Meningococcal disease continues to be an important, vaccine-preventable cause of death in the United States. Vaccination and other disease prevention efforts should be augmented for higher risk groups. Meningococcal mortality data can be used to assess the effectiveness of these efforts.

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Background Given the widespread impact of COVID-19, it is important to explore any atypical presentations and long-term sequelae associated with this viral infection, including the precipitation of inflammatory arthritis. Objective To identify and summarize clinical reports of acute inflammatory arthritis associated with COVID-19. Methods A systematic review of the PubMed (MEDLINE), Google Scholar, and Cochrane Central databases through January 31, 2022 was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The inclusion criteria were: human subjects and English language. Data extraction and qualitative synthesis of the demographics, clinical presentations, treatments, and outcomes were performed. Quality assessment was performed using the Joanna-Briggs Institute critical appraisal tools. Results A total of 37 articles collectively describing the cases of 54 patients were included. The mean age was 48.2 years (6-78 years). 53.7% of patients were male and 46.3% were female. The onset of articular symptoms varied considerably, and the majority of cases were described as polyarticular (29). The classification of inflammatory arthritis in the included studies was as follows: reactive (19), post-viral (13), new-onset rheumatoid arthritis (RA) (8), crystal-proven arthropathy flare (4), acute viral (2), new-onset psoriatic arthritis (2), flare of preexisting RA (2), and other (4). Arthritis treatment regimens varied but consisted largely of NSAIDs and corticosteroids with most patients experiencing improvement or resolution of their joint symptoms. Conclusion There is limited low-level evidence suggesting that patients may develop acute arthritis during or after SARS-CoV-2 infection. This review highlights the need for further research to elucidate the relationship between COVID-19 and the development of inflammatory arthritis.

Objective: To evaluate the impact of short-term smoking cessation on Metabolic Syndrome (Mets) component risk factors, and hormones related to MetS and human metabolism.Methods: Smoking veterans with MetS, attending stop smoking class, were followed up close to one year. Paired comparisons between after the follow up and baseline data were made using t-test.Results: A total of 95 smoking veterans with MetS completed average close to one year follow up. Thirty subjects completely quit for the average of 6 months, while 36 subjects continued smoking during the follow up. At the end of study, quitters average waist circumference increased 2.98 cm (0.69–5.27), weight increased 2.05 kg (−0.03 to 4.13), HDL cholesterol increased 4.17 mg/dl (1.03–7.32), triglyceride decreased 56.17 mg/dl ((−1.96 to 111.20), and MetS prevalence decreased 13% (p = 0.05). The changes in ghrelin were moderately positively associated with duration of quitting smoking (R2 = 43.99, and p < 0.01).Conclusion: Compared to the baseline, quitters HDL was up, triglyceride was down, and overall MetS prevalence was lower. The longer the duration of quitting, bigger the increase in ghrelin. There were no significant changes in serum leptin, ghrelin, serum insulin, and insulin resistance after quitting smoking.

IntroductionWe sought to determine time to return to work (RTW) among healthcare workers (HCWs) with mild/moderate coronavirus disease 2019 (COVID-19) and identify predictors of COVID-19 test positivity and illness duration. MethodsA retrospective review of HCWs presenting for COVID-19 testing/evaluation in December 2020 was performed to examine demographics, clinical characteristics, and RTW. ResultsOf 250 exposure incidents, 107 employees (42.80%) tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). No significant differences between COVID-19 positive and negative HCWs were noted in terms of key demographics, including age, gender, and CDC risk scores. Cough (77.57% vs 56.64%, p = 0.001), fatigue (66.36% vs 51.05%, p = 0.015), fever/chills (65.42% vs 37.06%, p < 0.001), myalgia (57.01% vs 35.66%, p = 0.008), and change in smell/taste (38.32% vs 13.29%, p < 0.001) were more prevalent among COVID-19 positive versus negative HCWs. Change in smell/taste (p < 0.001, OR 3.592), cough (p = 0.001, OR 2.966), and fever/chills (p = 0.019, OR 2.107) were independently associated with COVID-19 test positivity. Mean time to RTW from symptom onset was 13.09 days for COVID-19 positive HCWs. Female gender (p = 0.020, + 3.20 days), older age (p = 0.014, + 2.22 days), and myalgia (p = 0.021, + 2.23 days) were predictive of longer illness duration. ConclusionChange in taste/smell, cough, and fever/chills were independently associated with COVID-19 test positivity. Among HCWs with mild/moderate COVID-19 infection, the mean time to RTW was approximately 13 days with female gender, older age, and myalgia being predictive of delayed RTW.