Purpose: Multiple studies worldwide have reported the clinical and epidemiological features of coronavirus disease 2019 , with limited reports from the Middle East. This study describes the clinical and epidemiological features of COVID-19 cases in the Eastern Province of Saudi Arabia and identified factors associated with the severity of illness. Patients and Methods: This was an observational study of 341 COVID-19 cases. These cases were reported in the first three months after the first case in the country was identified. Clinical and demographic data were analyzed and described to identify the effects of age, sex, and ethnicity on illness severity. In addition, the duration of viral shedding and cycle threshold (Ct) values of real-time PCR were evaluated as predictors of severity. Results: The median age was 45 years. Males were twice as likely to be infected than females (p <0.0001). The duration of viral shedding ranged from 9 to 36 days. The most common clinical presentations include fever, shortness of breath, cough, myalgia, sore throat, vomiting, and headache. Critical cases were significantly higher in men (23% vs 8.7%), senior adults (>65 years), individuals of Bengali ethnicity, and in patients with comorbidities including diabetes, hypertension, and dyslipidemia (p =0.001). The case fatality rate was found to be 10%. The fatality was significantly higher in males than females (13.8% vs 2.6%), and in Asians (17.9%) than Arabs (6%) and Africans (0) (p =0.002). No association was found between viral load, represented by the RT-PCR cycle threshold (Ct) values, and severity of illness. Conclusion: Age, sex, and ethnicity are important predictors of COVID-19 severity. The cycle threshold (Ct) of the SARS-CoV-2 RT-PCR test cannot be used as a predictor of the criticality of illness.

Patient: Male, 25 Final Diagnosis: Iatrogenic ventriculitis due to Mycoplasma hominis Symptoms: — Medication: — Clinical Procedure: Extraventricular drain Specialty: Infectious Diseases Objective: Rare disease Background: Mycoplasma hominis , which rarely causes infection after neurosurgical procedures, is a small free-living organism, belonging to the genus Mycoplasma . M. hominis lacks a rigid cell wall and cannot be clearly visualized by routine light microscopy. Thus, it is challenging to diagnose infections caused by this pathogen. Here, we report a case of Mycoplasma hominis causing iatrogenic ventriculitis secondary to extraventricular drain. Case Report: A 25-year-old man who was a victim of a road traffic accident developed M. hominis ventriculitis secondary to extraventricular drain. Despite a delay in the diagnosis due to the difficulty of identifying M. hominis , the patient was successfully treated with intravenous ciprofloxacin 400 mg for 14 days. Conclusions: The findings of this case report, coupled with a thorough review of the literature, demonstrate the pathogenic potential of M. hominis . Particularly in developing countries, in which laboratories may have limited access to advanced technologies, such rare infectious diseases remain major diagnostic challenges.

Background Multiple studies worldwide reported the clinical and epidemiological features of coronavirus disease 2019 (COVID-19) with limited reports form the Middle East area. Methods This is an observational study to describe the clinical and epidemiological features of 341 COVID-19 cases in the Eastern Province of Saudi Arabia over the first three months from reporting the first case in the country and identify factors associated with severity of the illness. Results The median age was 45 years and males were twice as affected as females (p value < 0.0001). The duration of viral shedding ranged from 9 to 36 days. The most common clinical presentations include fever, shortness of breath, cough, myalgia, sore throat, vomiting, and headache. Severe and critical cases were significantly higher in males compared to females (23% vs 8.7%), senior adults (> 65 years), Bengali ethnicity, and in patient with com-morbidities including diabetes, hypertension, and dyslipidemia (p-value = 0.001). Furthermore, case fatality rate was found to be 10% and was significantly higher in male gender compared to female (13.8%vs 2.6%), and in Asian ethnicity (17.9%) compared to Arabs (6%) and African counterparts (0) (p-value = 0.002). No association was found between viral load represented by the RT-PCR cycle threshold (Ct) values and severity of illness. Conclusion Age, gender and ethnicity are important predictors of COVID-19 severity while Cycle threshold (Ct) of SARS-CoV-2 RT-PCR test cannot be used as a predictor of criticality of illness.