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The first case of COVID-19 infection in Saudi Arabia was reported in Qatif on March 2nd, 2020. Here, we describe the clinical characteristics of the initial COVID-19 patients in that area. This is an observational study describing the clinical presentation, radiographic and laboratory data of COVID-19 cases. From March 1st, 2020 to April 5th, 2020 we identified a total of 82 adult COVID-19 patients. The median age of the patients was 50 years, with a range of 30 to 60 years and most of patients were female 54 (65.9%). Of all the patients, 29 (35.4%) were contacts and 43 (52.4%) were returning travelers, mainly from Iraq (65% of the total returning travelers). Comorbidities were present in 50% of patients, G6PD deficiency in 33%, hypertension in 27%, and diabetes mellitus in 26%. Chest radiographs were abnormal in 46% of symptomatic and 15.5% of asymptomatic patients (P value = 0.0035). Of all patients, 4 (4.87%) required intensive care admission. There was no significant difference in time to negative RT-PCR with mean days to negativity of 13.6 and 16.9 for asymptomatic and symptomatic group, respectively (P value = 0.42). In the initial Epicenter of the COVID-19 in Saudi Arabia, the majority of the patients were asymptomatic and were returning travelers. Comorbidities were present in nearly half of the patients. [ABSTRACT FROM AUTHOR]

Shrinking lung syndrome (SLS) is an uncommon complication of systemic lupus erythematosus (SLE) that has also been seen in other autoimmune diseases and is linked with a high risk of acute or chronic respiratory failure. Alveolar hypoventilation in the presence of obesity-hypoventilation syndrome, systemic lupus erythematosus (SLE), and myasthenia gravis (MG) is uncommon and poses a diagnostic and therapeutic challenge. We reported a 33-year-old female patient from Saudi Arabia who suffered from obesity, bronchial asthma, newly diagnosed essential hypertension, type 2 diabetes mellitus, with recurrent acute alveolar hypoventilation, secondary to obesity hypoventilation syndrome and mixed autoimmune disease (systemic lupus erythematosus and myasthenia gravis), based on the correct constellation of clinical findings and laboratory evidence. The interesting aspect of this case report: is the presentation of the overlap of obesity hypoventilation syndrome and shrinking lung syndrome due to systemic lupus erythematosus with generalized and respiratory muscle dysfunction due to myasthenia gravis with good outcomes after therapy. [ABSTRACT FROM AUTHOR]