viral vector, protein or peptide-based, inactivated virus, and live attenuated virus platform. Each of these platforms has its own strength and weakness;however, they generally enable the vaccine to be developed safely, more quickly, and easier to upscale. In the other hand, the demand for COVID-19 vaccine has led to the development of vaccine being fast-tracked. Concerns are being raised for the efficacy, safety, equitability, and acceptance of these vaccines. Many are worried about the possibility of antibody-dependent enhancement that may worsen the recipient’s condition. Vaccine design therefore should take into account previous experience with vaccine-associated disease enhancement. Researchers should adhere to stringent standards of safety and efficacy when conducting vaccine’s clinical trials. Accelerated trials should also adhere to the Declaration of Helsinki for the ethics of medical research. Global partnership for vaccine development and equitable distribution is also needed to prevent resurgences of cases. Finally, there is a need to combat misinformation and distrust of COVID-19 vaccine in the eye of the general public. © 2020, Yerevan State Medical University. All rights reserved.
ABSTRACT
Background: The unpredictability of the progression of coronavirus disease 2019 (COVID-19) may be attributed to the low precision of the tools used to predict the prognosis of this disease. Objective: To identify the predictors associated with poor clinical outcomes in patients with COVID-19. Methods: Relevant articles from PubMed, Embase, Cochrane, and Web of Science were searched and extracted as of April 5, 2020. Data of interest were collected and evaluated for their compatibility for the meta-analysis. Cumulative calculations to determine the correlation and effect estimates were performed using the Z test. Results: In total, 19 papers recording 1,934 mild and 1,644 severe cases of COVID-19 were included. Based on the initial evaluation, 62 potential risk factors were identified for the meta-analysis. Several comorbidities, including chronic respiratory disease, cardiovascular disease, diabetes mellitus, and hypertension were observed more frequent among patients with severe COVID-19 than with the mild ones. Compared to the mild form, severe COVID-19 was associated with symptoms such as dyspnea, anorexia, fatigue, increased respiratory rate, and high systolic blood pressure. Lower levels of lymphocytes and hemoglobin;elevated levels of leukocytes, aspartate aminotransferase, alanine aminotransferase, blood creatinine, blood urea nitrogen, high-sensitivity troponin, creatine kinase, high-sensitivity C-reactive protein, interleukin 6, D-dimer, ferritin, lactate dehydrogenase, and procalcitonin;and a high erythrocyte sedimentation rate were also associated with severe COVID-19. Conclusion: More than 30 risk factors are associated with a higher risk of severe COVID-19. These may serve as useful baseline parameters in the development of prediction tools for COVID-19 prognosis.