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1.
Saudi Med J ; 41(9): 907-915, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32893272

RESUMO

OBJECTIVES: To summarize the outcomes of the coronavirus disease 2019 infections in the Eastern Mediterranean Region (EMR) in the first 4 months of the pandemic. METHODS: A meta-analysis approach was used in this context. We used the aggregate data from the World Health Organization Regional Office for the EMRO (until 26 May 2020) to generate this report. RESULTS: An analysis of official data from all 22 countries and territories in the Middle East, North Africa, the Horn of Africa, and Central Asia K=22 (a total of 438,717 cases) was performed. The total number of cases, recovered cases were 438,717,228,986,  and deaths was 11,290 in the EMR. Meta-analytic pooling of the point estimates of recovery rate per country in the EMR was 52.5% (95% CI 52.3% - 52.6%). The lowest recovery rates were in Somalia (4.3%), and the highest rates were in Tunisia (87.4%). Meta-analytic pooling of the point estimates of death rate per country in the EMR yielded 3.85% [95% CI 3.80% - 3.9%]. Meta-analytic pooling of the point estimates of recovery rate per country in the Gulf Cooperation Council countries was 46.1% (95% CI 45.8% - 46.3%). Meta-analytic pooling of the point estimates of death rate per country in the Gulf Cooperation Council countries was 0.6% (95% CI 0.50% - 0.65%). CONCLUSION: Wide variability was found between EMR countries in recovery and mortality, implying the possible impact of resource availability, and genetic and environmental factors on the morality and recovery of the COVID-19.


Assuntos
Infecções por Coronavirus/mortalidade , Pneumonia Viral/mortalidade , Taxa de Sobrevida , África do Norte/epidemiologia , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Humanos , Oriente Médio/epidemiologia , Mortalidade , Paquistão/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Somália/epidemiologia
2.
Nat Commun ; 11(1): 3832, 2020 07 31.
Artigo em Inglês | MEDLINE | ID: mdl-32737315

RESUMO

Tropical ectotherms are hypothesized to be vulnerable to environmental changes, but cascading effects of organismal tolerances on the assembly and functioning of reef fish communities are largely unknown. Here, we examine differences in organismal traits, assemblage structure, and productivity of cryptobenthic reef fishes between the world's hottest, most extreme coral reefs in the southern Arabian Gulf and the nearby, but more environmentally benign, Gulf of Oman. We show that assemblages in the Arabian Gulf are half as diverse and less than 25% as abundant as in the Gulf of Oman, despite comparable benthic composition and live coral cover. This pattern appears to be driven by energetic deficiencies caused by responses to environmental extremes and distinct prey resource availability rather than absolute thermal tolerances. As a consequence, production, transfer, and replenishment of biomass through cryptobenthic fish assemblages is greatly reduced on Earth's hottest coral reefs. Extreme environmental conditions, as predicted for the end of the 21st century, could thus disrupt the community structure and productivity of a critical functional group, independent of live coral loss.


Assuntos
Antozoários/fisiologia , Biodiversidade , Peixes/fisiologia , Modelos Estatísticos , Adaptação Fisiológica , Animais , Biomassa , Recifes de Corais , Planeta Terra , Ecossistema , Peixes/classificação , Cadeia Alimentar , Temperatura Alta , Oriente Médio , Oceanos e Mares
5.
J Prim Care Community Health ; 11: 2150132720955026, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32847464

RESUMO

BACKGROUND: COVID-19 is thought to be the most significant public health threat the modern world has encountered. Health care workers (HCWs) face enormous pressure due to work overload, negative emotions, exhaustion, lack of contact with their families, and risk of catching the infection and death. AIM: This study aims to assess the level of stress perceived by HCWs and possible associated factors during the COVID-19 outbreak in Palestine. METHODS: A cross-sectional sample of 430 frontlines HCWs was conducted using an online self-reported questionnaire. HCWs' stress from the COVID-19 outbreak, factors that increase stress, and the activities that reduced stress were assessed. Chi-square test was used to compare between a categorical variable and the study outcome; associations are presented as odds ratios (OR) and confidence intervals (95% CI) with 0.05 significance level. Al-Najah National University institutional review board granted ethics approval. RESULTS: Most respondents (74.0%) reported high-stress levels during the outbreak. Fear of transmitting the virus to family was the most stressful factor (91.6%). HCWs who did not have training on the outbreak response were more likely to have high-stress levels (OR = 2.7 [95% CI = 1.7-4.4], P < .001). Those with high stress reported being disappointed (OR = 2.4 [95% CI = 1.5-3.6], P < .001), and strongly considered taking sick leave (OR = 3.9 [95% CI = 1.9-7.9], P < .001). CONCLUSION: HCWs are under tremendous stress, given the ongoing COVID-19 pandemic. Understanding the psychological impact of the outbreak on HCWs and the activities that mitigate the stress is crucial to guide policies and interventions that can maintain psychological well-being.


Assuntos
Infecções por Coronavirus/epidemiologia , Pessoal de Saúde/psicologia , Estresse Ocupacional/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Adulto , Estudos Transversais , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Oriente Médio/epidemiologia , Inquéritos e Questionários
6.
Eur Rev Med Pharmacol Sci ; 24(13): 7524-7533, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32706095

RESUMO

OBJECTIVE: Weather-related dynamics have an impact on the pattern of health and disease. The present study aimed to investigate the effect of temperature and humidity on the daily new cases and daily new deaths due to COVID-19 in Gulf Cooperation Council (GCC) countries in the Middle East. MATERIALS AND METHODS: We selected all the six GCC countries, including Saudi Arabia, United Arab Emirates, Bahrain, Kuwait, Qatar and Oman. This region has a relatively high temperature and humidity, and has homogenous Arab ethnicity with a similar socioeconomic culture. The data on the global outbreak of COVID-19, including daily new cases and deaths were recorded from World Health Organization. The information on daily temperature and humidity was obtained from world climate web "Time and Date". The daily basis, mean temperature and humidity were recorded from the date of appearance of first case of COVID-19 in the region, Jan 29, 2020 to May 15, 2020. We also evaluated the growth factor, "a ratio by which a quantity multiplies itself over time; it equals daily cases divided by cases on the previous day". RESULTS: In GCC countries, the daily basis mean temperature from Jan 29, 2020 to May 15, 2020 was 29.20±0.30°C and humidity was 37.95±4.40%. The results revealed that there was a negative correlation and decrease in the number of daily cases and deaths from COVID-19 with increase in humidity in Oman, Kuwait, Qatar, Bahrain, United Arab Emirates and Saudi Arabia. The correlation coefficient between temperature with daily cases shows that an increase in temperature was associated with an increase in daily cases and deaths due to COVID-19, however, the temperature is still gradually rising in the region. The growth factor result for daily cases was 1.09±0.00 and daily deaths was 1.07±0.03 for COVID-19, and shows declining trends in GCC region. CONCLUSIONS: An increase in relative humidity was associated with a decrease in the number of daily cases and deaths due to COVID-19 in GCC countries. The daily growth factor for patients and deaths shows a declining trend. However, the climate is swiftly changing in the region; further studies may be conducted during the peak of summer season. The findings have outcomes for policymakers and health officials about the impact of temperature and humidity on epidemiological trends of daily new cases and deaths due to COVID-19.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Surtos de Doenças , Umidade , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Temperatura , Barein/epidemiologia , Humanos , Kuweit/epidemiologia , Oriente Médio/epidemiologia , Omã/epidemiologia , Pandemias , Catar/epidemiologia , Arábia Saudita/epidemiologia , Emirados Árabes Unidos/epidemiologia
7.
J Environ Manage ; 270: 110897, 2020 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-32721332

RESUMO

Pollution by NO3--N seriously threatens the quality of shallow groundwater (SG) around Erhai Lake, which is the 2nd largest source of freshwater in the plateau area in southwest China; further, NO3--N affects the lake water quality and human health. We collected SG samples during the dry and wet seasons in 2018 and 2019, and the potential NO3--N sources and their fates were identified in SG by NO3- isotopes and hydrochemical methods. Our results showed that the NO3--N concentrations in the SG in the wet season in farmland were far higher than those in the dry season in residential areas. The high variation in δ15N-NO3- and δ18O-NO3- (from -12.78‰ to +18.10‰ and -27.62‰ to +23.07‰, respectively, in the farmland and from -5.34‰ to +34.54‰ and -20.04‰ to +17.47‰, respectively, in the residential area) indicated multiple NO3--N sources in the SG. The NO3--N in the farmland mainly originated from chemical nitrogen fertilizer (NF, 36%), soil nitrogen (SN, 33%) and manure and sewage (M&S, 24%) in the dry season and from SN (61%) and NF (33%) in the wet season. The NO3--N in the residential area mainly originated from M&S (57%), SN (23%) and NF (14%) in the dry season and from SN (50%), NF (25%) and M&S (24%) in the wet season. Nitrogen transformation was dominated by denitrification in the SG. The most polluted SG area was observed on the east bank of Erhai Lake, NO3--N mainly originated from NF. But the NO3--N pollution slowed down from high altitude to lakeside and had multiple NO3--N sources on the west bank of Erhai Lake. The SG was contaminated by nitrogen from NF, SN and M&S along the flow path and flowed into Erhai Lake. Therefore, reducing soil nitrogen concentrations and chemical nitrogen fertilizer applications and improving sewage facilities are significant ways to mitigate nitrate pollution in the SG.


Assuntos
Água Subterrânea , Poluentes Químicos da Água/análise , Teorema de Bayes , China , Monitoramento Ambiental , Lagos , Oriente Médio , Nitratos/análise , Isótopos de Nitrogênio/análise
8.
J Infect Public Health ; 13(6): 839-842, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: covidwho-437440

RESUMO

Coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is currently a global threat to human population. The numbers of cases and deaths due to COVID-19 are escalating daily, putting health care systems worldwide under tremendous pressure. Policymakers in the affected countries have adopted varying strategies to deal with this crisis. As a result, the current COVID-19 status in terms of number of cases and deaths hugely varies between countries. The Gulf Cooperation Council (GCC) countries have managed to limit the massive spread of the infection among their populations by implementing proactive plans and timely decisions in response to COVID-19 outbreak; measures taken included suspension of flights, closure of educational institutes, curfew and lockdown of major cities, and provision of free-of-charge healthcare to patients. This review summarizes the COVID-19 status as of 18 May 2020 and highlights prevention and control measures applied in the GCC countries.


Assuntos
Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Implementação de Plano de Saúde , Humanos , Oriente Médio/epidemiologia , Pneumonia Viral/epidemiologia
10.
Eur Rev Med Pharmacol Sci ; 24(10): 5813-5818, 2020 May.
Artigo em Inglês | MEDLINE | ID: covidwho-547472

RESUMO

The CoVID-19 epidemic started in Wuhan, China and spread to 217 other countries around the world through direct contact with patients, goods transfer, animal transport, and touching unclean surfaces. In the Middle East, the first confirmed case in both Iran and UAE originated from China. A series of infections since those confirmed cases started in the Middle East originated from Qom, Iran, and other Shi'ite holy places. Thereafter, CoVID-19 has been transmitted to other countries in the Middle East. This report aims to trace all of the confirmed cases in the Middle East until March 6, 2020 and their further spread. This report proves that further transmission of CoVID-19 to the Middle East was because of human mobility, besides engaging in different Jewish and Shi'ite religious rites. This report suggests avoiding several religious rites, closing the borders of infected countries, and supporting the infected countries to prevent further transmission.


Assuntos
Infecções por Coronavirus/transmissão , Pneumonia Viral/transmissão , Religião , Viagem , Betacoronavirus/isolamento & purificação , Betacoronavirus/fisiologia , Análise por Conglomerados , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/patologia , Humanos , Oriente Médio , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/patologia
11.
Emerg Microbes Infect ; 9(1): 1457-1466, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32543353

RESUMO

Taiwan experienced two waves of imported infections with Coronavirus Disease 2019 (COVID-19). This study aimed at investigating the genomic variation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Taiwan and compared their evolutionary trajectories with the global strains. We performed culture and full-genome sequencing of SARS-CoV-2 strains followed by phylogenetic analysis. A 382-nucleotides deletion in open reading frame 8 (ORF8) was found in a Taiwanese strain isolated from a patient on February 4, 2020 who had a travel history to Wuhan. Patients in the first wave also included several sporadic, local transmission cases. Genomes of 5 strains sequenced from clustered infections were classified into a new clade with ORF1ab-V378I mutation, in addition to 3 dominant clades ORF8-L84S, ORF3a-G251V and S-D614G. This highlighted clade also included some strains isolated from patients who had a travel history to Turkey and Iran. The second wave mostly resulted from patients who had a travel history to Europe and Americas. All Taiwanese viruses were classified into various clades. Genomic surveillance of SARS-CoV-2 in Taiwan revealed a new ORF8-deletion mutant and a virus clade that may be associated with infections in the Middle East, which contributed to a better understanding of the global SARS-CoV-2 transmission dynamics.


Assuntos
Betacoronavirus/genética , Infecções por Coronavirus/virologia , Genoma Viral , Pneumonia Viral/virologia , Animais , Betacoronavirus/classificação , Betacoronavirus/isolamento & purificação , Linhagem Celular , Chlorocebus aethiops , Haemophilus parainfluenzae/isolamento & purificação , Humanos , Oriente Médio , Fases de Leitura Aberta , Pandemias , Filogenia , RNA Viral , Deleção de Sequência , Taiwan , Viagem , Células Vero , Cultura de Vírus , Sequenciamento Completo do Genoma
12.
Sci Total Environ ; 740: 140054, 2020 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-32562988

RESUMO

COVID-19 seems as global emergency, by infectious virus, caused respiratory illness like having symptoms of flue, sickness, headache, and difficulty in breathing. Within months the world has been transformed into new order, thousands of people died and many more are fallen ill due to COVID-19 outbreak. China was the first country to see the outbreak and the first country to control it. However, the disease has broken out in Europe, the Middle East, the United States and other places. The United States has the highest number of cases in the world.


Assuntos
Infecções por Coronavirus , Saúde Pública , Betacoronavirus , China , Europa (Continente) , Humanos , Oriente Médio , Pandemias , Pneumonia Viral , Estados Unidos
13.
Stud Health Technol Inform ; 271: 117-120, 2020 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-32578553

RESUMO

Mobile applications (apps) can improve health outcomes. In this study, we have described an app developed for documenting the history of vaccination among Syrian children in one of the largest refugees' camps in the Middle East region. This app includes health education information and automated reminders for parents, using a visual tool for parents with low literacy level. We have emphasized on the usability and technical concerns and have described the interdependency of technical and human considerations for such health app solution in a marginalized context.


Assuntos
Refugiados , Criança , Humanos , Jordânia , Oriente Médio , Software , Síria , Vacinação
14.
Sci Total Environ ; 740: 140089, 2020 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-32559543

RESUMO

Antimicrobial resistance is one of the biggest worldwide challenging problems that associates with high morbidity and mortality rates. The resistance of bacteria to various antibiotic classes results in difficulties in the treatment of infectious diseases caused by those bacteria. This paper highlights and provides a critical overview of observational and experimental studies investigating the presence of antibiotic resistant bacteria in different environments in Middle East countries and the mechanisms by which bacteria acquire and spread resistance. The data of this research considered the published papers within the last ten years (2010-2020) and was carried out using PubMed. A total of 66 articles were selected in this review. This review covered studies done on antibiotic resistant bacteria found in a wide range of environments including foods, animals, groundwater, aquatic environments as well as industrial and hospital wastewater. They acquire and achieve their resistance through several mechanisms such as antibiotic resistant genes, efflux pumps and enzymatic reactions. However, the dissemination and spread of antibiotic resistant bacteria is affected by several factors like anthropogenic, domestic, inappropriate use of antibiotics and the expulsion of wastewater containing antibiotic residues to the environments. Therefore, it is important to increase the awareness regarding these activities and their effect on the environment and eventually on health.


Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana/efeitos dos fármacos , Animais , Oriente Médio , Estudos Retrospectivos , Águas Residuárias
15.
Ann Parasitol ; 66(2): 125-133, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32530589

RESUMO

Parasitic zoonosis (PZs) have a cosmopolitan significant impact on public health but they are often omitted in discussions, especially in developing countries. Zoonotic parasites include protozoa, cestodes, nematodes, trematodes and arthropods, and notably in African and Arabian countries have a high prevalence among livestock and man. Through this comprehensive review, we summarize the extant published research of the most significant zoonotic parasites present in some countries of Arabic world and we identify the epidemiology and risk factors for significant infections and suggest some effective control measures. This review might help the researches, governments about the zoonotic impact of these neglected infections for future considerations and application for real control programs.


Assuntos
Parasitos , Doenças Parasitárias , Zoonoses , Animais , Humanos , Gado/parasitologia , Oriente Médio/epidemiologia , Parasitos/classificação , Parasitos/fisiologia , Doenças Parasitárias/epidemiologia , Doenças Parasitárias/parasitologia , Doenças Parasitárias/prevenção & controle , Doenças Parasitárias em Animais/epidemiologia , Doenças Parasitárias em Animais/parasitologia , Doenças Parasitárias em Animais/prevenção & controle , Prevalência , Fatores de Risco , Zoonoses/epidemiologia , Zoonoses/parasitologia
16.
Glob Public Health ; 15(8): 1244-1256, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32552389

RESUMO

As the COVID-19 pandemic spreads, concerns are particularly serious in conflict and humanitarian settings. Tackling the pandemic in those countries is challenging due to the fragility of socioeconomic and health systems. Palestine is one of those countries that is facing compounding challenges, instability, fragility, living conditions, poverty, and mobility, all of which are caused by multifactorial etiology. The Pandemic shows triple tragedies; virus (COVID-19 Pandemic), ongoing Israeli occupation (Politics), and Intra-Palestinian divide (Policies). Yet, Palestine's response to the pandemic is outperforming many countries in the region. The early preventative lockdown measures in the West Bank found effective and not overwhelming the already over-stretched health system. While in the Gaza Strip, the response was slow. Prisoners, labours, besieged people, socioeconomic-disadvantaged classes, and refugees were put at additional high risk. Nonetheless, measures taken were unconsolidated in both regions largely due to the political factors. A little collaboration and inter-agency task forces in preparedness and response was observed, and the mechanisms and governance remain ambiguous. A consolidated and evidence-based nation-wide plan is required, whereby state and non-state actors have a clear and transparent exit strategy. A new thinking approach to promote the public health system and evidence-informed policies in Palestine is an urgent national priority.


Assuntos
Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/epidemiologia , Política de Saúde , Pneumonia Viral/epidemiologia , Política , Prática de Saúde Pública , Betacoronavirus , Humanos , Oriente Médio/epidemiologia , Pandemias
17.
Eur Rev Med Pharmacol Sci ; 24(10): 5813-5818, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32495920

RESUMO

The CoVID-19 epidemic started in Wuhan, China and spread to 217 other countries around the world through direct contact with patients, goods transfer, animal transport, and touching unclean surfaces. In the Middle East, the first confirmed case in both Iran and UAE originated from China. A series of infections since those confirmed cases started in the Middle East originated from Qom, Iran, and other Shi'ite holy places. Thereafter, CoVID-19 has been transmitted to other countries in the Middle East. This report aims to trace all of the confirmed cases in the Middle East until March 6, 2020 and their further spread. This report proves that further transmission of CoVID-19 to the Middle East was because of human mobility, besides engaging in different Jewish and Shi'ite religious rites. This report suggests avoiding several religious rites, closing the borders of infected countries, and supporting the infected countries to prevent further transmission.


Assuntos
Infecções por Coronavirus/transmissão , Pneumonia Viral/transmissão , Religião , Viagem , Betacoronavirus/isolamento & purificação , Betacoronavirus/fisiologia , Análise por Conglomerados , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/patologia , Humanos , Oriente Médio , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/patologia
18.
Environ Sci Pollut Res Int ; 27(27): 34348-34356, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32557050

RESUMO

The objective of the present study was to assess the markers of arsenic, cadmium, mercury, and lead exposure in first-year RUDN University students of different geographic origins. A total of 274 first-year students of the RUDN University originating from Russia (n = 65), Asia (n = 57), Middle East (n = 84), Africa (n = 40), and Latin America (n = 28) were enrolled in the present study. Evaluation of As, Cd, Hg, and Pb levels in urine and hair was performed using inductively coupled plasma-mass spectrometry. The obtained data demonstrate that hair As levels in foreign students exceed that in Russian examinees. The highest Cd and Pb levels were detected in subjects from Africa and Latin America, whereas hair Hg content was significantly higher in Latin America students. Urinary Cd levels in foreign students exceeded those in Russian counterparts. In turn, the highest Hg concentration in urine was revealed in students originating from Middle East and especially Latin America. Urinary Pb levels were found to be the highest in students from Africa. Multiple regression analysis demonstrated that Asian, African, and Latin American origins were considered as a significant predictor of hair Hg content. Higher urinary Hg levels were associated with Asia, Middle East, and Latin American origins. Prior habitation in Africa and Asia was considered as predictor of higher hair Pb and urinary Cd levels. The observed difference may be indicative of geographic difference in toxic metal exposure patterns.


Assuntos
Arsênico/análise , Mercúrio/análise , África , Ásia , Cádmio/análise , Humanos , Chumbo/análise , Oriente Médio , Federação Russa , Estudantes , Universidades
20.
J Infect Public Health ; 13(6): 839-842, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32507401

RESUMO

Coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is currently a global threat to human population. The numbers of cases and deaths due to COVID-19 are escalating daily, putting health care systems worldwide under tremendous pressure. Policymakers in the affected countries have adopted varying strategies to deal with this crisis. As a result, the current COVID-19 status in terms of number of cases and deaths hugely varies between countries. The Gulf Cooperation Council (GCC) countries have managed to limit the massive spread of the infection among their populations by implementing proactive plans and timely decisions in response to COVID-19 outbreak; measures taken included suspension of flights, closure of educational institutes, curfew and lockdown of major cities, and provision of free-of-charge healthcare to patients. This review summarizes the COVID-19 status as of 18 May 2020 and highlights prevention and control measures applied in the GCC countries.


Assuntos
Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Implementação de Plano de Saúde , Humanos , Oriente Médio/epidemiologia , Pneumonia Viral/epidemiologia
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