HLA Ligand Binding in Cytokine Storm Stage with Convalescent Plasma Therapy: A Cytotoxic Activity Switching-off
Abstract
The potential of Convalescent Plasma Therapy (CPT) as the last effort for immunocompromised COVID-19 patients are not controversial anymore, but the mechanism which supports the anti-ligand-binding and memory cell should be broadly known. While p53 mutation associated CD4 has not been ready, memory cells could not know the lymphocyte induced up-regulation in cytokine storm stage, made lymphopenia. Keyword setting of lymphopenia mechanism-COVID-19, searching in Science Direct and other search engines, is used in this Systematic Review PRISMA design.
Immunocompromised patients including obese and old age is included, also Lymphocytopenia – ARDS, Diabetes Type 1. Cardiac arrest, cardiac arrhythmia, hypertension alone was excluded. References (15) that supported lymphocytopenia mechanism-COVID-19 are selected. About 15 million and 4,593 participants of COVID-19 patients with only 1½ Systematic Review due to the mechanism of lymphocytopenia and off reaction with CPT are recorded.
Lymphocytopenia cause by cytokine storm in week-2 COVID-19, while in low CD4 (Th) in this cytokine storm COVID-19, could be stronger and faster in week-1 st in the second infection on person with diabetes. CPT serum, is the only way to switch-off cytotoxic activity, and increase the lymphocyte again.
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Introduction
Severe respiratory distress and/or hypoxemia or life-threatening (shock, multi-organ failure, or requiring mechanical ventilation), cause of DIC (lymphocytopenia), become the cause of mortality in cytokine storm stage COVID-19 pandemic.
Whereas the rate of viral PCR results turned from positive to negative with Convalescence Plasma Therapy (CPT) are reported, but the using of it, is hindered by complex therapy antiviral, chloroquine, antibiotic, and vaccination hope. In the population, the diagnostic with a rapid test based on IgG and IgM has colonized the ceremony of red zone COVID-19 area, whereas swab-PCR which chasing mass of people as market share and market segment till to each remote corner which is in a green zone even so.
Utmost CPT has not yet reached significant statistics proven although its 1,4 Odd Ratio between added CPT and control standard therapy only.1 Diabetes and old-aged become the causa of 5,42% COVID-19 pandemic mortality.2 Effective without the invasive mechanical ventilator and reduce the mortality in COVID-19 has been reported.3
Conclusion
Convalescence Plasma Therapy Switch-off cytotoxic activity upon HLA ligand binding is the basic mechanism associated mortality in 2ndweek and 1st-week the second infection of COVID-19 with DM and immunocompromised patients.