Background: This meta-analysis outlines the role of elevated lactate dehydrogenase (LDH) levels in assessing the severity of coronavirus disease 2019 (COVID-19). Methods: The current study was designed as a systematic review and meta-analysis. Embase, PubMed, Web of Science, Scopus and Cochrane Central Register of Controlled Trials were searched to identify the usefulness of LDH as a marker of COVID-19 severity. All extracted data were analyzed using RevMan V.5.4 or STATA V.14 software. Results: A total of 264 records were selected for this meta-analysis. Pooled analysis showed that LDH levels were statistically significantly lower in the group of survivors compared to patients who died in hospital (standardized mean differences [SMD] = –3.10; 95% confidence interval [CI]: –3.40 to –2.79; I² = 99%; p < 0.001). Lower LDH levels were observed in non-severe groups compared to severe course of COVID-19 (SMD = –2.38; 95% CI: –2.61 to –2.14; I² = 99%; p < 0.001). The level of LDH was statistically significantly lower in the severe group compared to the critical group (SMD = –1.48; 95% CI: –2.04 to –0.92; I² = 98%; p < 0.001). Patients who did not require treatment in the intensive care unit (ICU) showed significantly lower levels of LDH compared to patients who required treatment in the ICU (SMD = –3.78; 95% CI: –4.48 to –3.08; I² = 100%; p < 0.001). Conclusions: This meta-analysis showed that elevated LDH was associated with a poor outcome in COVID-19. Background: This meta-analysis outlines the role of elevated lactate dehydrogenase (LDH) levels in assessing the severity of coronavirus disease 2019 (COVID-19). Methods: The current study was designed as a systematic review and meta-analysis. Embase, PubMed, Web of Science, Scopus and Cochrane Central Register of Controlled Trials were searched to identify the usefulness of LDH as a marker of COVID-19 severity. All extracted data were analyzed using RevMan V.5.4 or STATA V.14 software. Results: A total of 264 records were selected for this meta-analysis. Pooled analysis showed that LDH levels were statistically significantly lower in the group of survivors compared to patients who died in hospital (standardized mean differences [SMD] = –3.10; 95% confidence interval [CI]: –3.40 to –2.79; I² = 99%; p < 0.001). Lower LDH levels were observed in non-severe groups compared to severe course of COVID-19 (SMD = –2.38; 95% CI: –2.61 to –2.14; I² = 99%; p < 0.001). The level of LDH was statistically significantly lower in the severe group compared to the critical group (SMD = –1.48; 95% CI: –2.04 to –0.92; I² = 98%; p < 0.001). Patients who did not require treatment in the intensive care unit (ICU) showed significantly lower levels of LDH compared to patients who required treatment in the ICU (SMD = –3.78; 95% CI: –4.48 to –3.08; I² = 100%; p < 0.001). Conclusions: This meta-analysis showed that elevated LDH was associated with a poor outcome in COVID-19.

Recently, an old drug, disulfiram, has been shown to reduce cocaine intake by inhibiting dopamine beta (β)-hydroxylase. Its effectiveness was also reported in opioid treatment, as disulfiram attenuated morphine-induced tolerance and dependence. A similar mechanism of action was evident in a selective inhibitor of DβH, nepicastat, particularly in the aspect of cocaine-seeking behavior. Hence, the objective of this study was to verify whether or not nepicastat reproduces disulfiram activity in pain reduction. Moreover, determination of its likely biological effects resulting from interactions with targets other than DβH has been given, in particular acetylcholinesterase. As was found, nepicastat was characterized by the absence of desired antinociceptive activity, though its co-administration with morphine resulted in a dose- and time-dependent enhancement of morphine-induced analgesic effect and attenuation of tolerance. Similarly, nepicastat was found to manifest antimicrobial potency against selected bacterial strains, although the effect was found to be weak. Intriguingly, this compound interacted with acetylcholinesterase through inhibition of its activity. These results clearly indicate nepicastat as a potent molecule that exhibits various biological effects. This, in turn, suggests its possible application in pathological conditions that still require effective treatment.