The association between therapeutic plasma exchange and the risk of mortality among patients critically ill with COVID-19: a meta-analysis [version 1; peer review: 2 approved, 2 approved with reservations]

Background: Cytokine storm has been widely known to contribute to the development of the critical condition in patients with coronavirus disease 2019 (COVID-19), and studies had been conducted to assess the potential aspect of cytokine storm elimination by performing therapeutic plasma exchange (TPE). However, contradictory findings were observed. The objective of this study was to assess the association between TPE and the reduction of mortality of critically ill COVID-19 patients. Methods: A meta-analysis was conducted by collecting data from PubMed, Scopus, and Web of Science. Data on the mortality rate of critically ill COVID-19 patients treated with TPE plus standard of care and that of patients treated with standard of care alone were analyzed using a Z test. Results: We included a total of four papers assessing the association between TPE and the risk of mortality among critically ill COVID-19 patients. Our findings suggested that critically ill COVID-19 patients treated with TPE had lower risk of mortality compared to those without TPE treatment. Conclusion: Our study has identified the potential benefits of TPE in reducing the risk of mortality among critically ill COVID-19 patients

ATHEROVAX : Vaksin Atherosklerosis Menggunakan Heat – Killed Salmonella Typhimurium

Atherosklerosis adalah penyakit inflamasi kronik terhadap deposisi materi lemak pada dinding arteri. Penggunaan vaksinasi dalam pencegahan atherosklerosis merupakan hal yang potensial untuk dikembangkan. Salmonella Typhimurium dapat menyintesa phosphorylcholine (PC) yang juga terdapat pada oxidized low densitylipoprotein (oxLDL). Pemberian vaksin S. Typhimurium dimungkinkan dapat menginduksi antibodi yang protektif terhadap atherosklerosis. Tujuan penelitian ini untuk mengetahui efek pemberian bakteri S. Typhimurium dalam menghambat penebalan dinding aorta. Penelitian ini merupakan penelitian eksperimental laboratorik dengan posttest only controlled group design. Vaksin yang digunakan berupa heat killed S. Typhimurium sebanyak 108 bakteri tiap 100μL. Dua puluh tikus wistar sebagai hewan coba dibagi ke dalam satu kelompok kontrol negatif (diet normal) dan empat kelompok perlakuan yang diberi diet atherogenik yang terdiri dari kontrol positif, S. Typhimurium 100μL+CFA-IFA 100μL, S. Typhimurium 100μL, dan CFA-IFA 100μL. Vaksin diinjeksikan dua minggu sekali sebanyak lima kali. Hasil penelitian menunjukkan bahwa rerata asupan pakan tiap kelompok adalah sama (p>0,05). Pemberian S. Typhimurium+CFA-IFA, S. Typhimurium, dan CFA-IFA menurunkan ketebalan dinding aorta secara signifikan dibanding kelompok kontrol positif (p<0,05). Dalam penelitian ini didapatkan data tambahan bahwa S. Typhimurium saja dapat menurunkan berat badan dan penumpukan abdominal visceral fat secara signifikan terhadap kelompok kontrol positif (p<0,05). Kesimpulan penelitian adalah pemberian S. Typhimurium menurunkan penebalan dinding aorta kembali seperti normal. Selain itu, didapatkan bahwa S. Typhimurium menurunkan berat badan dan penumpukan abdominal visceral fat. Dengan demikian, heat killed S. Typhimurium berpotensi untuk dikembangkan sebagai vaksin atherosklerosi

Pengaruh Pemberian Sylibin dan Asam Rosmarinat Terhadap Kadar Podosin dan Nefrin Urin pada Tikus Diabetes

LATAR BELAKANG: Nefropati diabetik (ND) merupakan komplikasi diabetes melitus (DM) yang serius dan menjadi penyebab utama penyakit ginjal kronis (PGK). Hiperglikemia kronik memicu stres oksidatif dan mengaktivasi sistem renin-angiotensin-aldosteron (SRAA) yang menyebabkan inflamasi dan kerusakan podosit. Pelepasan podosit ditandai dengan terdeteksinya biomarker protein dalam urin, salah satunya podocin urin. Hingga kini belum ada terapi yang efektif untuk mencegah progresivitas ND. Silybin dan Asam Rosmarinat diharapkan menjadi terapi yang efektif dalam mencegah progresivitas ND melalui berbagai jalur. TUJUAN PENELITIAN: Mengetahui pengaruh pemberian silybin (SB), Asam Rosmarinat (AR) dalam mencegah ekskresi nefrin dan podocin urin pada tikus diabetes. METODE: Penelitian ini merupakan penelitian eksperimental laboratorik dengan desain true experimental laboratory dan metode randomized post-test only controlled group design. Subjek penelitian adalah tikus jantan strain Wistar yang memenuhi kriteria inklusi. Subjek terbagi menjadi 4 kelompok yaitu kelompok kontrol negative (KN), kelompok kontrol positif (KP), kelompok perlakuan SB dan kelompok perlakuan AR. Albuminuria, kadar nefrin dan kadar podocin urin diukur pada akhir studi dengan metode ELISA. HASIL: Terdapat 20 tikus sebagai subjek penelitian. Uji T berpasangan menunjukkan kadar albumin urin pada kelompok KP signifikan lebih tinggi sesudah induksi diabetes dibandingkan dengan sebelum (p = 0.000). Kadar podocin urin signifikan lebih rendah pada kelompok perlakuan SB (p=0.045) dibandingan dengan Kontrol positif,sementara tidak didapatkan perbedaan bermakna dibandingkan dengan kelompok AR (p=1,000). Kadar podocin urin signifikan lebih rendah pada kelompok perlakuan SB (p=0.008) dan AR (p=0.017) dibandingan dengan Kontrol positif. KESIMPULAN: Pemberian silybin dan asam rosmarinat dapat mencegah ekskresi nefrin dan podocin urin pada tikus diabetes. Terapi silybin monoterapi memiliki efek yang lebih baik dalam mencegah ekspresi nefrin dan podocin urin dibandingkan dengan asam rosmarinat

Seroconversion rates among different designs of COVID-19 vaccines: a network meta-analysis of randomized controlled trials

Background: The COVID-19 vaccination program, which uses various types of vaccines, has been applied since the beginning of 2021. However, the efficacy in the context of seroconversion rate remains unclear. Objective: To assess the seroconversion rates among different COVID-19 vaccines using a network meta-analysis approach. Methods: A network meta-analysis of randomized controlled trials (RCTs) was conducted during the study period. Data of interest, such as seroconversion rate and the type of COVID-19 vaccine, were extracted from each study. The analysis was performed using single-arm analysis by calculating the cumulative seroconversion rate. A network meta-analysis was conducted using the Bayesian method. Results: A total of 31 RCTs were included in our analysis. Our pooled calculation revealed that the seroconversion rates of inactivated messenger ribonucleic acid (mRNA), protein subunit, and vector COVID-19 vaccines during the follow-up periods were 93.2%, 93.9%, 65.3%, and 54.7%, respectively, at ≤ 15 days; 96.0%, 94.8%, 91.2%, and 89.7%, respectively, between days 16–30; and 98.5%, 98.6%, 98.5%, and 96.2%, respectively, between days 31–60.The indirect comparison revealed that in the follow-up periods of ≤ 15 and 16–30 days, the inactivated and mRNA COVID-19 vaccines had superior seroconversion rates compared with those of the protein subunit and vector vaccines. In the follow-up period of 31–60 days, the highest seroconversion rates were found in the inactivated, mRNA, and protein subunit COVID-19 vaccines. Conclusion: This study provides valuable information regarding the comparison of seroconversion rates of COVID-19 vaccines

Association between convalescent plasma and the risk of mortality among patients with COVID-19: a meta-analysis [version 3; peer review: 2 approved]

Background: Convalescent plasma (CCP) has been used for treating some infectious diseases; however, the efficacy of CCP in coronavirus disease 2019 (COVID-19) remains controversial. The aim of this research was to assess the efficacy of CCP as an adjunctive treatment in COVID-19 patients. Methods: Embase, PubMed, Web of Science, Cochrane and MedRix were searched for potentially relevant articles. All included papers were assessed for the quality using modified Jadad scale and Newcastle-Ottawa scale for randomized controlled trial (RCT) and non – RCT, respectively. We used a Q test and Egger test to assess the heterogeneity and publication bias among studies, respectively. Mortality rates between patients treated with standard treatment and standard treatment with CCP were compared using a Z test. Results: A total of 12 papers consisting of three cross-sectional studies, one prospective study, five retrospective studies, and three RCT studies were included in our analysis. Of them, a total of 1,937 patients treated with CCP and 3,405 patients without CCP were included. The risk of mortality was 1.92-fold higher in patients without CCP compared to patients treated with CCP (OR: 1.92; 95%CI: 1.33, 2.77; p=0.0005). In severe COVID-19 sub-group analysis, we found that patients without CCP had a 1.32 times higher risk of mortality than those treated with CCP (OR: 1.32; 95%CI: 1.09, 1.60; p=0.0040). Conclusions: CCP, as adjunctive therapy, could reduce the mortality rate among COVID-19 patients

The prevalence, predictors and outcomes of acute liver injury among patients with COVID-19: A systematic review and meta-analysis

The data on the predictors and prognosis of acute liver injury (ALI) among patients in coronavirus disease 2019 (COVID‐19) patients are limited. The aim of this study was to determine the prevalence, predictors and outcomes of ALI among patients with COVID‐19. A systematic review was conducted up to 10 June 2021. The relevant papers were searched from PubMed, Embase, Cochrane and Web of Sci- ence, and the data were analysed using a Z test. A total of 1331 papers were identified and 16 papers consisting of 1254 COVID‐19 with ALI and 4999 COVID‐ 19 without ALI were analysed. The cumulative prevalence of ALI among patients with COVID‐19 was 22.8%. Male and having low lymphocyte levels were more likely to be associated with ALI compared with female and having higher lymphocyte level, odds ratio (OR): 2.70; 95% confidence interval (CI): 2.03, 3.60 and mean difference (MD) −125; 95% CI: −207, −43, respectively. COVID‐19 patients with ALI had higher risk of developing severe COVID‐19 compared with those without ALI (OR: 3.61; 95% CI: 2.60, 5.02). Our findings may serve as the additional evaluation for the management of ALI in COVID‐19 patients

Global Prevalence and Potential Influencing Factors of COVID-19 Vaccination Hesitancy : A Meta-Analysis

Countries worldwide have deployed mass COVID-19 vaccination drives, but there are people who are hesitant to receive the vaccine. Studies assessing the factors associated with COVID-19 vaccination hesitancy are inconclusive. This study aimed to assess the global prevalence of COVID-19 vaccination hesitancy and determine the potential factors associated with such hesitancy. We performed an organized search for relevant articles in PubMed, Scopus, and Web of Science. Extraction of the required information was performed for each study. A single-arm meta-analysis was performed to determine the global prevalence of COVID-19 vaccination hesitancy; the potential factors related to vaccine hesitancy were analyzed using a Z-test. A total of 56 articles were included in our analysis. We found that the global prevalence of COVID-19 vaccination hesitancy was 25%. Being a woman, being a 50-year-old or younger, being single, being unemployed, living in a household with five or more individuals, having an educational attainment lower than an undergraduate degree, having a non-healthcare-related job and considering COVID-19 vaccines to be unsafe were associated with a higher risk of vaccination hesitancy. In contrast, living with children at home, maintaining physical distancing norms, having ever tested for COVID-19, and having a history of influenza vaccination in the past few years were associated with a lower risk of hesitancy to COVID-19 vaccination. Our study provides valuable information on COVID-19 vaccination hesitancy, and we recommend special interventions in the sub-populations with increased risk to reduce COVID-19 vaccine hesitancy