cord-003629-xogzl1lv 2019 title: Human metapneumovirus in Pediatric Patients with Acute Respiratory Tract Infections in the Aseer Region of Saudi Arabia OBJECTIVES: The objective of this study is to determine the presence of hMPV antigens in the nasopharyngeal secretions of pediatric patients hospitalized with respiratory tract infections in the Aseer region of Saudi Arabia. MATERIALS AND METHODS: This prospective, serological hospital-based study included all pediatric patients who were admitted to Aseer Central Hospital, Abha, Saudi Arabia, from July 2016 to November 2017 with upper and/or lower respiratory tract infections. CONCLUSIONS: The results obtained indicated that hMPV is a potential etiologic factor for the commonly occurring acute respiratory infections in hospitalized children from the Aseer region of Saudi Arabia. This prospective, serological study included pediatric patients who were admitted to Aseer Central Hospital, Abha, Kingdom of Saudi Arabia, from July 2016 to November 2017 with upper and/or lower respiratory tract infections. cord-017009-j069q0l3 2016 The most notable emerging viral infections in OWC include camelpox, Rift Valley fever (RVF), peste des petits ruminants (PPR), and Middle East respiratory syndrome coronavirus (MERS-CoV) infection. Outbreaks have been reported in Asia (Bahrain, Iran, Iraq, Oman, Saudi Arabia, the UAE, Yemen, Syria, Afghanistan, southern parts of Russia and India, and Pakistan) and in Africa (Algeria, Egypt, Ethiopia, Kenya, Mauritania, Morocco, Niger, Somalia, and Sudan). The first conclusive evidence of zoonotic CMLV infection in humans, associated with outbreaks in dromedary camels, has been recently reported in India where three human cases of camelpox have been reported (Bera et al. In September of 2010, an RVF outbreak occurred in northern Mauritania involving mass abortions in small ruminants and camels (Camelus dromedarius) and at least 63 human clinical cases, including 13 deaths. Middle East respiratory syndrome coronavirus infection in dromedary camels in Saudi Arabia cord-032513-uf4i46x9 2020 Therefore, the purpose of this PhD is to investigate the factors that have a significant impact on agile adoption in mobile app development by small and medium-size software organisations in Saudi Arabia. The aim of this PhD research is to investigate the factors influencing agile adoption in mobile application development sector in Saudi Arabia. This research aims to investigate the key factors that can either support or hinder agile adoption in mobile app development by software organisations in the Kingdom of Saudi Arabia. Therefore, this research will investigate the factors identified in previous studies to determine whether they can be considered as the main aspects affecting the adoption of agile in Saudi mobile app development. This cycle aims to conduct in-depth investigation to obtain a deep insight into the key factors that may influence agile adoption in Saudi mobile app development and the tools and techniques used. cord-201774-x5s32wdc 2020 It was with this Public Investment Fund that Saudi Arabia decided to buy out the football clubNewcastle United FCa mid-table club of the premier league. In this paper, we aim to forecast the investment levels and the subsequent improve in the league position of Newcastle United FC using the model of another premier league clubManchester City as the base. The Newcastle United Football Club is based around Tyne, Tyne and Wear in Newcastle with the British professional football team plays the highest flight of the Premier League for English football. Throughout the competition Newcastle was awarded four titles, six F.A. Cups and a community shield, including the 1969 inter-city fairs cup and the 2006 UEFA Intertoto Cup, a premier league club ''s 9th-highest award number won. Based on this deduction, we decided to use the statistics from City''s 2009/10 season to predict the performance of Newcastle United post their takeover on the basis of their similar past ranking and performance. cord-252883-1ub01j2x 2019 Since the first case of human infection by the Middle East respiratory syndrome coronavirus (MERS-CoV) in Saudi Arabia in June 2012, more than 2260 cases of confirmed MERS-CoV infection and 803 related deaths have been reported since the 16th of October 2018. The first case of infection attributed to Middle East respiratory syndrome coronavirus (MERS-CoV) was detected in Saudi Arabia in June 2012 [1] . Despite these viruses being identified in several reports as causing lower respiratory tract infections, it was generally accepted that coronaviruses were of low pathogenicity until the emergence of SARS-CoV (Severe Acute Respiratory Syndrome Coronavirus) in 2002, a virus with a fatality rate estimated at 10%. Very shortly afterwards, in September 2012, a second patient was admitted to hospital in the United Kingdom for severe respiratory infection related to a novel coronavirus following travel to the Middle East. Clinical features and viral diagnosis of two cases of infection with Middle East Respiratory Syndrome coronavirus: a report of nosocomial transmission cord-254234-8w1z3un6 2020 Water contamination, imported food, animal contact, and air transmission are also discussed in detail, to address their significant role as a source of infection and, thus, their impact on disease epidemiology in the Gulf countries'' populations. In this context, immigrant geographic origin, globalization of food supply to meet the demand of the increased labour force, food and water contamination, climate change, as well as poor hygiene after direct animal contact have all contributed to the annual flux in Cryptosporidium transmission and infection rates within the GCC countries [54, 57] . The literature search strategy was limited to title/abstract/keyword using the following MeSH terms/key words: (Cryptosporidium OR Cryptosporidiosis OR Parasite) AND (Infection OR Prevalence OR Incidence OR Occurrence OR Burden) AND (Human OR Animal OR Water OR Food) AND (Bahrain OR Kuwait OR Qatar OR Saudi Arabia OR Oman OR United Arab Emirates). cord-255339-oudj079q 2019 The most important zoonotic viral diseases of which eight were diagnosed (in dead or diseased animals or through antibody detection) on the Arabian Peninsula over the last years include rabies, Middle East Respiratory Syndrome (MERS-CoV), influenza virus (IFV), Alkhurma hemorrhagic fever, Crimean-Congo hemorrhagic fever (CCHF), Rift Valley fever (RVF), West Nile fever (WNV), and dengue fever virus. The same WHO epidemiological data suggest that in these 22 countries including Saudi Arabia, in recent years, there has been report of steadily increasing number of sporadic human cases, incidence, and outbreaks of the virus [122] . Surprisingly, the current review showed that during an outbreak, each of these eight most zoonotic viruses (rabies, MERS-CoV, influenza, AHFV, CCHFV, RVFV, DHFV, and WNV) which occurred and/or cases confirmed in Saudi Arabia particularly from (Jeddah and/or Makkah) areas with at least one or all of these eight zoonotic viral pathogenic diseases [33, 44, 46, 78, [96] [97] [98] [99] 121, 130, 156, 171] . cord-256589-45g5cvwt 2020 Objective: Saudi Arabia ranks second in the number of coronavirus disease 2019 (COVID-19) cases in the Eastern Mediterranean region. A susceptible-exposed-infectious-recovered (SEIR) prediction model was constructed to predict the trend in COVID-19 in Saudi Arabia in the next 6 months. We name our prediction model KSA-CoV-19, and with it, aim to find the following: 1) the anticipated epidemic curve of SARS-CoV-2 in Saudi Arabia, 2) the peak, the end, and the number of COVID-19 cases associated with the curve, and 3) the timing of upcoming Hajj 2020 (July 28 th -August 2 nd ) in relation to the anticipated epidemic curve. . https://doi.org/10.1101/2020.06.01.20119800 doi: medRxiv preprint Finally, we generated a model that simulated the natural course or "free fall" of the SARS-CoV-2 virus in Saudi Arabia. In this paper, we generated four different models that provided an estimation for the COVID-19 course in Saudi Arabia. cord-261421-k1s5iy3u 2015 To assess the temporal dynamics of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in dromedary camels, specimens were collected at 1–2 month intervals from 2 independent groups of animals during April 2013–May 2014 in Al-Ahsa Province, Saudi Arabia, and tested for MERS-CoV RNA by reverse transcription PCR. Furthermore, MERS-CoV infection in dromedary camels was definitively proven by the detection of virus and virus sequences in respiratory specimens, feces, and milk collected from camels in Qatar (9, 13) , Oman (14) , Saudi Arabia (5, 15, 16) , and Egypt (17) . To address these limitations and to clarify the dynamics of MERS-CoV infection in these animals, we conducted a year-round study in which we collected a large number of specimens from the upper respiratory tracts of live dromedary camels and from the lungs of dromedary camel carcasses. Middle East respiratory syndrome coronavirus infection in dromedary camels in Saudi Arabia cord-261524-nqukwoqz 2020 The quantitative data obtained in second phase showed the faculty member''s perspective about public health courses with sub-specialty needed to be set up in educational institutions to create competent workforce in public health were epidemiology (70.7%), environmental health (58.5%), public health education and promotion (56.1%), food safety (53.7%) and infection control (53.7%) should ( Table 3) . The students showed interest in perceiving the public health in sub-specialty epidemiology (38.5%), public health education and promotion (36.5%) and infection control (35.5%) and this finding shows availability of competent workforce in future (Table 4 ). This assessment of the educational needs of local public health organizations is an important step toward development of appropriate programs at the academic level to improve core competencies for public health professionals. Therefore, approximately 92.7% of Health Science faculty members and 97.5% of students had the opinion that there is a need to establish educational programs in Saudi Universities related to Public Health. cord-263016-28znb322 2015 Infection prevention/control and management guidelines for patients with Middle East respiratory syndrome coronavirus (MERS-CoV) infection Infection prevention and control guidelines for patients with Middle East respiratory syndrome coronavirus (MERS-CoV) infection Revised interim case definition for reporting to WHO e Middle East respiratory syndrome coronavirus (MERS-CoV) Revised interim case definition for reporting to WHO e Middle East respiratory syndrome coronavirus (MERS-CoV) Investigation of cases of human infection with Middle East respiratory syndrome coronavirus (MERS-CoV); interim guidance updated 3 Middle East respiratory syndrome coronavirus (MERS-CoV) in dromedary camels Middle East respiratory syndrome coronavirus infection in dromedary camels in Saudi Arabia Investigation of an imported case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in cord-264378-69mf7wi7 2019 OBJECTIVES: This study explored antimicrobial stewardship programme (ASP) team members'' perspectives regarding factors influencing the adoption and implementation of these programmes in Saudi hospitals. METHODS: This was a qualitative study based on face-to-face semistructured interviews with healthcare professionals involved in ASPs and activities across three Ministry of Health (MoH) hospitals in Saudi Arabia (n = 18). ASP team members highlight that lack of enforcement of policies and guidelines from the MoH and hospital administration is a significant barrier to ASP adoption and implementation. Second, healthcare organisation-related barriers such as lack of management support, disintegration, poor communication, lack of recruitment/shortage of ASP team members, lack of education and training, and lack of health information technology (IT). This is critical as the lack of top management support and commitment have been identified as significant barriers to ASP adoption and implementation in Saudi MoH hospitals (T3 Q4-5). cord-265363-xw56intn 2014 A prospective epidemiological study was conducted to evaluate the incidence of febrile cough episodes among adult Muslims travelling from Marseille to Saudi Arabia during the Hajj pilgrimage and to assess if use of statin had an influence on this incidence. This result suggests that while treatment with a statin has been demonstrated to reduce the mortality from severe sepsis associated with respiratory tract infections, it probably does not play a role in the outcome of regular febrile cough episodes as observed in the cohort studied here. The pre-travel questionnaire included demographic factors (age, gender, location of residence), indicators of immigration status (country of birth and duration of stay in France), socio-economic indicators (level of education, employment, type of housing, rooms per person and household, complementary health insurance modalities), health status indicators (diabetes, hypertension, chronic respiratory diseases, statin use, vaccination coverage against influenza) and number of previous travels to Saudi Arabia. cord-265964-cnp5bwet 2019 title: Assessment of nursing students perceptions of their training hospital''s infection prevention climate: A multi-university study in Saudi Arabia However, despite nursing students'' understanding of HAIs and their clinical exposure toward disease prevention and patient safety (Mitchell et al., 2014) , a considerable body of evidence indicates that nursing students are constantly challenged to implement standard precautions because of their views in the infection prevention climate of their training hospitals (Cruz, 2018) . Although some studies showed that infection prevention was cautiously practiced by health care professionals in Saudi Arabia (Colet et al., 2018) , training hospitals'' infection prevention climate among nursing students is not well described. This study was part of a large quantitative, cross-sectional study investigating the Saudi nursing students'' standard precautions compliance, patient safety competence, and perceptions of their training hospitals'' infection prevention climate. This study assessed the nursing students'' perception of training hospital infection prevention climate in Saudi Arabia. cord-266441-sd117tzs 2020 OBJECTIVES: This study is aimed at describing the epidemiological trends of primary CNS tumors in children and adults at the National Neurologic Institute in Saudi Arabia. The worldwide incidence age-standardized rates (ASR) of brain and nervous system cancer in high/very-high HDI (Human Development Index) regions versus low/medium HDI regions was 5.0 and 2.4 for men and 4.0 and 1.7 for women (Saudi Arabia is classified as very-high HDI according to the United Nations Development Program 4-tier system), respectively. Medulloblastomas were the most commonly reported histology type in the pediatric age group followed by low5 Journal of Cancer Epidemiology grade gliomas with a predominance of pilocytic astrocytoma. This study contains the largest institution-based ICD-O and WHO-classified epidemiological analysis of malignant and nonmalignant primary brain tumors in Saudi Arabia in adult and pediatric groups. With regard to a single tumor entity, meningioma was the most common primary brain tumor in adults while in the pediatric age group, medulloblastoma was the leading histology. cord-267090-jc1k3fki 2019 METHODS: A case-crossover design was used to identify associations between primary MERS cases and preceding weather conditions within the 2-week incubation period in Saudi Arabia using univariable conditional logistic regression. Data from meteorological stations closest to the largest city in each province were used to calculate the daily mean, minimum, and maximum temperature ((ο)C), relative humidity (%), wind speed (m/s), and visibility (m). Middle East respiratory syndrome coronavirus (MERS--CoV) is an emerging zoonotic agent that was first isolated in 2012 from a patient hospitalized in Saudi Arabia [1] , and has since infected over 2200 people with a 36% case fatality ratio [2] . By comparing weather conditions immediately before MERS cases to weather conditions at other times, this study aimed to identify environmental factors that are associated with primary human MERS in Saudi Arabia. The risk of primary human cases of MERS was associated with a decrease in temperature and humidity, and an increase in ground visibility. cord-268779-qbn3i2nq 2020 In this work, we propose a simulation model for the spread of Coronavirus Disease 2019 (COVID-19) in Saudi Arabia using a network-based epidemic model. The proposed model was used to evaluate the effectiveness of the control measures employed by the Saudi government, to predict the future dynamics of the disease in Saudi Arabia according to different scenarios, and to investigate multiple vaccination strategies. We aimed to match the model simulations with empirical data and then used the model to evaluate the effectiveness of the control measures employed by the Saudi government, to predict the future dynamics of the disease in Saudi Arabia according to different scenarios, and to predict the percentage of individuals that must be vaccinated to stop the outbreak (when a vaccine becomes available). Volz [35] modeled SIR dynamics on a static random network, which represents the population structure of susceptible and infected individuals and their contact patterns with an arbitrary degree distribution. cord-271681-jmoyy8rb 2016 To assess the epidemiologic and clinical features of the disease, we investigated all cases reported by the Saudi Arabia Ministry of Health (MoH) during January-June 2015, and we attempted genetic sequencing on all available specimens. At the time of this investigation, reporting in Saudi Arabia was required for all patients with clinical or radiologic evidence of MERS-CoV infection and a positive real-time reverse transcription-polymerase chain reaction (rRT-PCR) test result [21] . Genome analysis of human MERS-CoV strains from Saudi Arabia in 2015 and the recent outbreak in South Korea/China [31] [32] [33] and camels as noted above [35, 36] revealed a probable signature recombination event between 2 different parental clade B viruses involving a region of the ORF1ab and spike genes. Most cases identified in Saudi Arabia in February had documented exposure to healthcare facilities, a well-demonstrated risk factor for MERS-CoV infection [10] [11] [12] . cord-281068-bigb9890 2020 CONCLUSION: Precautionary measures adopted by the Saudi Arabian health authorities were evidently effective in controlling the spread and further burden of COVID-19. Since then, several precautionary measures have been implemented by the Saudi Arabian health authorities to prevent the anticipated spread of the disease based on international forecasts about the spread of COVID-19 in different countries globally. Once the first case of COVID-19 was confirmed in Saudi Arabia, the health authorities implemented strict precautionary measures to combat the outbreak. This study is an attempt by the author to assess the impact of precautionary measures to contain the COVID-19 outbreak, thus reducing the mortality rates in Saudi Arabia. To the author''s knowledge, this is the first study to assess the impact of precautionary measures in Saudi Arabia on combating a pandemic. 13 Country lockdown is one of the extreme measures adopted by the Saudi Arabian health DovePress authorities to control the spread of the disease. cord-283514-7rjo9k4d 2020 title: Impact of COVID-19Quarantine on Low Back Pain Intensity, Prevalence, and Associated Risk Factors among Adult Citizens Residing in Riyadh (Saudi Arabia): A Cross-Sectional Study This study aimed to estimate the effect of the coronavirus disease 2019 (COVID-19) quarantine on low back pain (LBP) intensity, prevalence, and associated risk factors among adults in Riyadh (Saudi Arabia). Furthermore, during the quarantine, a significantly higher LBP intensity was reported by those individuals who (a) were aged between 35 and 49 years old, (b) had a body mass index equal to or exceeding 30, (c) underwent higher levels of stress, (d) did not comply with the ergonomic recommendations, (e) were sitting for long periods, (f) did not practice enough physical activity (PA), and (g) underwent teleworking or distance learning. In this context, the present study''s purpose was to estimate the effect of the mentioned quarantine on LBP intensity, prevalence, and risk factors among adult citizens residing in Riyadh (Saudi Arabia). cord-288409-idq780jb 2016 title: Knowledge, Attitudes and Behaviours of Healthcare Workers in the Kingdom of Saudi Arabia to MERS Coronavirus and Other Emerging Infectious Diseases Objectives: The aim of this survey was to assess the knowledge, attitudes, infection control practices and educational needs of HCWs in the Kingdom of Saudi Arabia to MERS coronavirus and other emerging infectious diseases. The majority of respondents believed that patients with MERS-CoV and other emerging infectious diseases should be managed in specialised centres, but a significant proportion also agreed that general hospitals also had a role in managing such patients. A high proportion of respondents agreed that emergency department overcrowding, poor hand hygiene and mask use contributed to the risk of HCW being infected with MERS-CoV. This study also showed significant proportion with personal experience of MERS-CoV either as HCW at institutions caring for cases or being investigated for possible infection following contact with cases [10] . cord-289921-2x6011gr 2020 OBJECTIVE: Social distancing measures, such as stay-at-home, are currently implemented to control the COVID-19 pandemic in many countries, including Saudi Arabia. Hence, the aim of the current study was to evaluate the awareness and practices of the Saudi population in relation to social distancing (stay-at-home). A cross-sectional, observational study was conducted to evaluate the overall awareness and adherence of the Saudi population to social distancing to control the spread of COVID-19. 7 Therefore, this study was conducted to analyse the knowledge and practices of the population in KSA in relation to staying at home as a preventive measure for containing the COVID-19 pandemic. The responses indicated a high level of awareness among the Saudi population, with the majority of the participants (94%) expressing the view that everyone should practice social distancing. cord-291821-ovfqfurf 2011 Among all MGs, the public health issues, associated with the Hajj (an annual pilgrimage to Mecca, Saudi Arabia) is clearly the best reported—probably because of its international or even intercontinental implications in terms of the spread of infectious disease. Imperial organisations linked cholera morbus, a non-epidemic diarrhoea, to Hajj, allowing a public health industry to develop that used health concerns to control immigration, pilgrim passports, proof of suffi cient funds to allow return travel, maritime regulation, and vessel quarantine procedures. Effi cient reorganization of the pilgrimage in every direction is needed and should be facilitated by the governments of the large number of the countries involved." 34 By the early 20th century, non-Muslim European powers were heavily engaged in the management of the Hajj and would remain so until modern Saudi Arabia came into existence and acquired fi nancial independence through petrochemical wealth. cord-299519-hfgmmuy6 2019 A febrile acute respiratory illness with clinical, radiological, or histopathological evidence of pulmonary parenchymal disease (e.g. pneumonia or Acute Respiratory Distress Syndrome) that cannot be explained fully by any other etiology AND The person resides or traveled in the Middle East, or in countries where MERS-CoV is known to be circulating in dromedary camels or where human infections have recently occurred AND Testing for MERS-CoV is inconclusive. Ribavirin and interferon therapy in patients infected with the Middle East respiratory syndrome coronavirus: An observational study Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: A descriptive study Middle East respiratory syndrome coronavirus infection during pregnancy: A report of 5 cases from Saudi Arabia An observational, laboratory-based study of outbreaks of middle East respiratory syndrome coronavirus in Jeddah and Riyadh, kingdom of Saudi Arabia Ribavirin and interferon alfa-2a for severe Middle East respiratory syndrome coronavirus infection: A retrospective cohort study cord-301103-idu4j78a 2019 The nucleotide and amino acid sequences of MERS-CoV Spike protein gene were used to analyze the recombination, genetic diversity and phylogenetic relationship with selected sequences from Saudi Arabia. Recently, in another study, total 530 nucleotides deletion was observed in Spike gene from serum samples collected from Taif, Saudi Arabia and a novel genetic variant of MERS-CoV was designated as a quasispecies [29] . Multiple substitutions of amino acids were observed in RBD, part of Spike gene from a bat sample collected from Uganda and the recombination in the S1 subunit of the Spike gene was observed and it was expected that this variation likely to play an important role in the emergence of MERS-CoV causing disease in human [30] . The detection of MERS-CoV in human and camel determining the genetic diversity among Spike gene will further help researchers as well as health authority to design and develop an effective disease management and control strategies in the Kingdom of Saudi Arabia. cord-302384-gljfslhs 2020 title: Knowledge, Attitude and Practice Toward COVID-19 Among the Public in the Kingdom of Saudi Arabia: A Cross-Sectional Study This study investigated the knowledge, attitudes, and practices of the Saudi public, toward COVID-19, during the pandemic. To assess the differences in mean scores, and identify factors associated with knowledge, attitudes, and practices toward COVID-19, the data were run through univariate and multivariable regression analyses, respectively. Thus, this study aims to investigate the knowledge, attitudes and practices (KAP) of KSA residents, toward COVID-19 during the pandemic spike. To the researchers'' knowledge, this is the first study to investigate COVID-19 KAP, and associated sociodemographic characteristics among the general population of the KSA. Respondents adopted good and safe practices, as a result of Saudi Arabia''s health authorities providing education and outreach materials, to increase public understating of the disease, and influence behavioral change. Attitude and Practice (KAP) Study about Middle East Respiratory Syndrome Coronavirus (MERS-CoV) among Population in Saudi Arabia cord-302863-9e5ajbgq 2018 Our study was aimed at estimating the prevalence of dental caries and identifying key associated factors in four major risk domains, including socioeconomic factors, child oral health behavior and practices, child feeding practices, and dietary habits among primary school children in Saudi Arabia. This study aimed at estimating the prevalence of dental caries in primary teeth and identifying key associated factors in 6-8-year-old school children in Riyadh city of Saudi Arabia would contribute towards the knowledge of dental caries by enriching the baseline data and determining population-specific risk factors of such a highly prevalent and preventable condition. Our analysis is the first in Saudi Arabia to comprehensively evaluate and prioritize factors encompassing all four major risk domains for dental caries, including parental socioeconomic status, children oral health behavior and practices, child feeding practices, and dietary habits. cord-309081-v098m4dc 2017 title: Surveillance and Testing for Middle East Respiratory Syndrome Coronavirus, Saudi Arabia, April 2015–February 2016 Saudi Arabia has reported >80% of the Middle East respiratory syndrome coronavirus (MERS-CoV) cases worldwide. During April 2015–February 2016, Saudi Arabia identified and tested 57,363 persons (18.4/10,000 residents) with suspected MERS-CoV infection; 384 (0.7%) tested positive. In Saudi Arabia, persons who should be tested for MERS-CoV include suspect case-patients who meet at least 1 of 4 case definition categories (online Technical Appendix Table, https://wwwnc.cdc.gov/EID/article/23/4/16-1793-Techapp1. In addition to suspected cases, testing is recommended for close contacts of persons with confirmed MERS-CoV infection, regardless of symptoms, and can also be requested at the discretion of an infectious disease consultant. Since March 7, 2015, official reporting of cases referred for MERS-CoV testing in Saudi Arabia has exclusively been documented through the Health Electronic Surveillance Network (HESN). Confirmed MERS case-patients represented <1% of all tested persons in Saudi Arabia. cord-311654-ixn65hxb 2020 Apart from generic prevention and control issues of public health and lockdown measures to limit epidemic spread, specific issues of Mass Gathering (MG) sporting and religious events came under specific spotlight (Alzahrani et al, 2020; Baloch et al, 2020; McCloskey et al, 2020; . WHO with global MG partners, developed comprehensive key recommendations for COVID-19, and since end of February, 2020, there was a stepwise increase in cancellation, temporary suspension or postponement of international and national religious, sporting, musical, and other MGs, as countries worldwide took public health and other measures (WHO, 2020b; McCloskey et al, 2020; Petersen, McCloskey et al, 2020) . The successful completion of the 2020 Hajj is a major tribute to the leadership and commitment of the Saudi authorities, and it reflects their extensive experience of organising the annual Hajj pilgrimage, and continued commitment to improvement public health issues related to mass gatherings events. cord-312904-875s0md1 2020 Based on the existing scientific knowledge during this outbreak, the SSCP established an expert writing task force to conceptualize and draft the proposed recommendations that highlights the roles and responsibilities of pharmacists during epidemics and pandemics. These recommendations aim to provide the pharmacy profession community with several insights regarding the pharmacist''s roles and responsibilities in the community, supply chain, and healthcare settings based on existing scientific knowledge during this outbreak. Recommendation 1: We urge the Saudi Center for Disease Prevention and Control (CDC) and the Ministry of Health (MoH) to continue to utilize pharmacists'' expertise in prevention and treatment during epidemic and pandemic situations. Pharmacists can play an integral role in providing patient-focused services such as developing comprehensive care plans, therapeutic drug monitoring, and provide evidence-based recommendations. Recommendation 3: Pharmacists should take a proactive role in the development, implementation, and adherence to institutional and national guidelines related to the emerging outbreak such as COVID-19. cord-314357-u1m7yr8f 2018 title: Evaluation of preparedness of healthcare student volunteers against Middle East respiratory syndrome coronavirus (MERS-CoV) in Makkah, Saudi Arabia: a cross-sectional study AIM: To assess the knowledge and attitude of senior medical, dental, nursing and pharmacy students toward Middle East respiratory syndrome-corona virus (MERS-CoV) in Saudi Arabia. An ANOVA test was used to determine the association of study discipline and academic year with the student knowledge score on MERS. Since its first detection in Saudi Arabia in 2012, Middle East respiratory syndrome-corona virus (MERS-CoV) has become a major health problem (Bermingham et al. This study therefore aims to assess the knowledge and attitude of senior medical, dental, nursing and pharmacy students toward MERS in Makkah, Saudi Arabia. Section 2 comprised nine items and was designed to evaluate students'' in-depth knowledge about MERS including causes, sources of transmission, mortality, clinical manifestations, prevention strategies and risk groups for MERS. cord-316566-5iqtj3db 2016 12, 13 In high-income countries, some health indices showed counter-cyclical eff ects with economic contractions (eg, increases in suicides, depression, and anxiety disorders and worsening reproductive health outcomes). If Saudi Arabia maintains increased relief spending on child health, improvements in access to nutrition and health, and strong infectious diseases control then these approaches can also help reduce mortality. Since Saudi Arabia''s sociodemographic and geopolitical foundation is diff erent from that of the case studies available thus far, it is diffi cult to predict potential health eff ects of the present economic recession and newly proposed health-sector reforms. 3 The expatriate workforce of Saudi Arabia, which accounts for 56% of the total population and about 86% of the private sector workforce, are not covered by the government health-care system. 14 Despite free health care, Saudi Arabia''s shortcomings are in the control of non-communicable diseases and mitigation of risk factors for disease. The eff ect of economic recession on population health cord-318410-fznw4bbq 2020 title: Knowledge, attitudes and practices among people in Saudi Arabia regarding COVID-19: A cross-sectional study This study assessed the knowledge, attitude, and practices of public residents towards corona virus disease-2019 preventive measures in Saudi Arabia. Conclusions: This study showed satisfactory knowledge, attitude, and practice towards corona virus disease-2019 in Saudi Arabia. This survey aimed to study the knowledge, attitude, and practices of the participants towards COVID-19 preventive and precautionary measures in relation to containment of the pandemic in the Kingdom of Saudi Arabia by determining the participants'' socio-demographic characteristics, measuring participants'' knowledge about major facts concerning the virus, determining participants'' practices to prevent the spread of the infection, and measuring the response rate and participants'' level of adherence to MOH preventive and precaution measures. Knowledge, attitude and practice toward COVID-19 among the public in the Kingdom of Saudi Arabia: A cross-sectional study cord-318787-z6q11loy 2020 This paper attempts to utilize the modified Susceptible-Exposed-Infectious-Recovered (SEIR) model incorporating the SD, testing, and infectiousness of exposed and infectious compartments to study the COVID-19 pandemic in Saudi Arabia. To study the dynamics of the COVID-19 epidemic, several modified SEIR models have been used to incorporate various measures, especially social distancing, testing, public responses, and mobility restrictions [2, [6] [7] [8] [9] . The objective of this paper is to model the COVID-19 pandemic in Saudi Arabia using SEIR, including SD, testing, and the infectiousness of exposed and infectious populations. Similarly, the cumulative active cases that include exposed and infectious populations fit closely and the Levene test (statistic=0.5088, p-value=0.4758) proves the same. The model results in the current scenario of restrictions and testings depict that there are multiple peaks for active cases (Figure 3) . cord-319113-844o9nr2 2020 Objective The aim of this study is to analyze and evaluate the awareness of both the general public and healthcare providers in Qassim region in Saudi Arabia. Results showed significant positive correlation between the recognition of high-risk groups, reliable source of information, infection symptoms, disease prevention and available treatments. Results showed that there were significant differences of awareness levels among different groups of age and sex in response to the identification of COVID-19 treatment. Results showed significant positive correlation between high risk groups recognition, reliable source of information, infection symptoms, disease spread prevention and COVID-19 available treatments. The purpose of this study was to evaluate the awareness of healthcare professionals and the general public regarding COVID-19 in Qassim region, kingdom Saudi Arabia with focusing on both general awareness and detailed information. To the best of our knowledge, this is the first study that has sought to evaluate COVID-19 awareness in Saudi healthcare professionals and the general public in Qassim region. cord-319358-1bqzf7zw 2019 title: Assessing the impact of structured education on the knowledge of hospital pharmacists about adverse drug reactions and reporting methods in Saudi Arabia: an open-label randomised controlled trial OBJECTIVE: The aim of this study was to assess the impact of educational intervention on the knowledge of hospital pharmacists about ADRs. METHODS: This was a 3-month randomized controlled trial conducted in Saudi Arabia between January 2018 and March 2018. Given the poor knowledge of healthcare professionals about ADRs and its impact on ADR reporting, this study aims to assess the impact of structured education on the knowledge of hospital pharmacists about ADRs and their reporting methods in Saudi Arabia. At the 12-week follow-up, there was a significant improvement in the percentage of participants who were familiar with the types of ADRs that should be reported in adults (section 2 of the questionnaire in supplementary material) in the intervention group (from 0 at baseline to 28%; 95% CI 6.6-51.0; p = 0.008). cord-320928-flsaa1wx 2019 This study evaluated the perceived effectiveness of MERS-CoV educational programs and knowledge transfer among primary care HCWs at a hospital in Saudi Arabia that witnessed the largest outbreak of confirmed MERS-CoV cases in this country. CONCLUSIONS: A negative perception of the effectiveness of MERS-CoV knowledge transfer was associated with poorer knowledge and was more prevalent among male HCWs, physicians/pharmacists and less experienced HCWs. Hospitals should always refer to efficient knowledge sharing and educational strategies that render beneficial outcomes to patients, HCWs, and the public community. Therefore, there was an emerging need to evaluate the perceived effectiveness of MERS-CoV educational programs and knowledge transfer from the HCW''s perspective, in a setting that witnessed the largest outbreak of confirmed MERS-CoV cases in Saudi Arabia. This explains why HCWs with less work experience (< 5 years) had significantly more negative perceptions of knowledge transfer and the perceived effectiveness of MERS-CoV educational programs. cord-323898-054gv684 2020 Objectives: Assess the survival of hospitalized coronavirus disease 2019 (COVID-19) patients across age groups, sex, use of mechanical ventilators (MVs), nationality, and intensive care unit (ICU) admission in the Kingdom of Saudi Arabia. This high reported rate of hospitalization among COVID-19 cases may exacerbate the cost burden of viral respiratory infections in a country that was deeply affected by the Middle East Respiratory Syndrome (MERS) in 2012, and resulted in a huge financial burden with an estimated direct medical cost per patient of SAR 48,551.36 (United States dollars (USD) 12,947.03) [13] . In light of the high rate of hospitalization among COVID-19 patients in Saudi Arabia, there is a need to identify different sociodemographic (e.g., age, sex) and medical (e.g., mechanical ventilator (MMV) use, ICU admission) status that might increase mortality risk. cord-326632-botshfa1 2020 METHODS: In a cross-sectional study, HCWs at three tertiary hospitals in Saudi Arabia were surveyed via email with an anonymous link, by a concern scale about Covid-19 pandemic during 15–30 April, 2020. Predictors of high concern scores were; HCWs of Saudi nationality (p < 0.001), younger age (p = 0.003), undergraduate education (p = 0.044), living with others (p = 0.003) working in the western region (p = 0.003) and direct contact with patients (p = 0.018). In multiple regression analysis ( Table 4) , predictors of high concern scores were; HCWs of younger age (p = 0.003), Saudi nationality (p < 0.001), undergraduate education (p = 0.044), and those working in the western region (p = 0.003), living with others (p = 0.003) and in direct contact with patients (p = 0.018). cord-329275-cd71wttk 2014 Nasal swab samples were independently tested as described (5) for influenza virus A/H3N2 (16), influenza B virus (16), influenza C virus (17) , and A(H1N1)pdm09 virus (18) ; human adenovirus (19) ; human bocavirus (20) , human cytomegalovirus (21) ; human coronaviruses (HCoVs); human enterovirus (22) ; human metapneumovirus (23); human parainfluenza viruses (HPIVs); human parechovirus (24); human respiratory syncytial virus (25) ; and human rhinovirus (HRV) (26) by using real-time reverse transcription PCRs. HCoVs and human HPIVs were detected by using an HCoV/HPIV R-Gene Kit (Argene/bioMérieux, Marcy l''Etoile, France) (27) . Of 19 participants whose post-Hajj specimens were positive for HRV, 17 (89.5%) had acquired the infection during their stay in Saudi Arabia (Figure 1 ). Of 50 participants whose post-Hajj specimens were positive for ≥1 respiratory virus, 43 (86.0%) reported ≥1 respiratory symptom during their stay in Saudi Arabia, of whom 37 (86.0%) still had respiratory symptoms at the time of sampling. Also, of 79 participants whose post-Hajj specimens were negative for respiratory viruses, 74 (93.7%) reported ≥1 respiratory symptom during their stay Saudi Arabia, of whom 53 (71.6%) still had respiratory symptoms at the time of sampling. cord-331129-vwavivmo 2020 This study presented a comprehensive plan for developing a policy based on current challenges, recognition of policy goals, assessment of potential options and alternatives, identification of stakeholders, proposition of recommended solutions, and implementation of the framework to transform nursing standards and link these changes with the Saudi Vision 2030. Globally, nurses have made important contributions to a range of health priorities including universal health coverage, mental and community health, emergency preparedness and response, patient safety, and the provision of comprehensive patient-centered care 1 However, Saudi Arabia has entered a new era of progress and prosperity after developing Vision 2030-a program that contributes a series of developments in the fields of health delivery systems, nursing, trade, education, communications, science, and technology. However, in juxtaposition with developed countries, Saudi Arabia faces extreme staffing shortages, socio-cultural challenges, paucity of international and national benchmark evidence, absence of clear and defined scope of nursing practice, and, most importantly, policies and regulations along with the ensuing repercussions on the quality of care being offered 6, 7 . cord-331228-wbd0s4fo 2016 authors: Shehata, Mahmoud M.; Gomaa, Mokhtar R.; Ali, Mohamed A.; Kayali, Ghazi Role of the spike glycoprotein of human Middle East respiratory syndrome coronavirus (MERS-CoV) in virus entry and syncytia formation Middle East respiratory syndrome coronavirus (MERS-CoV)-Saudi Arabia Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study First cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infections in France, investigations and implications for the prevention of human-to-human transmission Clinical features and viral diagnosis of two cases of infection with Middle East respiratory syndrome coronavirus: a report of nosocomial transmission Middle East respiratory syndrome coronavirus infection in dromedary camels in Saudi Arabia cord-337060-jkzbyqtm 2020 METHODS: Two cross-sectional Likert-scale based questionnaires targeted at students and teachers separately, designed to explore stakeholders'' satisfaction in three areas of emergency distance teaching/learning: The use of virtual classrooms, completion of course learning outcomes (CLOs) and assessment via alternative methods during the COVID-19 lockdown period. Diverging stacked bar chart to show results from a 5-point Likert-scale student-targeted questionnaire to measure student level of agreement with several statements in 3 categories concerned with the educational process during COVID-19 lockdown, these included: Virtual classrooms, Completion of CLOs and Alternative assessment methods (n = 363). Diverging stacked bar chart to show results from a 5-point Likert-scale teacher-targeted questionnaire to measure teachers'' level of agreement with several statements in 3 main categories concerned with the educational process during COVID-19 lockdown, these included: Virtual classrooms, Course learning outcomes (CLOs) and Alternative assessment methods (n = 74). cord-340104-6n0sn5lk 2016 This large study population determined the burden of respiratory viruses associated with ARI in children over a 2-year period a multiplex molecular testing platform. With over 60% of 2235 children testing positive for respiratory viruses, more infections were detected than previous studies [Akhter et al., 2009; Al Hajjar et al., 2011; Alanazi et al., 2013; Bukhari and Elhazmi, 2013] . This high rate was significantly different from that obtained in the present 2-year study (23% detection for RSV in children positive for respiratory viruses), as well as others [Alanazi et al., 2013; Amer et al., 2015] . Viruses associated with respiratory tract infections in children attending to the emergency room, king abdulaziz medical city, riyadh, Saudi Arabia Viral agents causing acute lower respiratory tract infections in hospitalized children at a tertiary care center in Saudi Arabia cord-343168-gphud9yx 2020 title: Depression and anxiety during 2019 coronavirus disease pandemic in Saudi Arabia: a cross-sectional study A cross-sectional study using an online survey was conducted in Saudi Arabia between March 27 th and April 27 th , 2020, to explore depression and anxiety among the general population during the COVID-19 pandemic. Previously validated assessment scales, the Patient Health Questionnaire (PHQ)-9, and Generalized Anxiety Disorder 7-item (GAD-7) were used to assess depression and anxiety among the study participants. The prevalence rate of moderate-to-severe depression symptoms in this study seems to be considerably higher than that of those reported by the Chinese study that included 1210 respondents during the COVID-19 outbreak (16.5%) whereas comparable rates for anxiety were noted (28.8%) [3] . Further, the study of Wang et al (2020) revealed that the female gender was significantly associated with a greater psychological impact of the COVID-19 outbreak and had higher levels of stress, anxiety, and depression (p < 0.05) (3) . cord-348278-is20odaq 2016 Middle East Respiratory Syndrome coronavirus (MERS-CoV) emerged in 2012 has since resulted in sporadic cases, intra-familial transmission and major outbreaks in healthcare settings. Middle eastern respiratory syndrome corona virus (MERS CoV): case reports from a tertiary care hospital in Saudi Arabia Epidemiological, demographic, and clinical characteristics of 47 cases of middle east respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study Clinical aspects and outcomes of 70 patients with middle east respiratory syndrome coronavirus infection: a single-center experience in Saudi Arabia Middle east respiratory syndrome-coronavirus (MERS-CoV): a case-control study of hospitalized patients Dromedary camels and the transmission of middle east respiratory syndrome coronavirus (MERS-CoV) Middle east respiratory syndrome coronavirus quasispecies that include homologues of human isolates revealed through whole-genome analysis and virus cultured from dromedary camels in Saudi Arabia Health-care associate transmission of middle east respiratory syndrome corona virus, MERS-CoV, in the Kingdom of Saudi Arabia cord-351057-xrv3k1fo 2020 In a review of 14 studies of the psychological burden of COVID-19 pandemic on medical and non-medical hospital staff, significant stress and anxiety symptoms were reported by the surveyed staff [11] . Our study aimed to explore the prevalence of anxiety and the main predictors for high anxiety levels among HCWs in Saudi Arabia during the current COVID-19 pandemic. This study surveyed a large sample of HCWs working in Saudi Arabia during the COVID-19 pandemic and evaluated their level of anxiety during this time. Organizational factors that were related to increased anxiety levels were lack of regular communication and updates from the organization, insufficient and unsatisfactory quality of information about COVID-19, lack of access to COVID-19 testing for the staff, and lack of a crisis management plan; These findings are consistent with other studies looking at the impact of COVID-19 on the mental health of HCWs [16, 17] . cord-351413-3nfukrfl 2019 title: Spatiotemporal Clustering of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Incidence in Saudi Arabia, 2012–2019 We analyzed the spatiotemporal clustering of the MERS-CoV incidence in Saudi Arabia between 2012 and 2019 at the city level by using Kulldorff''s spatial scan statistics via SaTScan 9.6 [39] . The results of the spatiotemporal cluster analysis of MERS-CoV infection, using years and months as the time aggregates from 2012 to 2019, showed significant most likely and secondary clusters in Saudi Arabia (Table 3; Table 4 and Figure 5 ; Figure 6 ). Wadi The results of the spatiotemporal cluster analysis of MERS-CoV infection, using years and months as the time aggregates from 2012 to 2019, showed significant most likely and secondary clusters in Saudi Arabia (Table 3; Table 4 and Figure 5 ; Figure 6 ). Community case clusters of middle east respiratory syndrome Coronavirus in Hafr Al-Batin, Kingdom of Saudi Arabia: A descriptive genomic study cord-351685-n70tkf38 2020 title: Demographic Variations of MERS-CoV Infection among Suspected and Confirmed Cases: An Epidemiological Analysis of Laboratory-Based Data from Riyadh Regional Laboratory METHODS: It was a surveillance system-based study, for which data from a total of 23,646 suspected patients in Riyadh and Al Qassim regions were analyzed from January 2017 until December 2017 to estimate the prevalence of MERS-CoV among suspected cases and to determine potential demographic risk factors related to the confirmation of the diagnosis. During the study period, i.e., the year 2017, only 119 confirmed cases were reported, which means that the number of MERS-CoV infection cases has decreased in Riyadh and Al-Qassim regions in comparison to that of the last three years. Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study cord-353354-34tqy9tb 2020 title: Prevalence of Diabetes, Management and Outcomes among Covid-19 Adult Patients Admitted in a Specialized Tertiary Hospital in Riyadh, Saudi Arabia This retrospective study aimed to characterize comorbidities and associated with mortality among hospitalized adults with Covid-19 managed as per the Saudi Ministry of Health protocol in a specialized tertiary hospital in Riyadh, Saudi Arabia. The present retrospective study aims to determine the common comorbidities and risk factors that are associated with mortality among hospitalized patients admitted for Covid-19 and managed as per the Saudi MoH protocol for patients suspected of/confirmed with COVID-19 in a single specialized tertiary hospital in the capital Riyadh, Saudi Arabia. Nonetheless, the high prevalence of T2DM and hypertension among hospitalized Covid-19 patients have already been observed not only in majority of industrialized countries with high cases of SARS-CoV2 infection, but have also been associated with higher risk for severe outcomes, including death [11] [12] [13] . cord-356048-nku844kt 2018 RECENT FINDINGS: In the context of Hajj, one of the largest religious MGs at Mecca, Saudi Arabia, respiratory tract infections are the leading cause of infectious diseases in pilgrims with a prevalence of 50–93%. In this review, we summarize recent findings in the field of infectious diseases associated with international MGs. The Hajj (Table 1) The Hajj, an annual Muslim pilgrimage to Mecca, Saudi Arabia, is one of the largest religious MGs in the world with about two million pilgrims from 185 countries [4] . The predominance of bacterial pathogens in Hajj-related gastrointestinal infections poses a major risk to public health through the potential emergence and transmission of antimicrobial-resistant bacteria [53] . (Table 1) Although numerous gastrointestinal and respiratory outbreaks have been documented at large-scale open-air festivals, particularly music festivals, with thousands of participants, these events are probably neglected, in terms of public health attention, as well as surveillance and prevention of infectious disease strategies, compared to other categories of MGs [78] . cord-356314-mhkhey2w 2020 The Saudi Ministry of Health provided detailed data on the incidence of COVID-19 in the Kingdom daily, with the following details: (a) the number of newly confirmed cases, (b) number of active cases, (c) number of critical cases, (d) percentage of cases stratified by age group [adults, children, and elderly] (available from 2 May until 25 May), and (e) percentage of cases stratified by gender (available from 2 May until 25 May). The key findings were: (1) the epidemiological status in KSA reached a steady level after 2 months from the beginning of the pandemic, due to the implementation of successful healthcare and treatment protocols, (2) the international travel restrictions and household quarantine were effective ways to control the epidemic of COVID-19 the KSA, (3) the rates of critical cases and mortality in KSA are at a low level, due to the younger population in Saudi Arabia compared to European and Asian countries, and the effective control measures taken by the government, and (4) in the KSA, COVID-19 was more common among adults and males compared to other demographic groups.