Leptospirosis is a bacterial zoonosis with a wide spectrum of clinical presentations. In order to identify potential risk factors and predictors of disease severity, a meta-analysis of the clinical features of severe and non-severe leptospirosis patients was conducted. PubMed was searched to collect studies on the difference in clinical characteristics of severe and nonsevere patients, and data were analyzed using Comprehensive Meta-Analysis V3 software. Results showed that patients with severe outcomes were more likely to have dyspnoea, oliguria, and hemorrhagic symptoms than nonsevere patients. Determining these predictors in the early stages of the disease could thus significantly reduce the development of severe cases and related mortality.
The aim: To evaluate the content of trace elements Zn, Cu and Se in blood serum and their relationship with viral load and the degree of liver fibrosis according to the results of the FibroMax test in patients with CHC.
Materials and methods: 62 outpatients with a verified diagnosis of CHC were under observation, in which serum Zn, Cu and Se levels, viral load and degree of liver fibrosis were determined according to the FibroMax test.
Results: HCV 1b genotype was detected in all patients. The proportion of patients with a high viral load was 32%, with a low viral load – 68%. In 19% of patients, the level of Zn was below normal, and the levels of Cu and Se were within the reference values. The proportion of patients without fibrosis was 32%, 16% had minimal fibrosis, 40% had moderate fibrosis, 8% had progressive fibrosis, and 3% had severe fibrosis. 68% of patients had active inflammation of various degrees, liver steatosis – 65%, non-alcoholic steatohepatitis – 48%, inflammation caused by alcohol consumption was absent. No statistically significant difference was found in serum trace element levels and viral load (p>0.05). A weak negative correlation between the level of Zn and the degree of fibrosis (ρ=-0.340, p=0.007) and a negligible negative correlation between the level of Zn and inflammation activity (ρ=-0.286, p=0.024) were revealed. Patients with fibrosis grade ≥F2 had lower Zn levels compared to patients with fibrosis ≤F1 (0.607 (0.540, 0.691) mg/l vs. 0.716 (0.593, 0.875) mg/l, p=0.01), and when comparing there was no difference in Cu and Se levels (р>0.05).
Conclusions: Thus, there is a relationship between the level of Zn in blood serum and the degree of liver damage in patients with CHC, which indicates the prospects for further research.
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