No abstract

The coronavirus disease 2019 (COVID-19) pandemic has caused human tragedy through the global spread of the viral pathogen SARS-CoV-2. Although the underlying factors for the severity of COVID-19 in different people are still unknown, several gene variants can be used as predictors of disease severity, particularly variations in viral receptor genes such as angiotensin-converting enzyme 2 (ACE2) or major histocompatibility complex (MHC) genes. The reaction of the immune system, as the most important defense strategy in the case of viruses, plays a decisive role. The innate immune system is important both as a primary line of defense and as a trigger of the acquired immune response. The HLA-mediated acquired immune response is linked to the acquired immune system. In various diseases, it has been shown that genetic alterations in components of the immune system can play a crucial role in how the body responds to pathogens, especially viruses. One of the most important host genetic factors is the human leukocyte antigen (HLA) profile, which includes HLA classes I and II and may be symbolic of the diversity of immune response and genetic predisposition in disease progression. COVID-19 will have direct contact with the acquired immune system as an intracellular pathogen after exposure to the proteasome and its components through class I HLA. Therefore, it is assumed that in different genotypes of the HLA-I class, an undesirable supply causes an insufficient activation of the immune system. Insufficient binding of antigen delivered by class I HLA to host lymphocytes results in uncertain identification and insufficient activation of the acquired immune system. The absence of secretion of immune cytokines such as interferons, which play an important role in controlling viral infection in the early stages, is a complication of this event. Understanding the allelic diversity of HLA in people infected with coronavirus compared with uninfected people of one race not only allows identification of people with HLA susceptible to COVID-19 but also provides better insight into the behavior of the virus, which helps to take effective preventive and curative measures earlier.

Background: Urinary tract stones are common urological problems with a considerable burden worldwide. Management strategies mostly rely on the stone’s characteristics and the patient’s clinical conditions. Extracorporeal shock wave lithotripsy (ESWL) is a method of choice for managing small calculus. However, the success rate of ESWL and the prognostic factor of success widely vary among different studies. The aim of the present study was to evaluate these prognostic factors in an Iranian population undergoing ESWL. Methods: The present retrospective study was conducted in Imam Ali Hospital of Bojnurd, Iran. Every patient who was referred for the ESWL of distal urethral calculus (5-20 mm) and failed to respond to medical treatment enrolled in this study. The prevalence and relationship between various individual factors and ESWL outcomes were evaluated among the study patients. Results: Among 49 patients (24 males and 25 females) who had urinary tract stones, the mean (±standard deviation) of age was 42.7 (14.04) years. ESWL could successfully treat urinary tract stones in 43 patients (85%). The kidney stone diameter was not related to having a successful procedure (P=0.447). Moreover, the stroke number and receiving tamsulosin were not significantly associated with favorable ESWL outcomes (P=0.909 and P=0.590, respectively). Twenty-seven patients (45.1%) received pethidine during the procedure. There was a significant relationship between receiving analgesics and favorable ESWL outcomes (P=0.033). Conclusion: The results demonstrated that 85% of the distal urinary tract stones that are smaller than 20 mm can be successfully managed by ESWL, and providing analgesics was significantly related to better outcomes.

Introduction: Angiotensin-converting enzyme 2 (ACE2) is the central receptor of coronavirus disease 2019 (COVID-19) in host cells. Genetic polymorphisms in the ACE2 gene may promote cardiovascular disease and systemic inflammatory injury in a patient affected by COVID-19. Thus, the genetic background may account for the substantial inter-individual diversity in illness susceptibility or severity. Our study was conducted to find a significant relationship between ACE2 rs4646142 and rs2285666 polymorphisms and susceptibility to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods: In this study, we randomly selected 230 samples, including 76 patients with severe clinical symptoms and 154 patients with mild clinical symptoms (the positive case of COVID-19 was confirmed by real-time reverse transcriptase polymerase chain reaction [RT-PCR] assay). Then, we performed DNA extraction and investigated the polymorphisms of rs2285666 and rs4646142 by RFLP-PCR method with TaqI and Alu1 restriction enzymes. Results: The study population included 107 men and 123 women, and the mean (±SD) age of the participants was 42.66±10.2. First, the levels of IgM and IgG were examined, and a significant association was observed in the level of IgM between the two groups of COVID-19 patients with mild and severe symptoms, as opposed to IgG. Meanwhile, no significant difference was observed between ACE2 rs4646142 and rs2285666 polymorphisms and the severity of COVID-19. Conclusion: To better understand the genetic variations in people’s susceptibility to COVID-19, this study was designed to evaluate the association between various ACE2 polymorphisms and the infection risk of SARS-CoV-2. However, no statistical difference was discovered.