1Department of Internal Medicine, University of Toledo, Toledo, OH

2Department of Internal Medicine, St. Vincent Charity Medical Center, Cleveland, OH

3Division of Pulmonary and Critical Care Medicine, University of Toledo, Toledo, OH

4Division of Rheumatology, University of Toledo, Toledo, OH

The authors have no conflicts of interest to declare.

A. Beran and H. Ayesh designed the study, collected, analyzed, interpreted the data, and drafted the manuscript. W. Sayeh, O. Srour, M. Mhanna, W. Khokher, N. Altorok, Z. Noori, and R. Musallam collected the data and reviewed the literature. N. Altorok and R. Assaly supervised and critically revised the manuscript. All authors read and approved the final manuscript.