Recently, there has been increasing evidence among people infected with coronavirus disease 2019 (COVID-19) of being diagnosed with the typical acute post-infectious inflammatory polyneuroradiculopathy that was formerly known as Guillain-Barré syndrome (GBS), and it is not uncommon that some of them develop chronic inflammatory demyelinating polyneuroradiculopathy (CIDP). However, there is still a large debate and controversy about the link between COVID-19 and polyneuropathy. As a result, a multicentric retrospective cohort study was conducted in Basrah Governorate in the south of Iraq that included 2240 patients over a period of six months. Of those, 1344 patients had a history of COVID-19 in the previous year, and 1.14% of them developed inflammatory polyneuropathy, while only 0.29% (896 patients) of those with no history of COVID-19 had developed inflammatory polyneuropathy. This difference is highly significant, with a relative risk equal to six. The majority of the inflammatory polyneuropathy (44.4%) was diagnosed four to 12 weeks after the COVID-19 infection, with GBS being the most common type (72.2% of cases). Moreover, the nerve conduction velocity, the distal latency, and the amplitude of the most studied nerves were slower, more prolonged, and lower, respectively, among the COVID-19 groups compared with the non-COVID-19 group. Furthermore, there is an inverse correlation between the nerve conduction velocity in the majority of studied nerves and certain inflammatory biomarkers, such as serum ferritin, interleukin-6, and c-reactive protein. Although the occurrence of inflammatory polyneuropathy is more common among the less severe groups of COVID-19, if it occurs in the severe groups, it shows a more aggressive presentation.

Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by a painful symmetrical peripheral polyarthritis. Extra-articular involvement in RA is a common condition. Pulmonary involvement occurs in 20 to 67 % of RA patients and it is responsible for about 10-20 % of mortality in RA patients. Objectives: To evaluate the extent and pattern of pulmonary involvement in RA patients by using spirometry. Methods: A case control study conducted at the rheumatology unit of Al Sader teaching hospital, forty RA patients [33(82.5%) female and 7(17.5%) male] and sixty apparently healthy subjects {50(83.3%) female and 10(16.7 %) male} were included in the study. All subjects had subjected to a pulmonary function test (PFT) for pulmonary function evaluation using MIR spirolab III. Measured and predicted forced vital capacities (FVC), forced expiratory volume in the first second (FEV1) and FEV1 / FVC ratio were considered as the parameters in this study for both groups. Results: Nine patients were found to have a restrictive pattern of pulmonary function test, while obstructive pattern was found in only one patient. On the other hand, the pulmonary function tests were normal in all of sixty healthy control. The mean of FEV1 in patient group (2.07 ± 0.56L) and of FEV1% (95.8%  25.2) are significantly lower than those in the control group (2.46 ± 0.65 L; 105.3%  13.09). In addition, mean FVC in the patient group (2.35 ± 0.62L) and its mean percentage (92%  22.68) showed a clear significant reduction compared to those in control group (2.71 ± 0.67 L; 100.53  12.12). No significant difference (P = 0.173) has been observed in FEV1 / FVC ratio between patient (88.17  7.47) and control group (89.87  4.99). Conclusions: Different pattern of pulmonary function abnormalities could be manifested in RA patients and the restrictive pattern represents the most common feature. Spirometry is indicated as a baseline assessment and for follow up of RA patient to enhance early detection and management of the pulmonary involvement.

Infection with the novel coronavirus that causes coronavirus disease 2019 results in a variety of clinical symptoms, including various neurological abnormalities. Peripheral nervous system symptoms, such as peripheral neuropathies, were often recorded in the medical literature, primarily as Guillain-Barré syndrome. Mononeuropathy multiplex is a multifocal axonal neuropathy commonly associated with vasculitis or connective tissue disease. Recent evidence about its associations with severe COVID-19 infection and intensive care unit hospitalization is being considered. A 58-year-old man with clinical and electrophysiological confirmation of mononeuropathy multiplex was reported during the peri-COVID-19 illness. He was treated with steroids and achieved a satisfactory response. Therefore, clinical and neurophysiological evaluation is recommended for any patient presenting with neurological manifestations following COVID-19 infection.

ObjectivesHypothyroidism adversely affects pulmonary function, which may improve by thyroxine therapy. Limited studies about the effect of hypothyroidism on spirometric parameters in adult patients were conducted in Basra, south of Iraq. Moreover, the effect of thyroxine therapy on spirometric parameters was not covered by these studies. In this study, pulmonary function in adult’s hypothyroid patients was evaluated by spirometry to detect any impairment, type of impairment, and to evaluate the effect of thyroxine therapy.MethodsA comparative study was conducted in Al-Faiha Specialized Diabetes, Endocrine, and Metabolism Center (FDEMC) in Al-Faiha teaching hospital, Basrah, Iraq. Subjects are divided into four groups: uncontrolled hypothyroid group (n=72), controlled hypothyroid group (n=60), newly diagnosed hypothyroid group (n=52), and control group (n=110). Spirometry was done to all subjects in sitting position, it’s repeated at least three times and the best result was recorded.ResultsA significantly (p<0.05) less spirometric parameters and more abnormal pulmonary function test (PFT) were noticed in hypothyroid groups, the reduction were more pronounced in the uncontrolled hypothyroid group. The abnormality in PFT was mostly of restrictive type. A significantly (p<0.05) negative correlation has been found between thyroid-stimulating hormone (TSH) and spirometric parameters, while the correlation of fT4 is significantly (p<0.05) positive with FVC% and FEV%.ConclusionIn hypothyroidism, high TSH and low fT4 are recognized causes of a reduction in spirometric parameters. Therefore, spirometry can be used to detect pulmonary function changes in hypothyroidism.

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