Purpose: To report on the underlying risk factors, clinical characteristics, presentation, and survival of coronavirus disease 2019 (COVID-19) associated mucormycosis (CAM) cases referred for ophthalmological consultation in two different Egyptian settings during the third viral pandemic wave (April to August of 2021). Methods: A multicentric, retrospective analysis involving one public and two private hospitals in metropolitan Cairo, and two university hospitals in upper Egypt (Aswan and Assuit). Cases that fulfilled the diagnostic criteria of mucormycosis, with a prior or concurrent COVID-19 infection, were included. Results: Of the 26 patients included in the final analysis, 15 (57.7%) were from Cairo and 11 (42.3%) were from upper Egypt. Twenty-five patients (96.2%) had poorly controlled diabetes mellitus and 20 (76.9%) had received corticosteroid treatment for COVID-19, of which 30.8% had mild or moderate disease. The median duration from COVID-19 till the onset of CAM was 20.5 days. No visual function could be detected in the affected eye of 16 patients (61.6%) on presentation. The mortality rate was 46.2% despite surgical debridement in half of the cases that died. Conclusion: CAM continues to be a concrete threat throughout Egypt, especially in patients with poorly controlled diabetes mellitus and those who inadvertently receive steroid therapy. It remains to be seen if increased vaccination coverage and early detection due to increased awareness would result in declining rates and adverse sequelae of CAM. A national registry would allow for better monitoring of the disease trends.

Mucinous cystadenoma of the appendix is a rare condition characterized by abnormal mucus accumulation in the appendiceal. Laparoscopic appendectomy is a common approach worldwide and can be used in the management of mucinous cystadenoma with lower postoperative complication rates. A 30-year-old female had sharp pain localized to the right abdomen for 2 days. It was aggravated by movement and associated with nausea and vomiting. Laboratory findings were normal, but the abdominal computerized tomography scan demonstrated a cystic tumor in the right abdomen dorsal to the cecum and the ascending colon. Diagnostic laparoscopy showed a large cystic mass well-circumscribed encapsulated involving the appendix in the lower right abdomen. After demonstrating pathologic examination, the final diagnosis was mucinous cystadenoma of the appendix. Management of the appendicular mucinous cystadenoma can be successfully achieved through atraumatic laparoscopic excision of the tumor, it is safe, feasible and has a short postoperative recovery period.

Aims This study aimed to investigate the potential of tocilizumab therapy in minimizing mortality and mechanical ventilation (MV) requirements among hospitalized COVID-19 patients. Methods A single-center, retrospective, observational cohort study of 375 patients with severe COVID-19 (March 1 and April 22, 2020) included 150 patients treated with Tocilizumab and 225 consecutive control patients adjusted for age and gender. Both groups received concomitant standard of care treatments in addition to Tocilizumab. The statistical methods relied on survival analyses, conditional logistic regression models, and contingency analyses. The primary outcomes included in-hospital mortality and the MV requirement. Results Tocilizumab associated with improved in-hospital mortality (34.7% vs 46.7%, P = 0.0136) and lower requirement for MV on days 1, 3, and 5 after treatment (P = 0.005, P < 0.0001, and P = 0.0021, respectively). Lower mortality was observed if tocilizumab was administered within 48 hours after admission (P = 0.0226). Older age and low blood oxygen saturation on admission decreased the odds of survival (P < 0.005). Conclusion Our study demonstrates a significant reduction in mortality and decreased requirement of MV with tocilizumab treatment in addition to the standard of care. Early administration of Tocilizumab within 48 hours reduces the risk of mortality.