As the coronavirus disease 2019 (COVID-19) pandemic is evolving, more complications associated with COVID-19 are emerging. In this case report, we present a case of rhinocerebral mucormycosis concurrent with COVID-19 pneumonia in a 41-year-old man with a history of type 1 diabetes mellitus (T1DM). COVID-19 pneumonia was diagnosed with reverse transcription-polymerase chain reaction (RT-PCR). He was promptly treated with steroids and hydroxychloroquine, as this was the recommended regional COVID-19 practice patterns at the time. He was treated with intravenous (IV) fluids and an insulin drip for his diabetic ketoacidosis (DKA), cefepime and IV abelcet, along with three surgical debridements for the rhinocerebral mucormycosis. The pneumonia resolved during the course of his stay in the hospital. With prompt diagnosis and treatment of rhinocerebral mucormycosis, the patient was cleared for discharge and was instructed to complete his course of treatment with coumadin and IV abelcet at home. Saprophytic fungi cause rhinocerebral mucormycosis, a rare opportunistic infection of the sinuses, nasal passages, oral cavity and brain. It usually occurs in patients with poorly controlled diabetes mellitus or those who are immunocompromised, which is again demonstrated in this case report. In the setting of COVID-19 pneumonia and an underlying condition, healthcare professionals should act promptly. In cases where mucormycosis infection is suspected, a prompt diagnosis and treatment should be started because of the angioinvasive character and rapid disease progression that contribute to the severity of the mucormycosis infection.

Background: CrossFit is an increasingly popular, rapidly growing exercise regimen. Few studies have evaluated CrossFit-associated musculoskeletal injuries on a large scale. This study explores such injuries and associated risk factors in detail. Objective: To identify the most common musculoskeletal injuries endured during CrossFit training among athletes at different levels of expertise. Design: Survey-based retrospective cross-sectional study. Setting: Distribution at CrossFit gyms in the United States and internationally. Also published on active online forums. Participants: A total of 885 former and current CrossFit athletes. Methods: Institutional review board-approved 33-question Web-based survey focused on CrossFit injuries and associated risk factors. Survey submissions were accepted for a period of 6 months. Main outcome measurements: Specific injuries with associated workouts, risk factors that affected injury including (1) basic demographics, (2) regional differences in reported injuries, (3) training intensity, and (4) expertise level at time of injury. Results: Of the 885 respondents, 295 (33.3%) were injured. The most common injuries involved the back (95/295, 32.2%) and shoulder (61/295, 20.7%). The most common exercises that caused injury were squats (65/295, 22.0%) and deadlifts (53/295, 18.0%). Advanced-level (64/295, 21.7%) athletes were more significantly injured than beginner-level (40/295, 13.6%) athletes. International participants were 2.2 times more likely than domestic US participants to suffer injury. Individuals with 3+ years of CrossFit experience were 3.3 times more likely to be injured than those with 2 or less years of experience. Participants who trained for 11+ h/week were significantly more likely to be injured than those who trained less than or equal to 10 h/week. Conclusions: As CrossFit becomes more popular, it is important to monitor the safety of its practitioners. Further studies are needed to explore how to lower this injury prevalence of 33.3%. Areas to focus on include factors that have caused the regional (international vs US states) differences, level of expertise/experience differences (advanced level vs intermediate and beginner levels), and stretching routine modifications.

Coronavirus 2019 (COVID-19) pneumonia was first noted in Wuhan, China. Since the start of the pandemic, there have been millions of cases diagnosed. The average time from onset of symptoms to testing negative SARS-CoV-2 via reverse transcription polymerase chain reaction is roughly 25 days. In patients who continually test positive for COVID-19, it is essential to determine precisely which risk factors contribute to the increase in viral shedding duration. We present a case about a 62-year-old man who has persistently tested positive for COVID-19 for more than 230 days. We followed his treatment course, in which he had been hospitalized multiple times since the onset of symptoms back in April 2020. We have determined that patients with immunosuppression, especially those taking corticosteroids, are at increased risk of prolonged viral shedding. It is essential to continually monitor these immunocompromised patients as they required a greater time period in order to have an appropriate immune response in which antibodies are created.

No abstract

Coronavirus disease 2019 (COVID-19) was first identified at the end of 2019 as a cluster of pneumonia cases in Wuhan, China. By February 2020, this virus quickly spread, becoming a global pandemic. The spectrum of symptomatic infection severity can range from mild, severe, and critical disease. Many correlated comorbidities were established, including smoking, socioeconomic background, gender (male prevalence), hypertension, obesity, cardiovascular disease, chronic lung disease, diabetes mellitus, cancer, and chronic kidney disease. In an extensive literature search, post-COVID-19 necrotizing Staphylococcus aureus pneumonia with pneumothorax has not been recorded. We present a case about a 62-year-old male who presented with symptoms of COVID-19 with many underlying comorbidities, including hypertension and hyperlipidemia. He was on ventilatory support during his first week in the hospital and then received supplemental oxygenation as he recovered from his COVID-19 pneumonia. Nearly a month and a half after his initial presentation, he quickly decompensated and was started on supplemental oxygen and the necessary treatments. It was then, with the aid of lab work and imaging, that we determined that he had developed necrotizing Staphylococcus aureus pneumonia with pneumothorax. He was adequately treated, and once he was stable, he was discharged home and was told to continue his therapy.