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Background The global battle to contain the novel coronavirus disease 2019 (COVID-19) pandemic rages on. Previous studies described the clinical characteristics of COVID-19, but knowledge gaps remain in the Middle East region. Identifying these features will help in mapping the disease and guiding pandemic management. A multi-center, retrospective cross-sectional study was initiated to describe the demographic data, clinical characteristics, and outcomes of COVID-19 cases across all the regions of Saudi Arabia. Methods The analysis included all laboratory-confirmed positive COVID-19 patients from the 1st of March 2020 to 31st of March 2020 across all regions of Saudi Arabia. Demographic data, clinical characteristics, incubation periods, laboratory findings, and patient outcomes data were retrieved from 1519 cases in the Health Electronic Surveillance Network Database. Results The median age was 36 years and 54.3% (n = 825) of the patients were men. Patients working in health care facilities represented 12.5% of the cases (n = 190) and 9.3% of cases were asymptomatic. The median incubation period was 6 days. The most common symptoms were cough (89.4%), fever (85.6%), and sore throat (81.6%); 20.1% of the patients had underlying comorbidities. Hypertension was seen in 8.8% and diabetes in 7.6% of all the cases. The percentage of cases with temperatures >38֯C was 20.3% (n = 129), and 1.6% of patients had heart rates ≥125 beats/min and 4.7% of them had respiratory rates of >24 breaths/min. Lymphocytopenia occurred in 37.5% of cases. Overall, 71.6% of patients were admitted to hospitals and 4.7% required ICU treatment. We could not completely assess the clinical courses or final outcomes of COVID-19 patients. Conclusion In this multi-center retrospective study, fever and cough were common symptoms. Special attention should be addressed toward asymptomatic carriers and workers in health care facilities as they play a key role in disease transmission.

The Hajj pilgrimage, held in the Kingdom of Saudi Arabia, is among the largest mass gatherings in the world. More than 2.5 million Muslim pilgrims assemble from over 180 countries worldwide to perform Hajj. The Saudi government recognized the potential risks associated with this event since the first novel coronavirus disease 2019 (COVID-19) case was detected in the country on March 2, 2020. The return of possibly infected pilgrims to their countries after this huge mass gathering event could have turned Hajj into a superspreading event during the global COVID-19 pandemic. A multidisciplinary Saudi team from governmental sectors, including the Global Center for Mass Gatherings Medicine, shared in the assessment, planning, execution, and success of this holy event to prevent the spread of disease. The World Health Organization welcomed the Saudi government's decision to protect the wellbeing and safety of pilgrims and strengthen regional and global health security. A total of 1,000 pilgrims from 160 different countries were randomly selected to perform the rituals. Of all the pilgrims, healthcare personnel, and nonmedical employees facilitating the rituals, no confirmed cases of COVID-19 were identified during or after Hajj. This article highlights the success of the risk mitigation plan in place during the Hajj pilgrimage in 2020 (1441 Hijri year) during the COVID-19 pandemic and the efforts of the Saudi government to prevent associated outbreaks.