Several intricate interactions of environmental and genetic factors can lead to autoimmune conditions in susceptible hosts. Systemic lupus erythematosus (SLE) is a complex systemic autoimmune disease which can be triggered or exacerbated by infection or infectious reactions. The causal link between infections and autoimmunity has been established through clinical studies. Though several viral infections have been associated with SLE, yet the impact of COVID-19 on SLE onset and flares has not been well established. We report a young female who developed new-onset SLE shortly after having COVID-19 infection. Her clinical and lab parameters were highly suggestive of SLE and she responded to standard medical therapy. We also briefly discuss the pathogenetic mechanisms of autoimmunity in cases of viral infections.

Early diagnosis is a fundamental component of global tuberculosis control. The objective of this study was to evaluate the diagnostic yield of post-bronchoscopy sputum (PBS) testing as part of a tuberculosis diagnostic work-up. All new residents in the State of Qatar undergo a tuberculosis (TB) screening program. Those with abnormal chest radiology, negative sputum acid-fast bacilli (AFB) smears, and nucleic acid amplification testing (NAAT) for M. tuberculosis, undergo an additional bronchoscopic evaluation for TB. We prospectively enrolled individuals who were going to undergo bronchoscopy to provide two PBS samples for AFB smears and mycobacterial cultures between 18 September 2018 and 12 March 2021. A total of 495 individuals, with a median age of 31 years, were included. The majority of the patients were males (329, 66.5%). The most frequent country of origin was India (131, 26.5%) followed by the Philippines (123, 24.8%). The addition of PBS to bronchoalveolar lavage (BAL) testing allowed microbiological confirmation of tuberculosis in an additional 13 patients (3.9%), resulting in improved sensitivity (from 77.9% to 81.9%), negative predictive value (from 69.2% to 73.2%), and negative likelihood ratio (from 0.22 to 0.18). Where resources are available, the incorporation of routine PBS examination as part of tuberculosis diagnostic work-up can enhance the diagnostic yield.

Background: Worldwide, 5–10% of people with chronic hepatitis B virus infection are co-infected with hepatitis D virus. In Qatar, there are no data on hepatitis D virus infection among patients positive for hepatitis B surface antigen (HBsAg). Aims: To determine the seroprevalence of hepatitis D virus infection among patients with chronic hepatitis B virus infection in Qatar and assess the characteristics of these patients. Methods: This was retrospective cohort study of all HBsAg-positive individuals tested for hepatitis D virus between 1 January 2010 and 29 December 2019 within Hamad Medical Corporation. Data were retrieved from electronic records and included demographic and clinical information of the patients. Results: Of 2348 HBsAg-positive patients, 125 were positive for hepatitis D virus (seroprevalence 5.3%). The median age of hepatitis D positive patients was significantly higher than patients negative for hepatitis D virus (P = 0.001). Most patients with hepatitis D had a hepatitis B viral load < 2000 IU/mL (53.6%) and were negative for hepatitis B e antigen (93.6%). A significantly greater proportion of patients positive for hepatitis D virus infection than those negative were infected with hepatitis C virus (P < 0.001), and had liver cirrhosis (P < 0.001) and hepatocellular carcinoma (P = 0.006) Conclusions: Hepatitis D virus infection is associated with lower hepatitis B virus viraemia and more advanced liver disease.

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