A Systematic Review and Meta-analysis to Identify Risk Factors for Developing Long COVID-19.

AIM: This systematic review and meta-analysis was undertaken to identify the risk factors of long coronavirus disease 2019 (COVID-19) to provide insight for selecting cases for more aggressive monitoring and treatment after COVID-19 infection and reduce morbidity due to long COVID-19. MATERIALS AND METHODS: All relevant studies published till July 2022 were searched for in PubMed, Trip database, and the Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library). Reference lists of the studies selected for appraisal were also considered. The National Institute of Health Clinical Database and Google Scholar were searched for unpublished studies. All cohort studies which studied risk factors for long COVID-19 in adults (>18 years age-group) were included. Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines were used for data extraction and bias assessment were. The outcomes were risk factors identified as being related with persistent symptoms 3 months after recovery from COVID-19. Random-effects model (RevMan 5.3) was used to pool the data. RESULTS: Total nine studies were included with overall quality scores ranging from 16 to 19 out of the maximum 22. Pooled results demonstrated statistically significant association of long COVID-19 with female gender [odds ratio (OR) -1.67; 95% confidence interval (CI) 1.33-2.09], need of hospitalization (OR -1.80; 95% CI 1.22-2.64), and hospital stay (OR 2.41; 95% CI 0.75-4.07). CONCLUSION: Female gender, need for hospitalization and duration of hospitalization during acute COVID-19 infection are the risk factors for later development of long COVID-19. There should be specific guidelines for monitoring and treatment of this population after acute COVID-19 infection.

Urinary Kringle Domain-Containing Protein HGFL: A Validated Biomarker of Early Sickle Cell Anemia-Associated Kidney Disease.

INTRODUCTION: Chronic kidney disease (CKD) is a prevalent complication of sickle cell anemia (SCA). Hyperfiltration that delayed detection of CKD is common in SCA patients. Identification of novel urinary biomarkers correlating with glomerular filtration rates may help to detect and predict progression of renal disease. METHODS: Reanalysis of mass spectra of urinary samples obtained from University of Illinois at Chicago identified kringle domain-containing protein HGFL. RESULTS: HGFL levels correlated with hyperfiltration, were significantly reduced at CKD stage 1 compared to stage 0, negatively correlated with progression of CKD and were suitable for differentiation of stage 1. Better prediction of CKD progression to stage 2 was observed for HGFL-based risk prediction compared to the estimated glomerular filtration rate (eGFR)-based prediction. Results from a Howard University patient cohort supported the utility of HGFL-based test for the differentiation of stage 1 of CKD. CONCLUSION: Urinary HGFL may contribute additional information beyond eGFR and improve diagnosis of early-stage CKD in SCA patients.

A current review on P2X7 receptor antagonist patents in the treatment of neuroinflammatory disorders: a patent review on antagonists.

Chronic inflammation is defined by an activated microglial state linked to all neurological disorders, including Alzheimer's disease, Parkinson's disease, and amyotrophic lateral sclerosis (a motor neuron disease that affects the brain and spinal cord). P2X7 receptors (P2X7R) are ATP-activated ion-gated channels present on microglial surfaces. Prolonged ATP release under pathological settings results in sustained P2X7R activation, which leads to inflammasome development and cytokine release. P2X7R and its enabling roles have recently been linked to neurodegenerative diseases, making it a potential research subject. This research provides an overview of current patents for chemicals, biologics, and medicinal applications. The World Intellectual Property Organization (WIPO), European Patent Office (EPO, Espacenet), and the United States Patent and Trademark Office (USPTO) databases were searched for patents using the keywords "P2X7R and Neuroinflammation." During the study period from 2015 to 2021, 103 patents were examined. The countries that protected these innovations were the United States, PCT (Patent Cooperation Treaty states), Europe, Canada, Australia, and India. Janssen Pharmaceutica NV had the most applications, followed by Acetelion Pharmaceuticals LTD., Renovis Inc., Kelly Michael G, Kincaid Jhon, Merck Patent GMBH, H Lundbeck A/S, and many more. The P2X7R is a possible diagnostic and therapeutic target for cancer, pain disorders, and inflammation. For P2X7 R, several compounds have been discovered and are presently the subject of clinical trial investigations. This study featured patents for P2X7R antagonists, which help treat conditions including neuroinflammation.

Complete resolution of a large squamous cell carcinoma of the lacrimal duct in a young African American male after non-surgical management.

PURPOSE: The following case describes a 28-year old African American male who presented with squamous cell carcinoma of the lacrimal duct. Despite its size and location, his tumor showed complete resolution with non-surgical treatment. OBSERVATIONS: The patient presented with a 4-month history of dacryocystitis-like symptoms in the right eye, with no prior medical history and a history of tobacco smoking. Pathology indicated that SCC arose as nests within a benign sinonasal inverted papilloma. He received cisplatin chemotherapy and radiotherapy with tumor resolution in 4 months. Several months after the end of treatment, he experienced irreversible visual deterioration which led to enucleation of the right eye. The patient has remained in remission for 4 years following the treatment. CONCLUSIONS: The complete resolution of the mass with non-surgical management supports the most recent literature endorsing a multidisciplinary approach for localized tumors. Our patient is the only African American identified in the literature and the youngest reported patient to present with this tumor. Most case studies have not emphasized race, ethnicity and demographics, although it is known that morbidity in malignancy is impacted by these factors.