Rheumatic Autoimmune Diseases Following Covid-19 Infection: An Observational Study in Iraqi Kurdistan Region

Background/Aims In December 2019, a new type of novel coronavirus (COVID-19) was identified in Wuhan, China. The likelihood of developing an autoimmune and/or rheumatic diseases in COVID-19 survivors is high and a serious matter. The acute SARS-CoV-2 infection may unmask previously undiagnosed rheumatic conditions. We aimed to study rheumatic autoimmune disease manifestations diseases following COVID-19 infection survival. Methods The study was an observational case series study. The data collection was carried out in Iraqi Kurdistan region between the 1st of July 2021 and 20th of March 2022. Seventy-five patients were included: the patients who previously had confirmed COVID-19 infection who developed symptoms of rheumatic autoimmune diseases post COVID-19 cure. The study was conducted via a rigorous evaluation by two rheumatologists. Patients were investigated by (ESR (mm/h) and CRP (mg/L), some autoimmune screen panel for suspecting rheumatological disease patients were sent for ANA, anti-CCP (U/ML) and rheumatoid factor (IU/M) L. Then, patients were diagnosed according to the classification criteria for suspected autoimmune diseases and those with exacerbation were evaluated clinically and by laboratory;rheumatoid arthritis by DAS28, systemic lupus erythematosus by C3, C4. Results A total of seventy-five participants post-COVID-19 infection were enrolled in this study. Age of the participants was 47.15 +/-16.18 SD, more of the participants were female (69) out of 75. For most of the patients the ESR were high with p value of 0.012, which was statistically significant. ANA was high titre in SLE patients which was (3.05+/-2.4) and in antiphospholipid syndrome p-value was significant at 0.042, Anti-CCP were positive in RA patients and in those with exacerbation of RA (44+/-10, 31.7+/-5.7 respectively), DAS28 was (4.95+/-0.59) moderate and high disease activity in patients with exacerbations. C3, C4 were low in patients with exacerbation of SLE (0.47+/-0.22, 0.03+/-0.01, respectively). Most of the patients developed symptoms post-COVID-19 between 4-10 weeks (37 participants). Conclusion Rheumatic autoimmune diseases presenting post-COVID-19 survival most commonly were systemic lupus erythematous followed by rheumatoid arthritis. and previous autoimmune diseases presented with exacerbation. (Table Presented).

British Society for Rheumatology Annual Conference 2023 Abstracts

The proceedings contain 343 papers. The topics discussed include: implementation of a disease modifying anti-rheumatic drug blood monitoring software: 8 years of experience in a single center;effectiveness of colchicine among patients with COVID-19 infection: a randomized, open labelled, clinical trial;rheumatic autoimmune diseases following COVID-19 infection: an observational study in Iraqi Kurdistan region;COVID-19 in male elite Irish-based athletes at a national sports institute;the effects of a pain management program for patients with an inflammatory arthritis;a retrospective analysis of the effectiveness safety of platelet rich plasma injections in primary osteoarthritis in knee joint, in patients attending a tertiary care hospital, Sri Lanka;a cohort study;do proformas used in fracture liaison service appointments reflect national osteoporosis clinical standards? a content analysis;calcium pyrophosphate dihydrate crystal in operated rheumatoid arthritis of the knee;cardiac amyloidosis: a case series of 31 patients with a comprehensive literature review;scoping review for the application of center of pressure for patient or intervention assessment in rheumatoid conditions;and four SNPs associated with monocyte/macrophage cell lineage uniquely associated with CRPS-1 in discovery and replication cohorts and suggest predisposition to regional osteopenia and digit misperception.

Epidemiological Approach of SARS-CoV2 in the First Month of Appearance in the Kurdistan Region of Iraq

The new emerging coronavirus SARS-CoV2 is an alerting pandemic worldwide. Understanding the epidemiology, viral behavior in the host, and the severity of the disease in an infected patient is a demanding approach for the healthcare system which lead to plan and contemplate the response for further waves of the same virus and even other related viruses. The evaluation of the protection measurements along with analyzing the recorded data of epidemiology and spread provides thorough insights toward the new Coronavirus modes of transmission, infection, and severity. Kurdistan Region of Iraq was hit by the SARS-CoV2 on March 2020 when first confirmed case recorded. The present paper analyzed a full month data of confirmed hospitalized and quarantined cases with regard to age, sex, geographical distribution. The highest risks were shown to be males of their young ages of 30-39 years old in Sulaimani province due to the social structure of the Kurdish population and the geographical position of Sulaimani. Social integration played a significant role in the spreading the virus in all cities of Kurdistan first onset of the virus in the community. Diagnosed hospitalized cases were mostly suffered from high fever, dry cough and breathing difficulties. The mortality rate was shown to be reasonable, and the majority of the cases were recovered after hospitalization and receive supportive treatment. Social distancing and total lockdown played a significant role in viral spread containment. The health authorities prevented devastating outbreak through tracing all the cases and their contacts, isolating the suspicious contacts, quarantining the neighborhoods were the virus found. Further investigation is needed in a larger scale of data in order to be armed with adequate knowledge for any other waves of COVID-19 in the region.Copyright © 2020 Ubiquity Press. All rights reserved.

The Impact of COVID-19 on Individuals and Communities Through the Lens of a Kurdish Artist: A Narrative Inquiry Study.

The COVID-19 pandemic affects individuals and society at different levels. For a brief period during the pandemic, the Kurdish government closed all governmental organizations and interconnected routes, except for medical and security settings, and announced a curfew. In this article, we portray the effects of the pandemic on individuals and communities from an artist's view through an art-based narrative inquiry. Narrative analysis is used for analyzing texts or visual data in story form. It describes the life experiences of individuals and the environment in which they reside. Data came from the observations and experiences of the first author during the time he conducted research regarding the impacts of COVID-19 on different aspects of the Kurdish community in the Kurdistan Region through our previous research. The images and stories show that individuals feared COVID-19 and struggled to protect themselves from infection. They faced prolonged social distancing, quarantine, and complete lockdown and lost their family members and loved ones-their relationships with family members and others were disrupted during the pandemic. Additionally, vulnerable groups, such as children and older adults, have been especially affected psychologically during the COVID-19 pandemic. We suggest that the pandemic has affected different groups of people and impacted the health security of Iraqi Kurdistan society. Our findings add a conceptual understanding of the health threat of the pandemic that can be used to implement health services and health policy for individuals and communities in Iraqi Kurdistan.

Medicinal Plants Traditionally Used in the Management of COVID-19 in Kurdistan Region of Iraq

Coronaviruses are infectious respiratory tract illnesses, but they can also affect the digestive tract and infect both humans and animals. The new coronavirus results in complicated health problems all over the world. The most urgent concern of all researchers around the world has been the treatment of the virus. The following study aimed to use quantitative ethnobotany to help scientist in addressing the deadly virus. Expert sampling method was adopted with the aid of an in-depth interview guide. Thirty-nine respondents were interviewed. Eighty-one medicinal plant species from 35 families were documented. Males 25 (64.1%) constitute the greater percentage of the total respondents. Majority of the respondents had formal education. Eighty-one medicinal plant species from 35 families were documented. Leaves are the most utilized 25.8 followed by seed 17.7 and fruits 12.1%, respectively. Relative frequency of citation ranged from 0.5 to 0.9, whereas the FL value ranged from 0.4 to 0.85, revealing how effective the documented plant species are in the management of COVID-19 in the region. A greater amount of research into documented medicinal plants is warranted because of the high likelihood that they contain many active ingredients.

COVID-19 vaccine breakthrough infection among fully vaccinated healthcare workers in Duhok governorate, Iraqi Kurdistan: A retrospective cohort study.

The aims of this study were: to determine the incidence of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection among vaccinated healthcare workers (HCWs), assess risk factors associated with the vaccine breakthrough (BT), and compare the effectiveness of vaccine manufacturers against SARS-CoV-2 variant of concern among HCWs in Duhok governorate. It is a multicenter retrospective cohort study, which enrolled 944 HCWs through March 2022. COVID-19 vaccinated HCWs aging 18 and above were included. A random sampling process was performed by asking the participants to fill out a standardized questionnaire by means of interviews or participant-completed surveys. Fully vaccinated HCWs with positive polymerase chain reaction tests were considered to have vaccine BT infection. Two hundred and eighty-four (30.1%) out of 944 vaccinated HCWs had SARS-CoV-2 infection postvaccination, of whom 241 (84.9%) were fully vaccinated, concluding that the incidence of BT infection is 25.5%. There were 422 (44.7%) males and 522 (55.3%) females. Most vaccine BT infections had developed in SARS-CoV-2 Omicron variant (53.5%). The majority of BT infections were mild to moderate (95.5%). Occupation, namely dentist was a significant risk factor, with a p value of 0.001. HCWs with a history of SARS-CoV-2 infection prevaccination were more prone to a vaccine BT infection (p value =0.002). Pfizer vaccine manufacturers revealed the highest effectiveness against BT infection (p value =0.0001). Paramedics showed a significant association with the disease severity (p value =0.02). The three available vaccine manufacturers in the Duhok governorate are effective against COVID-19 BT infections. Dentists and paramedics were significantly associated with poor COVID-19 outcomes.

The Incidence of Musculoskeletal Manifestations among Patients with COVID 19 Infection

Background-Patients with COVID-19 may manifest musculoskeletal symptoms;myalgia is frequently detected in COVID-19 infected patients. The study aims to examine the incidence of musculoskeletal manifestations in the Iraqi Kurdistan Region and its correlation with the disease severity, and the patient’s outcomes. Further, it attempts to correlate the disease severity with the smoking. Method-A sample of one thousand (1000) COVID-19 infected patients from the Iraqi Kurdistan Region, were examined in an observational cross-sectional study to obtain relevant data for the patients treated in the COVID-19 care centres in Erbil city. The study lasted from 15 August 2020 to 15 June 2021. Conclusion-The study shows that the musculoskeletal manifestations are frequent in COVID-19 infected patients;79.4% of patients had fatigue, 66.8% had myalgia, 56.9% had backache, and 41.5% had arthralgia, fatigue is the most common symptom. The smokers manifest severe or critical conditions of the disease.

COVID-19 OUTBREAK: THE KURDISTAN REGION PERSPECTIVE

Covid-19 first appeared in Wuhan, China then spread across the globe including Kurdistan region, Iraq. Seven types of coronaviruses can infect human (SARS, MERS, 229E, OC43, NL63, HKU1 and most recent SARS-CoV-2), four of these (HKU1, OC43, NL63, 229E) cause mild infection in the upper respiratory, while SARS, MERS and SARS-CoV-2 are responsible for high mortality rate, particularly SARS-CoV-2 is highly pathogenic and has caused acute respiratory disease, which endangers human health and public safety. Compared with SARS and MERS, the Covid-19 mortality rate is low since the majority of the cases have recovered. Despite its low mortality, the COVID-19 death toll is high, because COVID—19 has caused pandemics and spread across the world, while SARS and MERS only caused endemics. So far large portions of the world population have been affected by the Covid-19, the disease led to an emergency of public health and concern of the international community, thus putting health institutions across the globe on alert. Since, the Spanish flu at the beginning of last century, the Covid-19 pandemic is only the second outbreak to extremely influence the world countries' health system, economy, and psychology of the world population, in this respect Kurdistan region of Iraq has not been an exception. This review study focuses on virology, pathogenesis, global and regional epidemiology, clinical presentations, diagnosis, treatment and control, and vaccinations concerning the Kurdistan region of Iraq.

Risk Perception and Behavioral Response to COVID-19: A Survey of University Students and Staff in the Iraqi Kurdistan Region.

This study explores the risk perceptions and behavioral responses of university academics and students toward the COVID-19 pandemic. All universities in Iraqi Kurdistan were invited to take part in a self-administered online survey; 976 individuals ultimately completed it. The survey included eight main questions about personal risk perception and behavioral response to COVID-19 based on a five- or nine-point ordinal scale. A high percentage of the respondents perceived it as highly unlikely they were at risk of getting infection (26.9%), serious illness (29.7%), and death (41.7%). The percentage of the respondents who applied protective measures frequently or always was high for most protective behavior types, except for wearing masks, wearing gloves, and avoiding touching the face. There was a significant (P < .001) weak positive correlation between risk perception and protective behaviors. The respondents followed protective behavior measures reasonably, but the frequency of undertaking some important protective behaviors was relatively low.