The Association between COVID-19 and Reactive Arthritis: A Systematic Review of Case Reports and Case Series.

INTRODUCTION: Reactive arthritis (ReA) is a joint inflammation that follows an infection at a distant site, often in the gastrointestinal or urogenital tract. Since the emergence of COVID-19 in January 2020, several case reports have suggested a relation between reactive arthritis and severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), due to the novelty of the disease, most findings were reported in the form of case reports or case series, and a comprehensive overview is still lacking. METHODS: We searched PubMed/Medline and Embase to identify studies addressing the association between ReA and COVID-19. The following terms were used: ("Reactive Arthritis" OR "Post-Infectious Arthritis" OR "Post Infectious Arthritis") AND ("COVID-19" OR "SARS-CoV-2" OR "2019-nCoV"). RESULTS: A total number of 35 reports published up to February 16th, 2022, were included in this study. A wide range of ages was affected (mean 41.0, min 4 max 78), with a higher prevalence of males (61.0%) from 16 countries. The number and location of the affected joints were different in included patients, with a higher prevalence of polyarthritis in 41.5% of all cases. Cutaneous manifestations and visual impairments were found as the most common associated symptoms. Most patients (95.1%) recovered, with a mean recovery time of 24 days. Moreover, arthritis induced by COVID-19 seems to relieve faster than ReA, followed by other infections. CONCLUSION: ReA can be a possible sequel of COVID-19 infection. Since musculoskeletal pain is a frequent symptom of COVID-19, ReA with rapid onset can easily be misdiagnosed. Therefore, clinicians should consider ReA a vital differential diagnosis in patients with post-COVID-19 joint swelling. Additional studies are required for further analysis and to corroborate these findings.

Isoniazid-resistant tuberculosis in Iran: A systematic review.

Isoniazid (INH) is one of the most potent anti-tuberculosis (TB) agents. INH resistance is an obstacle to the treatment of TB disease and the National TB control Program (NTP). We aimed to determine the true prevalence of INH-resistant TB in Iran. Several databases including Embase, Medline, Cochrane library and Iranian databases were searched to identify studies addressing INH-resistant tuberculosis in Iran. We identified 156 articles, of which 129 records were excluded based on their titles and abstracts. In a secondary screening, we assessed the eligibility of 27 full-text articles of which, 6 did not report usage data. Finally, 21 studies published from different regions of Iran from March 1999 until July 2015 were included in this study. Comprehensive meta-analysis (V2.2, Biostat) software was used to analyze the data. The meta-analysis showed that 12.8% (95% CI 9.4-15.8; I(2) = 87.8; P < 0.001 test for heterogeneity) of new TB cases and 40.1% (95% CI 28.5-53.0; I(2) = 88.2; P < 0.001 test for heterogeneity) of previously treated cases were resistant to INH. High prevalence of INH resistance among TB patients has been reported in many health-care settings, suggesting that better management of such cases, use of effective treatment regimens and establishing advanced diagnostic facilities are needed to avoid further emergence of INH-resistant TB.