Search

Introduction Obstructive sleep apnea (OSA) is characterized by repetitive upper airway collapse resulting in episodes of apnea and hypopnea. Studies have shown worsened coronavirus disease 2019 (COVID-19) severity due to coexisting respiratory conditions and suggest increased severity of COVID-19 in patients with or at high risk of OSA. However, the extent of this correlation is unclear. This retrospective study aimed to evaluate the association between OSA severity and COVID-19 severity and assess the impact of continuous positive airway pressure (CPAP) compliance. Methods This single-center retrospective study was conducted at King Abdulaziz University Hospital (KAUH), a tertiary care center in Jeddah, Saudi Arabia. Data were collected from 62 adult patients with OSA who were diagnosed via polysomnography (PSG) and had a positive documented severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) test result. COVID-19 severity was categorized into mild, moderate, and severe. Results There was no significant correlation between OSA severity as measured by the apnea-hypopnea index (AHI), low oxyhemoglobin desaturation (LSAT), arousal index (AI), respiratory disturbance index (RDI), or the type of treatment used, including adherence to CPAP, and the outcomes of COVID-19. However, higher arousal with respiratory index (ARI) and a lower percentage of time with SpO2 < 90% (T90) values were linked to moderate COVID-19 severity with significant p-values of 0.046 and 0.007, respectively. Conclusion There was no significant correlation between the severity or types of OSA treatment and the severity of COVID-19. Further research including multicenter studies with bigger populations and extensive sleep study data is warranted. Understanding the OSA-COVID-19 link may improve risk stratification and patient management., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. The Unit of Biomedical Ethics Research Ethics Committee (REC) issued approval reference number 82-22. The REC recommends granting permission of approval to conduct the project. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2025, Alqahtani et al.)

Empyema is defined as an accumulation of frank pus within the pleural cavity. Empyema necessitans is a rare complication of the pleural space infection when the existing empyema extends into adjacent structures beyond the pleural space, usually into the soft tissue of the chest wall. If severe, it can externalize to the skin. Historically, one of the most common causes of this condition was uncontrolled tuberculous infections. Our study describes a case where empyema necessitans could be classed as iatrogenic. This patient was initially admitted for empyema secondary to community-acquired pneumonia, which was successfully treated with a course of antibiotics and insertion of a chest drain. She was discharged but had to be re-admitted after one month, this time with a chest wall swelling at the point of recent chest drain insertion, which began to ooze purulent discharge. Imaging confirmed the diagnosis of empyema necessitans, which was then treated with a combination of surgical and antimicrobial therapy. Empyema necessitans are now seldom encountered, owing mainly to effective antibiotics and anti-tuberculous treatment. It is perhaps even more rarely seen as a complication of chest drain insertion. However, the report emphasizes the need to consider empyema necessitates in the list of differentials when assessing a patient with chest wall swelling, particularly where they have recently undergone pleural intervention., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Bokhary et al.)

Since the declaration of coronavirus disease 2019 (COVID-19) as a pandemic, it remains a widespread infection with a major impact on global resources and health infrastructure. The hallmark of COVID-19 continues to be the well-documented effects it has on the respiratory system. With the passage of time, the involvement of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus in other systems has become more apparent, with the increased incidence of thromboembolic events, cardiac involvement as well as gastrointestinal and neurological symptoms secondary to the infection. Our case report demonstrates a presentation of vertigo, hearing loss, tinnitus, and aural fullness. Our patient was diagnosed as positive for COVID-19 by reverse transcription-polymerase chain reaction (RT-PCR) nine days prior to developing these symptoms. Her COVID-19 infection was otherwise relatively mild, for which she did not seek any medical intervention. A careful assessment ruled out cerebrovascular causes and led us to the diagnosis of SARS-CoV-2-induced labyrinthitis. Our patient was successfully treated as an outpatient without unnecessary investigations and responded well to standard therapy for viral labyrinthitis as per National Health Service (NHS) guidelines. She eventually reported having made a full recovery within three weeks of the initial encounter. Audio-vestibular consequences of COVID-19 are less reported compared to other symptoms of neurological involvement, such as gustatory or olfactory dysfunction, which have become key indicators aiding in the diagnosis of the infection. Among these disorders, the commonly reported presentation is that of vestibular neuronitis. Our case report demonstrates that labyrinthitis is also among the neurological manifestations to be considered as a result of COVID-19, which can be safely managed in the community with the same strategies as those employed for other viral triggers. It also reveals the need for further research into the effects that COVID-19 may have on the audio-vestibular system., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Bokhary et al.)

Brucellosis is a form of zoonotic infection caused by various  Brucella  organisms. It most commonly presents as a case of pyrexia of unknown origin, alongside symptoms such as night sweats, malaise, arthralgias, and myalgias. This report describes the case of a man who presented with pyrexia of unknown origin for one month; he was diagnosed to be a case of brucellosis after enteric fever was ruled out. Investigations were ordered as it was a differential diagnosis with high clinical suspicion due to the presenting complaint and potential exposure of tainted consumable products. The systemic disease was determined to be brucellosis following blood results demonstrating positive antibody titers, and the suspicion of exposure due to widespread inadequacies in sterilization of food products., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Rizvi et al.)