Background: More severe cases of COVID-19 are more likely to be hospitalized and around one-fifth, needing ICU admission. Understanding the common laboratory features of COVID-19 in more severe cases versus non-severe patients could be quite useful for clinicians and might help to predict the model of disease progression. This systematic review and meta-analysis aimed to compare the laboratory test findings in severe vs. non-severe confirmed infected cases of COVID-19. Methods: Electronic databases were systematically searched in PubMed, EMBASE, Scopus, Web of Science, and Google Scholar from the beginning of 2019 to 3rd of March 2020. Heterogeneity across included studies was determined using Cochrane's Q test and the I 2 statistic. We used the fixed or random-effect models to pool the weighted mean differences (WMDs) or standardized mean differences and 95% confidence intervals (CIs). Findings: Out of a total of 3009 citations, 17 articles (22 studies, 21 from China and one study from Singapore) with 3396 ranging from 12 to1099 patients were included. Our meta-analyses showed a significant decrease in lymphocyte, monocyte, and eosinophil, hemoglobin, platelet, albumin, serum sodium, lymphocyte to C-reactive protein ratio (LCR), leukocyte to C-reactive protein ratio (LeCR), leukocyte to IL-6 ratio (LeIR), and an increase in the neutrophil, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, blood urea nitrogen (BUN), creatinine (Cr), erythrocyte Sedimentation Rate (ESR), C-reactive protein (CRP), Procalcitonin (PCT), lactate dehydrogenase (LDH), fibrinogen, prothrombin time (PT), D-dimer, glucose level, and neutrophil to lymphocyte ratio (NLR) in the severe group compared with the non-severe group. No significant changes in white blood cells (WBC), Creatine Kinase (CK), troponin I, myoglobin, IL-6 and K between the two groups were observed. Interpretation: This meta-analysis provides evidence for the differentiation of severe cases of COVID-19 based on laboratory test results at the time of ICU admission. Future well-methodologically designed studies from other populations are strongly recommended.

The discovery of immune checkpoint proteins such as PD-1/PDL-1 and CTLA-4 represents a significant breakthrough in the field of cancer immunotherapy. Therefore, humanized monoclonal antibodies, targeting these immune checkpoint proteins have been utilized successfully in patients with metastatic melanoma, renal cell carcinoma, head and neck cancers and non-small lung cancer. The US FDA has successfully approved three different categories of immune checkpoint inhibitors (ICIs) such as PD-1 inhibitors (Nivolumab, Pembrolizumab, and Cemiplimab), PDL-1 inhibitors (Atezolimumab, Durvalumab and Avelumab), and CTLA-4 inhibitor (Ipilimumab). Unfortunately, not all patients respond favourably to these drugs, highlighting the role of biomarkers such as Tumour mutation burden (TMB), PDL-1 expression, microbiome, hypoxia, interferon-γ, and ECM in predicting responses to ICIs-based immunotherapy. The current study aims to review the literature and updates on ICIs in cancer therapy.

OBJECTIVE: Understanding the common laboratory features of COVID-19 in severe cases versus non-severe patients could be quite useful for clinicians and might help to predict the model of disease progression. MATERIALS AND METHODS: Electronic databases were systematically searched in PubMed, EMBASE, Scopus, Web of ‎Science, and Google Scholar from inception to 3rd of March 2020. Heterogeneity across included ‎studies was determined using Cochrane’s Q test and the I2 statistic. We used the fixed or random-effect models to pool ‎the weighted mean differences (WMDs) or standardized mean differences and 95% confidence ‎intervals (CIs).‎RESULTS:‎ Out of a total of 3009 citations, 17 articles (22 studies, 21 from China and one study from Singapour) with 3396 ranging from 12-1099 patients, ‎were included. Our meta-analyses showed a significant decrease in ‎lymphocyte, monocyte, and eosinophil, hemoglobin, platelet, albumin, serum sodium, lymphocyte to C-reactive protein ratio (LCR), leukocyte to C-reactive protein ratio (LeCR), leukocyte to IL-6 ratio (LeIR), and an increase in the ‎neutrophil, alanine ‎aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, blood urea nitrogen (BUN), creatinine (Cr), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), procalcitonin (PCT), lactate dehydrogenase (LDH), fibrinogen, prothrombin time (PT), D-dimer, glucose ‎level, and neutrophil to lymphocyte ratio (NLR) in the severe group compared with the non-severe group. However, no significant changes were observed in white blood cells (WBC), ‎ creatine kinase (CK), troponin I, myoglobin, interleukin-6 (IL-6), and potassium (K) between the two groups.‎CONCLUSIONS: This meta-analysis provides evidence for the differentiation of severe cases of COVID-19 based on laboratory test results at the time of hospital admission. Future well-methodologically designed studies from other populations are strongly recommended.

The aim of this meta-analysis was to investigate whether the blood concentrations of patients with multiple sclerosis (MS) are associated with those of the healthy control group in terms of trace elements including zinc (Zn), iron (Fe), manganese (Mn), magnesium (Mg), selenium (Se), and copper (Cu). A comprehensive search was performed in online databases including PubMed, Scopus, Embase, and Web of Science for studies, which have addressed trace elements in MS up to July 23, 2020. The chi-square test and I 2 statistic were utilized to evaluate inter-study heterogeneity across the included studies. Weighted mean differences (WMDs) and corresponding 95% CI were considered as a pooled effect size (ES). Twenty-seven articles (or 32 studies) with a total sample comprised of 2895 participants (MS patients (n = 1567) and controls (n = 1328)) were included. Pooled results using random-effects model indicated that the levels of Zn (WMD = − 7.83 mcg/dl, 95% CI = − 12.78 to − 2.87, Z = 3.09, P = 0.002), and Fe (WMD = − 13.66 mcg/dl, 95% CI = − 23.13 to − 4.19, Z = 2.83, P = 0.005) were significantly lower in MS patients than in controls. However, it was found that levels of Mn (WMD = 0.03 mcg/dl, 95% CI = 0.01 to 0.04, Z = 2.89, P = 0.004) were significantly higher in MS patients. Yet, no significant differences were observed in the levels of Mg, Se, and Cu between both groups. This meta-analysis revealed that the circulating levels of Zn and Fe were significantly lower in MS patients and that Mn level was significantly higher than those in the control group. However, it was found that there was no significant difference between MS patients and controls with regard to levels of Mg, Se, and Cu.

This meta‐analysis was conducted to evaluate the effects of garlic extract on total cholesterol (TC), triglycerides (TG), low‐density lipoprotein‐cholesterol (LDL‐c) and high‐density lipoprotein‐cholesterol (HDL‐c), among the patients with coronary artery disease (CAD). Literature searches were conducted in EMBASE, Scopus, PubMed, Web of Science and Cochrane Library until Sep18th, 2020. Inter‐study heterogeneity was examined using Cochrane's Q and I2 tests. The random‐effect models were utilised to pool the weighted mean differences (WMDs) and the corresponding 95% confidence intervals (CIs). Six articles were enrolled in the current meta‐analysis. Garlic consumption significantly reduced TC levels (WMD −16.32 mg/dL; 95% CI −31.22, −1.43; P = .032). We found no significant effects on TG (WMD −10.93 mg/dL; 95% CI −26.19, 4.32; P = .160), HDL‐c (WMD 4.55 mg/dL; 95% CI −1.13, 10.23; P = .116) and LDL‐c concentrations (WMD −3.65 mg/dL; 95% CI −13.21, 5.92; P = .455). Significant heterogeneity was observed for HDL‐c (I2 = 76.8%). However, the findings of sensitivity analysis revealed that upon exclusion of the potential heterogeneity source, the pooled WMD on HDL‐c levels were stable. Garlic supplementation may result in a decrease in TC, but will not affect TG, HDL‐c and LDL‐c levels among CAD patients.