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Background: About 5-10% of coronavirus disease 2019 (COVID-19) infected patients require critical care hospitalization and a variety of respiratory support, including invasive mechanical ventilation. Several nationwide studies from Saudi Arabia have identified common comorbidities but none were focused on mechanically ventilated patients in the Al-Ahsa region of Saudi Arabia., Objectives: Identify characteristics and risk factors for mortality in mechanically ventilated COVID-19 patients., Design: Retrospective chart review SETTING: Two general hospitals in the Al-Ahsa region of Saudi Arabia PATIENTS AND METHODS: We included mechanically ventilated COVID-19 patients (>18 years old) admitted between 1 May and 30 November 2020, in two major general hospitals in the Al-Ahsa region, Saudi Arabia. Descriptive statistics were used to characterize patients. A multivariable Cox proportional hazards (CPH) model was used exploratively to identify hazard ratios (HR) of predictors of mortality., Main Outcome Measures: Patient characteristics, mortality rate, extubation rate, the need for re-intubation and clinical complications during hospitalization., Sample Size and Characteristics: 154 mechanically ventilated COVID-19 patients with median (interquartile range) age of 60 (22) years; 65.6% male., Results: Common comorbidities were diabetes (72.2%), hypertension (67%), cardiovascular disease (14.9%) and chronic kidney disease (CKD) (14.3%). In the multivariable CPH model, age >60 years old (HR=1.83, 95% CI 1.2-2.7, P =.002), CKD (1.61, 95% CI 0.9-2.6, P =.062), insulin use (HR=0.65, 95% CI 0.35-.08, P <.001), and use of loop diuretics (HR=0.51, 95% CI 0.4, P =.037) were major predictors of mortality., Conclusion: Common diseases in mechanically ventilated COVID-19 patients from the Al-Ahsa region were diabetes, hypertension, other cardiovascular diseases, and CKD in this exploratory analysis., Limitations: Retrospective, weak CPH model performance., Conflicts of Interest: None.

Background: Blastomycosis is a disease caused by the fungus Blastomyces-a thermally dimorphic fungus that can cause granulomatous and/or purulent infection., Case Presentation: We report here a case of chronic blastomycosis infection in a 24-year-old male patient from Saudi Arabia who presented with recurrent skin abscesses associated with deep-seated and multilevel paraspinal (dorsal and lumbar) collections and bilateral empyema with pulmonary involvement and bilateral psoas abscesses. The diagnosis was made after a CT-guided pleural biopsy revealed the characteristic histopathological findings of blastomycosis. The patient underwent several drainage procedures and was successfully treated with a long-term course of oral itraconazole., Conclusions: Chronic blastomycosis may have clinical and radiologic features similar to thoracic tuberculosis or malignant disease. There is no definite clinical symptom of blastomycosis, and thus a high degree of suspicion is required for early diagnosis. This case is a rare form of blastomycosis with chronic multifocal purulent infection and is the second case of blastomycosis reported in Saudi Arabia., (© 2022. The Author(s).)