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Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is responsible for coronavirus disease (COVID-19), potentially has severe adverse effects, leading to public health crises worldwide. In COVID-19, deficiency of ACE-2 is linked to increased inflammation and cytokine storms via increased angiotensin II levels and decreased ACE-2/Mas receptor axis activity. MiRNAs are small sequences of noncoding RNAs that regulate gene expression by binding to the targeted mRNAs. MiR-200 dysfunction has been linked to the development of ARDS following acute lung injury and has been proposed as a key regulator of ACE2 expression. LncRNA growth arrest-specific transcript 5 (GAS5) has been recently studied for its modulatory effect on the miRNA-200/ACE2 axis. Objective: The current study aims to investigate the role of lncRNA GAS5, miRNA-200, and ACE2 as new COVID-19 diagnostic markers capable of predicting the severity of SARS‐CoV‐2 complications. Methods: A total of 280 subjects were classified into three groups: COVID-19-negative controls (n=80), and COVID-19 patients (n=200) who required hospitalization were classified into two groups: group (2) moderate cases (n=112) and group (3) severe cases (n = 88). Results: The results showed that the serum GAS5 expression was significantly down-expressed in COVID-19 patients; as a consequence, the expression of miR-200 was reported to be overexpressed and its targeted ACE2 was down-regulated. The ROC curve was drawn to examine the diagnostic abilities of GAS5, miR-200, and ACE2, yielding high diagnostic accuracy with high sensitivity and specificity Conclusion: lncRNA-GAS5, miRNA-200, and ACE2 panels presented great diagnostic potential as they demonstrated the highest diagnostic accuracy for discriminating moderate COVID-19 and severe COVID-19 cases.

Background: the prevalence of mood and anxiety disorders is higher among persons living with diabetes compared to those without diabetes. Numerous studies have demonstrated that both obesity and metabolic disorders are associated with depression. This study aimed to confirm the association between depression and risk factors as obesity and type 2 diabetes mellitus.Subjects and methods: This comparative cross-sectional study was carried out on 90 adults attending to the Diabetes outpatient clinic in Internal Medicine Department, Faculty of Medicine, Zagazig University Hospitals. They were divided into three groups, 30 patients with type 2 diabetes mellitus with normal body mass index (BMI), 30 obese non-diabetic individuals and 30 obese type 2 diabetic patients. Full medical history, clinical examination, laboratory investigation and assessment of depression were performed. Result: Age was 51.60±14.28, 42.26±12.21 and 51.93±9.89 respectively and Group B it was significantly younger than other two groups with no significant difference between them. No significant difference was found between groups regarding disease duration or diabetes mellitus (DM) treatment and also complication but regarding comorbidity Group C was significantly associated with comorbidity. Group A was significantly lower regarding Beck Depression Inventory and overall depression was significantly associated with group B and Group C as it was 30.0% and 46.7% respectively. Grade and overall depression were significantly associated with BMI >35 group. Conclusion: Type 2 diabetes mellitus and morbid obesity (BMI > 35) were associated with high prevalence of depression. It is evident that several modifiable and non-modifiable risk factors play an important role in the pathogenesis of diabetes and depression among population.

Background: Rheumatoid arthritis (RA) is a relatively common autoimmune disease in which genetic risk factors are well defined. Genetic studies are promising in exploring the long noncoding ribonucleic acids (lncRNAs): growth arrest-specific 5 (GAS5) and H19, and their possible role in the assessment of RA. Aim of the Work: The aim of the study was to describe the expression of GAS5 and H19 in serum samples of Egyptian RA patients in comparison to healthy controls, then to investigate its possible relation to RA clinical characteristics and disease activity. Patients and Methods: Levels of GAS5 and H19 expression were compared in serum samples from Egyptian RA patients (n = 100) and age- and sex-matched healthy controls (n = 100) and then correlated within the RA group to disease activity measured by the Disease Activity Score 28–erythrocyte sedimentation rate (DAS28-ESR). Results: GAS5 was downregulated (0.59 ± 0.36), while H19 was upregulated (7.41 ± 1.3) in sera of Egyptian RA patients in comparison with controls (1.07 ± 0.09 and 1.1 ± 0.09 respectively). Further analysis showed a significant negative correlation of GAS5 to DAS28-ESR (r = -0.380). However, H19 showed a positive correlation to DAS28-ESR (r = 0.487 (P < 0.05). Conclusion: GAS5 was related to less disease activity, while H19 tended to be associated with more active disease. They might be useful in RA as potential biomarkers for disease activity assessment in the following years. Still, further researches are needed to support our findings and precisely determine their potential utility in RA.

Introduction: Thyroid hormones play a key role in the maintenance of body growthby modulating metabolism and the immune system. In the 20th century,researchers found that thyroid dysfunction is associated with theincreased mortality of patients admitted to the intensive care units (ICU).This study was conducted to evaluate the prognostic value of the thyroid functions; free triiodothyronine(FT3), total triiodothyronine (TT3), free thyroxin (FT4), total thyroxine (TT4) and thyroid-stimulating hormone (TSH) in unselected ICU patients. Methods: A total of 183 unselected critically ill patients without known thyroid diseases were screened for eligibility and followed up during their ICU stay. Patient’s baseline characteristics, the Acute Physiology and Chronic Health Evaluation II (APACHE II), thyroid hormones and C-reactive protein (CRP) levels were determined. The primary outcome was ICU mortality. The patients were divided into two groups; group (1) survivors and group (2) non-survivors. Potential predictors were analysed for possible association with outcomes. We also evaluated the ability of thyroid hormones together with APACHE II score to predict ICU. Results:Among thyroid hormone functions, FT3had the greatest power to predict ICU mortality, as suggested by the largest area under the curve (AUC) of 0.838. The AUC for FT3 was nearly the same for APACHE II score (0.822) but greater than that for CRP (0.722). Multiple regression analysis revealed that FT3 and TSH levels, APACHE II score and CRP level could independently predict primary outcome. The addition of FT3 and TSH levels to APACHE II score gave an NRI of 55.80%. The level of FT3 showed a significant negative correlation with APACHE II score (r = - 0.382, p = 0.000) and with CRP (r = - 0.244, p = 0.001).The level of TSH showed a significant negative correlation with APACHE II score (r = - 0.194, p = 0.008). Conclusion: Among thyroid functions, the serum levels of both FT3 and TSH are the most powerful and independent predictors of ICU mortality. Moreover, the addition of FT3 and TSH to APACHE II score could significantly improve the ability to predict ICU outcome. Key words:Thyroid Function, ICU, APACHE, Mortality