Introduction Viral infection such as coronavirus disease 2019 (COVID-19) can exacerbate and aggravate neurological disorders due to autoimmune etiology like myasthenia gravis (MG). Experimental therapies used in COVID-19 are also factors that can cause the worsening of MG symptoms. This review aimed to assess and conclude the research-based study systematically to analyze the relationship of MG and COVID-19. Method This study was conducted in accordance to Cochrane handbook for systematic reviews and the guideline of preferred reporting items for systematic review and meta-analysis (PRISMA) and synthesis without meta-analysis (SWiM) in systematic reviews: reporting guideline. Inclusion criteria in this review were primary studies of every design, articles published in English around January 2000–October 2021, and the study used human as subject. A systematic literature finding was applied in 15 electronic scientific resources. The authors evaluated the study quality and risk of bias of each retrieved article. Results The authors found the study through electronic scientific resources that met inclusion and exclusion criteria. The authors evaluated 362 articles identified in literature searching, 22 articles met the criteria for this review and then underwent the evaluation of study quality and risk of bias. Conclusion COVID-19 infection can increase the risk of new-onset MG, myasthenic crisis, respiratory failure, and mortality rate due to cytokine storm in MG patients. The management of COVID-19 patients with MG is tailored to each person and based on national guidelines and local expert recommendations.

Introduction Smoking is one of the most important causes of mortality and morbidity in the world, as it is related to the risk factor and etiology of respiratory-tract diseases. Long-term smoking causes both structural and functional damage in the respiratory airways, leading to changes in nasal mucociliary clearance (NMC). Objectives The aim of the present study was to look systematically into the current literature and carefully collect and analyze results to explore NMC in smokers. Data Synthesis Two independent reviewers conducted a literature search on some Electronic database: Pubmed, Medline, Ebsco, Springer Link, Science Direct, Scopus, and Proquest searching for articles fulfilling the inclusion and exclusion criteria. The lead author independently assessed the risk of bias of each of the included studies and discussed their assessments with the other two authors to achieve consensus. Of the 1,654 articles identified in the database search, 16 met the criteria for this review. Most of the articles (15 out of 16) showed the impairment of NMC in smokers. Conclusion The present systematic review suggests that there is an impairment of NMC in smokers. The impairment is not only observed in cigarette smoking, but also in passive smoking, bidi smoking, electronic smoking, and hookah smoking. The impairment of NMC in chronic exposure to smoking is caused by the ciliotoxic effect, hypersecretion and viscoelastic change of mucous, airway surface liquid depletion, increased oxidative stress, and deteriorations in the inflammatory and immune systems.

Introduction Coronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Initially, COVID-19 is a disease that attacks the respiratory tract, but now the clinical manifestations of COVID-19 are various, including acute ischemic stroke (AIS). Emergency surgeries such as mechanical thrombectomy (MT) for AIS must be performed without any delay even during the COVID-19 pandemic, to reduce morbidity and mortality. Besides the focus on patient’s health, the safety of healthcare workers must also be considered. The aim of the study was to evaluate and summarize the scientific literature systematically to explore MT for AIS in the COVID-19 pandemic. Data synthesis The independent reviewers searched the literature through 12 electronic databases, searching for articles fulfilling inclusion and exclusion criteria. The data from all included studies were presented in a summary table featuring key points of each study. The authors independently assessed the risk of bias of 15 included articles. Conclusion Although MT procedure has been prolonged during the pandemic, clinical outcomes and procedure-related serious adverse events have remained unchanged during the COVID-19 pandemic. The screening process and the implementation of the PCS algorithm must be performed to reduce the spread of COVID-19 infection without threatening patient safety and clinical outcomes. The standard precaution of infection and the health assurance of healthcare workers and their families (including mental health) are also important factors that must be given special attention and consideration in the COVID-19 pandemic.