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Pang J, Wang MX, Ang IYH, Tan SHX, Lewis RF, Chen JIP, Gutierrez RA, Gwee SXW, Chua PEY, Yang Q, Ng XY, Yap RK, Tan HY, Teo YY, Tan CC, Cook AR, Yap JCH, Hsu LY. Potential Rapid Diagnostics, Vaccine and Therapeutics for 2019 Novel Coronavirus (2019-nCoV): A Systematic Review. J Clin Med 2020; 9:E623. [PMID: 32110875 PMCID: PMC7141113 DOI: 10.3390/jcm9030623] [Citation(s) in RCA: 320] [Impact Index Per Article: 80.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 02/17/2020] [Accepted: 02/19/2020] [Indexed: 01/09/2023] Open
Abstract
Rapid diagnostics, vaccines and therapeutics are important interventions for the management of the 2019 novel coronavirus (2019-nCoV) outbreak. It is timely to systematically review the potential of these interventions, including those for Middle East respiratory syndrome-Coronavirus (MERS-CoV) and severe acute respiratory syndrome (SARS)-CoV, to guide policymakers globally on their prioritization of resources for research and development. A systematic search was carried out in three major electronic databases (PubMed, Embase and Cochrane Library) to identify published studies in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Supplementary strategies through Google Search and personal communications were used. A total of 27 studies fulfilled the criteria for review. Several laboratory protocols for confirmation of suspected 2019-nCoV cases using real-time reverse transcription polymerase chain reaction (RT-PCR) have been published. A commercial RT-PCR kit developed by the Beijing Genomic Institute is currently widely used in China and likely in Asia. However, serological assays as well as point-of-care testing kits have not been developed but are likely in the near future. Several vaccine candidates are in the pipeline. The likely earliest Phase 1 vaccine trial is a synthetic DNA-based candidate. A number of novel compounds as well as therapeutics licensed for other conditions appear to have in vitro efficacy against the 2019-nCoV. Some are being tested in clinical trials against MERS-CoV and SARS-CoV, while others have been listed for clinical trials against 2019-nCoV. However, there are currently no effective specific antivirals or drug combinations supported by high-level evidence.
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Affiliation(s)
- Junxiong Pang
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; (M.X.W.); (I.Y.H.A.); (S.H.X.T.); (R.F.L.); (J.I.-P.C.); (S.X.W.G.); (P.E.Y.C.); (Q.Y.); (X.Y.N.); (R.K.S.Y.); (H.Y.T.); (Y.Y.T.); (A.R.C.); (J.C.-H.Y.); (L.Y.H.)
- Centre for Infectious Disease Epidemiology and Research, National University of Singapore, Singapore 117549, Singapore
| | - Min Xian Wang
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; (M.X.W.); (I.Y.H.A.); (S.H.X.T.); (R.F.L.); (J.I.-P.C.); (S.X.W.G.); (P.E.Y.C.); (Q.Y.); (X.Y.N.); (R.K.S.Y.); (H.Y.T.); (Y.Y.T.); (A.R.C.); (J.C.-H.Y.); (L.Y.H.)
- Centre for Infectious Disease Epidemiology and Research, National University of Singapore, Singapore 117549, Singapore
| | - Ian Yi Han Ang
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; (M.X.W.); (I.Y.H.A.); (S.H.X.T.); (R.F.L.); (J.I.-P.C.); (S.X.W.G.); (P.E.Y.C.); (Q.Y.); (X.Y.N.); (R.K.S.Y.); (H.Y.T.); (Y.Y.T.); (A.R.C.); (J.C.-H.Y.); (L.Y.H.)
| | - Sharon Hui Xuan Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; (M.X.W.); (I.Y.H.A.); (S.H.X.T.); (R.F.L.); (J.I.-P.C.); (S.X.W.G.); (P.E.Y.C.); (Q.Y.); (X.Y.N.); (R.K.S.Y.); (H.Y.T.); (Y.Y.T.); (A.R.C.); (J.C.-H.Y.); (L.Y.H.)
| | - Ruth Frances Lewis
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; (M.X.W.); (I.Y.H.A.); (S.H.X.T.); (R.F.L.); (J.I.-P.C.); (S.X.W.G.); (P.E.Y.C.); (Q.Y.); (X.Y.N.); (R.K.S.Y.); (H.Y.T.); (Y.Y.T.); (A.R.C.); (J.C.-H.Y.); (L.Y.H.)
| | - Jacinta I-Pei Chen
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; (M.X.W.); (I.Y.H.A.); (S.H.X.T.); (R.F.L.); (J.I.-P.C.); (S.X.W.G.); (P.E.Y.C.); (Q.Y.); (X.Y.N.); (R.K.S.Y.); (H.Y.T.); (Y.Y.T.); (A.R.C.); (J.C.-H.Y.); (L.Y.H.)
| | | | - Sylvia Xiao Wei Gwee
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; (M.X.W.); (I.Y.H.A.); (S.H.X.T.); (R.F.L.); (J.I.-P.C.); (S.X.W.G.); (P.E.Y.C.); (Q.Y.); (X.Y.N.); (R.K.S.Y.); (H.Y.T.); (Y.Y.T.); (A.R.C.); (J.C.-H.Y.); (L.Y.H.)
- Centre for Infectious Disease Epidemiology and Research, National University of Singapore, Singapore 117549, Singapore
| | - Pearleen Ee Yong Chua
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; (M.X.W.); (I.Y.H.A.); (S.H.X.T.); (R.F.L.); (J.I.-P.C.); (S.X.W.G.); (P.E.Y.C.); (Q.Y.); (X.Y.N.); (R.K.S.Y.); (H.Y.T.); (Y.Y.T.); (A.R.C.); (J.C.-H.Y.); (L.Y.H.)
- Centre for Infectious Disease Epidemiology and Research, National University of Singapore, Singapore 117549, Singapore
| | - Qian Yang
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; (M.X.W.); (I.Y.H.A.); (S.H.X.T.); (R.F.L.); (J.I.-P.C.); (S.X.W.G.); (P.E.Y.C.); (Q.Y.); (X.Y.N.); (R.K.S.Y.); (H.Y.T.); (Y.Y.T.); (A.R.C.); (J.C.-H.Y.); (L.Y.H.)
| | - Xian Yi Ng
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; (M.X.W.); (I.Y.H.A.); (S.H.X.T.); (R.F.L.); (J.I.-P.C.); (S.X.W.G.); (P.E.Y.C.); (Q.Y.); (X.Y.N.); (R.K.S.Y.); (H.Y.T.); (Y.Y.T.); (A.R.C.); (J.C.-H.Y.); (L.Y.H.)
| | - Rowena K.S. Yap
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; (M.X.W.); (I.Y.H.A.); (S.H.X.T.); (R.F.L.); (J.I.-P.C.); (S.X.W.G.); (P.E.Y.C.); (Q.Y.); (X.Y.N.); (R.K.S.Y.); (H.Y.T.); (Y.Y.T.); (A.R.C.); (J.C.-H.Y.); (L.Y.H.)
| | - Hao Yi Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; (M.X.W.); (I.Y.H.A.); (S.H.X.T.); (R.F.L.); (J.I.-P.C.); (S.X.W.G.); (P.E.Y.C.); (Q.Y.); (X.Y.N.); (R.K.S.Y.); (H.Y.T.); (Y.Y.T.); (A.R.C.); (J.C.-H.Y.); (L.Y.H.)
| | - Yik Ying Teo
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; (M.X.W.); (I.Y.H.A.); (S.H.X.T.); (R.F.L.); (J.I.-P.C.); (S.X.W.G.); (P.E.Y.C.); (Q.Y.); (X.Y.N.); (R.K.S.Y.); (H.Y.T.); (Y.Y.T.); (A.R.C.); (J.C.-H.Y.); (L.Y.H.)
| | | | - Alex R. Cook
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; (M.X.W.); (I.Y.H.A.); (S.H.X.T.); (R.F.L.); (J.I.-P.C.); (S.X.W.G.); (P.E.Y.C.); (Q.Y.); (X.Y.N.); (R.K.S.Y.); (H.Y.T.); (Y.Y.T.); (A.R.C.); (J.C.-H.Y.); (L.Y.H.)
| | - Jason Chin-Huat Yap
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; (M.X.W.); (I.Y.H.A.); (S.H.X.T.); (R.F.L.); (J.I.-P.C.); (S.X.W.G.); (P.E.Y.C.); (Q.Y.); (X.Y.N.); (R.K.S.Y.); (H.Y.T.); (Y.Y.T.); (A.R.C.); (J.C.-H.Y.); (L.Y.H.)
| | - Li Yang Hsu
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; (M.X.W.); (I.Y.H.A.); (S.H.X.T.); (R.F.L.); (J.I.-P.C.); (S.X.W.G.); (P.E.Y.C.); (Q.Y.); (X.Y.N.); (R.K.S.Y.); (H.Y.T.); (Y.Y.T.); (A.R.C.); (J.C.-H.Y.); (L.Y.H.)
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Shanmugaraj B, Malla A, Phoolcharoen W. Emergence of Novel Coronavirus 2019-nCoV: Need for Rapid Vaccine and Biologics Development. Pathogens 2020; 9:E148. [PMID: 32098302 PMCID: PMC7168632 DOI: 10.3390/pathogens9020148] [Citation(s) in RCA: 88] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 02/19/2020] [Accepted: 02/21/2020] [Indexed: 12/24/2022] Open
Abstract
Novel Coronavirus (2019-nCoV) is an emerging pathogen that was first identified in Wuhan, China in late December 2019. This virus is responsible for the ongoing outbreak that causes severe respiratory illness and pneumonia-like infection in humans. Due to the increasing number of cases in China and outside China, the WHO declared coronavirus as a global health emergency. Nearly 35,000 cases were reported and at least 24 other countries or territories have reported coronavirus cases as early on as February. Inter-human transmission was reported in a few countries, including the United States. Neither an effective anti-viral nor a vaccine is currently available to treat this infection. As the virus is a newly emerging pathogen, many questions remain unanswered regarding the virus's reservoirs, pathogenesis, transmissibility, and much more is unknown. The collaborative efforts of researchers are needed to fill the knowledge gaps about this new virus, to develop the proper diagnostic tools, and effective treatment to combat this infection. Recent advancements in plant biotechnology proved that plants have the ability to produce vaccines or biopharmaceuticals rapidly in a short time. In this review, the outbreak of 2019-nCoV in China, the need for rapid vaccine development, and the potential of a plant system for biopharmaceutical development are discussed.
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Affiliation(s)
- Balamurugan Shanmugaraj
- Research unit for Plant-produced Pharmaceuticals, Chulalongkorn University, Bangkok 10330, Thailand; (B.S.); (A.M.)
- Department of Pharmacognosy and Pharmaceutical Botany, Chulalongkorn University, Bangkok 10330, Thailand
| | - Ashwini Malla
- Research unit for Plant-produced Pharmaceuticals, Chulalongkorn University, Bangkok 10330, Thailand; (B.S.); (A.M.)
- Department of Pharmacognosy and Pharmaceutical Botany, Chulalongkorn University, Bangkok 10330, Thailand
| | - Waranyoo Phoolcharoen
- Research unit for Plant-produced Pharmaceuticals, Chulalongkorn University, Bangkok 10330, Thailand; (B.S.); (A.M.)
- Department of Pharmacognosy and Pharmaceutical Botany, Chulalongkorn University, Bangkok 10330, Thailand
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153
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Liu R, Ma H, Shu J, Zhang Q, Han M, Liu Z, Jin X, Zhang F, Wu X. Vaccines and Therapeutics Against Hantaviruses. Front Microbiol 2020; 10:2989. [PMID: 32082263 PMCID: PMC7002362 DOI: 10.3389/fmicb.2019.02989] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 12/10/2019] [Indexed: 12/16/2022] Open
Abstract
Hantaviruses (HVs) are rodent-transmitted viruses that can cause hantavirus cardiopulmonary syndrome (HCPS) in the Americas and hemorrhagic fever with renal syndrome (HFRS) in Eurasia. Together, these viruses have annually caused approximately 200,000 human infections worldwide in recent years, with a case fatality rate of 5–15% for HFRS and up to 40% for HCPS. There is currently no effective treatment available for either HFRS or HCPS. Only whole virus inactivated vaccines against HTNV or SEOV are licensed for use in the Republic of Korea and China, but the protective efficacies of these vaccines are uncertain. To a large extent, the immune correlates of protection against hantavirus are not known. In this review, we summarized the epidemiology, virology, and pathogenesis of four HFRS-causing viruses, HTNV, SEOV, PUUV, and DOBV, and two HCPS-causing viruses, ANDV and SNV, and then discussed the existing knowledge on vaccines and therapeutics against these diseases. We think that this information will shed light on the rational development of new vaccines and treatments.
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Affiliation(s)
- Rongrong Liu
- Department of Microbiology, School of Basic Medicine, Fourth Military Medical University, Xi'an, China
| | - Hongwei Ma
- Department of Microbiology, School of Basic Medicine, Fourth Military Medical University, Xi'an, China
| | - Jiayi Shu
- Scientific Research Center, Shanghai Public Health Clinical Center & Institutes of Biomedical Sciences, Key Laboratory of Medical Molecular Virology of Ministry of Education & Health, Shanghai Medical College, Fudan University, Shanghai, China.,Viral Disease and Vaccine Translational Research Unit, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, China
| | - Qiang Zhang
- School of Biology and Basic Medical Sciences, Soochow University, Suzhou, China
| | - Mingwei Han
- Cadet Brigade, School of Basic Medicine, Fourth Military Medical University, Xi'an, China
| | - Ziyu Liu
- Department of Microbiology, School of Basic Medicine, Fourth Military Medical University, Xi'an, China
| | - Xia Jin
- Scientific Research Center, Shanghai Public Health Clinical Center & Institutes of Biomedical Sciences, Key Laboratory of Medical Molecular Virology of Ministry of Education & Health, Shanghai Medical College, Fudan University, Shanghai, China
| | - Fanglin Zhang
- Department of Microbiology, School of Basic Medicine, Fourth Military Medical University, Xi'an, China
| | - Xingan Wu
- Department of Microbiology, School of Basic Medicine, Fourth Military Medical University, Xi'an, China
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154
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Abstract
So far, dromedary camels are the only known animal reservoir for Middle East respiratory syndrome (MERS) coronavirus (MERS-CoV). Previous published serological studies showed that sera of Bactrian camels were all negative for MERS-CoV antibodies. However, a recent study revealed that direct inoculation of Bactrian camels intranasally with MERS-CoV can lead to infection with abundant virus shedding and seroconversion. In this study, we examined the presence of MERS-CoV antibodies in Bactrian and hybrid camels in Dubai, the United Arab Emirates (where dromedaries are also present), and Bactrian camels in Xinjiang, China (where dromedaries are absent). For the 29 serum samples from Bactrian camels in Dubai tested by the MERS-CoV spike (S) protein-based enzyme-linked immunosorbent assay (S-ELISA) and neutralization antibody test, 14 (48%) and 12 (41%), respectively, were positive for MERS-CoV antibodies. All the 12 serum samples that were positive with the neutralization antibody test were also positive for the S-ELISA. For the 11 sera from hybrid camels in Dubai tested with the S-ELISA and neutralization antibody test, 6 (55%) and 9 (82%), respectively, were positive for MERS-CoV antibodies. All the 6 serum samples that were positive for the S-ELISA were also positive with the neutralization antibody test. There was a strong correlation between the antibody levels detected by S-ELISA and neutralizing antibody titers, with a Spearman coefficient of 0.6262 (P < 0.0001; 95% confidence interval, 0.5062 to 0.7225). All 92 Bactrian camel serum samples from Xinjiang were negative for MERS-CoV antibodies tested using both S-ELISA and the neutralization antibody test. Bactrian and hybrid camels are potential sources of MERS-CoV infection.IMPORTANCE Since its first appearance in 2012, Middle East respiratory syndrome (MERS) has affected >25 countries, with >2,400 cases and an extremely high fatality rate of >30%. The total number of mortalities due to MERS is already greater than that due to severe acute respiratory syndrome. MERS coronavirus (MERS-CoV) has been confirmed to be the etiological agent. So far, dromedaries are the only known animal reservoir for MERS-CoV. Previously published serological studies showed that sera of Bactrian camels were all negative for MERS-CoV antibodies. In this study, we observed that 41% of the Bactrian camel sera and 55% of the hybrid camel sera from Dubai (where dromedaries are also present), but none of the sera from Bactrian camels in Xinjiang (where dromedaries are absent), were positive for MERS-CoV antibodies. Based on these results, we conclude that in addition to dromedaries, Bactrian and hybrid camels are also potential sources of MERS-CoV infection.
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155
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Alharbi NK, Qasim I, Almasoud A, Aljami HA, Alenazi MW, Alhafufi A, Aldibasi OS, Hashem AM, Kasem S, Albrahim R, Aldubaib M, Almansour A, Temperton NJ, Kupke A, Becker S, Abu-Obaidah A, Alkarar A, Yoon IK, Azhar E, Lambe T, Bayoumi F, Aldowerij A, Ibrahim OH, Gilbert SC, Balkhy HH. Humoral Immunogenicity and Efficacy of a Single Dose of ChAdOx1 MERS Vaccine Candidate in Dromedary Camels. Sci Rep 2019; 9:16292. [PMID: 31705137 PMCID: PMC6841732 DOI: 10.1038/s41598-019-52730-4] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 10/16/2019] [Indexed: 11/08/2022] Open
Abstract
MERS-CoV seronegative and seropositive camels received a single intramuscular dose of ChAdOx1 MERS, a replication-deficient adenoviral vectored vaccine expressing MERS-CoV spike protein, with further groups receiving control vaccinations. Infectious camels with active naturally acquired MERS-CoV infection, were co-housed with the vaccinated camels at a ratio of 1:2 (infected:vaccinated); nasal discharge and virus titres were monitored for 14 days. Overall, the vaccination reduced virus shedding and nasal discharge (p = 0.0059 and p = 0.0274, respectively). Antibody responses in seropositive camels were enhancedby the vaccine; these camels had a higher average age than seronegative. Older seronegative camels responded more strongly to vaccination than younger animals; and neutralising antibodies were detected in nasal swabs. Further work is required to optimise vaccine regimens for younger seronegative camels.
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Affiliation(s)
- Naif Khalaf Alharbi
- Department of Infectious Disease Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
| | - Ibrahim Qasim
- Ministry of Environment, Water and Agriculture (MEWA), Riyadh, Saudi Arabia
| | - Abdulrahman Almasoud
- Department of Infectious Disease Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Haya A Aljami
- Department of Infectious Disease Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Mohamed W Alenazi
- Department of Infectious Disease Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Ali Alhafufi
- Ministry of Environment, Water and Agriculture (MEWA), Riyadh, Saudi Arabia
| | - Omar S Aldibasi
- Department of Bioinformatics and Biostatistics, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Anwar M Hashem
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Samy Kasem
- Ministry of Environment, Water and Agriculture (MEWA), Riyadh, Saudi Arabia
- Department of Virology, Faculty of Veterinary Medicine, Kafrelsheikh University, Kafrelsheikh, El Geish Street, 33516, Egypt
| | - Raed Albrahim
- Ministry of Environment, Water and Agriculture (MEWA), Riyadh, Saudi Arabia
| | - Musaad Aldubaib
- College of Agriculture and Veterinary Medicine, Qassim University, Qassim, Saudi Arabia
| | - Ali Almansour
- Ministry of Environment, Water and Agriculture (MEWA), Riyadh, Saudi Arabia
| | - Nigel J Temperton
- Viral Pseudotype Unit, Medway School of Pharmacy, University of Kent, Chatham, Kent, ME4 4TB, United Kingdom
| | - Alexandra Kupke
- Institute of Virology, Philipps University of Marburg, Marburg, Germany
- German Center for Infection Research (DZIF), Partner Site Gieβen-Marburg-Langen, Germany
| | - Stephan Becker
- Institute of Virology, Philipps University of Marburg, Marburg, Germany
- German Center for Infection Research (DZIF), Partner Site Gieβen-Marburg-Langen, Germany
| | - Ali Abu-Obaidah
- Ministry of Environment, Water and Agriculture (MEWA), Riyadh, Saudi Arabia
| | - Ali Alkarar
- Ministry of Environment, Water and Agriculture (MEWA), Riyadh, Saudi Arabia
| | - In-Kyu Yoon
- International Vaccine Institute, Seoul, South Korea
| | - Esam Azhar
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- Special Infectious Agents Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Teresa Lambe
- The Jenner Institute, University of Oxford, Oxford, OX3 7DQ, UK
| | - Faisal Bayoumi
- Ministry of Environment, Water and Agriculture (MEWA), Riyadh, Saudi Arabia
| | - Ali Aldowerij
- Ministry of Environment, Water and Agriculture (MEWA), Riyadh, Saudi Arabia
| | - Osman H Ibrahim
- Ministry of Environment, Water and Agriculture (MEWA), Riyadh, Saudi Arabia
| | - Sarah C Gilbert
- The Jenner Institute, University of Oxford, Oxford, OX3 7DQ, UK
| | - Hanan H Balkhy
- Department of Infectious Disease Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Department of Infection Prevention and Control, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
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