Background: Coronavirus disease-2019 (COVID-19) is a global pandemic and high mortality rate among severe or critical COVID-19 is linked with SARS-CoV-2 infection-induced hyperinflammation of the innate and adaptive immune systems and the resulting cytokine storm. This paper attempts to conduct a systematic review and metaanalysis of published articles, to evaluate the association of inflammatory parameters with the severity and mortality in COVID-19 patients. Methods: A comprehensive systematic literature search of medical electronic databases including Pubmed/ Medline, Europe PMC, and Google Scholar was performed for relevant data published from January 1, 2020 to June 26, 2020. Observational studies reporting clear extractable data on inflammatory parameters in laboratoryconfirmed COVID-19 patients were included. Screening of articles, data extraction and quality assessment were carried out by two authors independently. Standardized mean difference (SMD)/mean difference (MD/WMD) and 95% confidence intervals (CIs) were calculated using random or fixed-effects models. Results: A total of 83 studies were included in the meta-analysis. Of which, 54 studies were grouped by severity, 25 studies were grouped by mortality, and 04 studies were grouped by both severity and mortality. Random effect model results demonstrated that patients with severe COVID-19 group had significantly higher levels of Creactive protein (CRP), erythrocyte sedimentation rate (ESR), procalcitonin (PCT), interleukin-6 (IL-6), interleukin-10 (IL-10), interleukin-2R (IL-2R), serum amyloid A (SAA) and neutrophil-to-lymphocyte ratio (NLR) compared to those in the non-severe group. Similarly, the fixed-effect model revealed significant higher ferritin level in the severe group when compared with the non-severe group. Furthermore, the random effect model results demonstrated that the non-survivor group had significantly higher levels of CRP, PCT, IL-6, ferritin, and NLR when compared with the survivor group. Conclusion:In conclusion, the measurement of these inflammatory parameters could help the physicians to rapidly identify severe COVID-19 patients, hence facilitating the early initiation of effective treatment. Prospero registration number: CRD42020193169.

Background: Hypothyroidism is a clinical entity resulting from a deficiency of thyroid hormones or, more rarely, from their impaired activity at the tissue level. Several mineral and trace elements are essential for normal thyroid hormone metabolism and co-existing deficiencies of these elements can impair thyroid function. The present study was conducted with the aim to find out the concentrations of zinc and copper in hypothyroidism and to determine the possible correlations between trace elements and thyroid hormones. Material and Methods:Our study included 40 patients with hypothyroidism and 40 normal control subjects. In all the subjects, T3, T4, and TSH were measured by ELISA whereas trace elements zinc and copper were measured colorimetrically.Results: Both zinc and copper were significantly reduced in patients of hypothyroidism as compared to controls (57.05±7.54 µg/dl vs. 98.02±7.77 µg/dl, p<0.001 and 73.86±6.22 µg/dl vs. 114.97±18.18 µg/dl, p<0.001, respectively). Zinc was significantly and positively correlated with T3 (r=0.326; p<0.05) in hypothyroidism patients but there was no significant correlation of zinc with rest of the hormones i.e, T4 (r=0.078; p>0.05) and TSH (r=-0.026; p>0.05) levels. With regard to copper, we did not find any significant correlation of copper with T3 (r=0.076; p>0.05), T4 (r=0.171; p>0.05) and TSH (r=0.167; p>0.05). Conclusion:In conclusion, hypothyroid patients had significantly decreased concentration of zinc and copper. Hence, diet rich in trace elements, viz. zinc and copper should be supplied to patients of hypothyroidism in order to maintain normal thyroid hormone function.

Objective: The objective of the study was to evaluate and compare serum total protein, serum albumin and thyroid hormones in children with Protein Energy Malnutrition (PEM) and in healthy controls.Methods: Present study was a cross sectional hospital based case control study, total 75 children of age group 1-5 years were included in this study. Triiodothyronine (T3), thyroxine (T4) and thyroid stimulating hormone (TSH) was estimated by electro-chemiluminescence immunoassay method, serum total protein by biuret method, albumin by BCG method and plasma hemoglobin by CMG method. Result: In malnourished children, there is significant decrease in serum total protein (4.76 gm %), albumin (2.24 gm %) and Hb (10.57 gm %) as compared to normal healthy children. Serum T3 (0.51 ng/ml), and T4 (3.93 µg/ml) levels were significantly decreased and non-significant changes in TSH (4.26 µUI/ml) levels in children with PEM was observed as compared to healthy controls. Conclusion: The reduction in protein is due to decreased intake of proteins and reduced biosynthesis. The decreased in T3 and T4 levels in malnourished children is probably due to a decrease in circulating plasma proteins.

Aims: To find out the correlation between Osteopontin (OPN), oxidative stress and total antioxidant capacity (TAC) in female hypothyroidism subjects. Study Design: Case Control study Place and Duration of Study: The present case control study was conducted with the collaboration of the Department of Biochemistry, Santosh Medical college, Ghaziabad and Muzaffarnagar Medical College, Muzaffarnagar from September 2018 to September 2020. Methodology: The study includes 120 female hypothyroidism subjects and 120 age and sex matched normal healthy individuals as controls.  Serum OPN was estimated by commercially available ELISA kit, MDA by method described by Satoh et al. method, TAC by FRAP method and Ceruloplasmin was estimated on Access 2 Beckman Coulter clinical chemistry analyser. Results: The anthropometric parameters, Body mass index (BMI), waist circumference (WC), hip circumference (HC) and waist hip ratio (WHR) were increased significantly in all the female hypothyroidism subjects as compared to controls. Study showed increased levels of TSH and MDA and decreased levels of serum Osteopontin, T3, T4, TAC and Ceruloplasmin (Cp) in hypothyroid subjects as compared to controls. A Significant positive correlation was found between OPN vs T3, OPN vs T4, OPN vs TAC and OPN vs Cp whereas significant negative correlation was found between OPN vs TSH, and OPN vs MDA. Conclusion:  In the present study, we found decreased levels of Osteopontin in hypothyroidism subject. Pearson’s correlation analysis predicts, OPN negatively correlated with MDA and positively correlated with total antioxidant capacity and ceruloplasmin. Hence, Osteopontin, malondialdehyde, total antioxidant capacity and ceruloplasmin should all be considered while assessing the hypothyroidism.