The Incidence Proportion of SARS-CoV-2 Infections and the Percentage of Deaths among Infected Healthcare Workers in Poland.

(1) Background: The incidence proportion of SARS-CoV-2 infection among healthcare workers (HCWs) in Poland is not exactly known. This study aims to present secondary epidemiological data identifying the scale of the spread of novel coronavirus infection and the estimation of vaccination coverage in selected professional groups of HCWs in Poland. (2) Methods: The secondary epidemiological data included both the number of infections and infection fatality rate (IFR) in individual occupational groups, which occurred throughout the observation period (January 2021-July 2022), both in the country and in individual voivodeship (administrative area). (3) Results: The incidence proportion of SARS-CoV-2 infections among HCWs was 16.48%. The highest percentage of infected workers concerned laboratory scientists (21.62%) and paramedics (18%). The highest frequency of infections among HCWs occurred in the province of Zachodnio-Pomorskie (18.9%). Due to COVID-19, 558 healthcare workers died during the analysed period, mostly nurses (n = 236) and doctors (n = 200). The results regarding the vaccination coverage of HCWs against COVID-19 indicate the highest percentage of vaccinated were among doctors (83.63%) and the lowest among physiotherapists (38.2%). (4) Conclusions: In general, the percentage of infections was high in Poland during the pandemic (16.48%). Significant territorial differences were observed in the frequency of infections, deaths, and percentage of vaccinated workers in individual voivodeships.

The prevalence and determinants of SARS-CoV-2 infections among healthcare workers, results of a cross-sectional study in the Silesian Voivodeship.

OBJECTIVES: A significant proportion of healthcare workers (HCWs) had been infected with SARS-CoV-2, which complicated the organization of patient care during the COVID-19 pandemic. However, the exact scale of infection prevalence among the group of HCWs is not known, therefore this study aimed to assess the prevalence of SARS-CoV-2 infection among HCWs in the Silesian voivodeship, Poland, and to define its determinants. MATERIAL AND METHODS: The cross-sectional study was conducted in 2 multidisciplinary hospitals in the Silesian voivodeship during the period October 2021-February 2022. The standardized WHO questionnaire Surveillance protocol for SARS-CoV-2 infection among health workers was completed by 242 HCWs. To assess the prevalence of SARS-CoV-2 infection and its determinants, such as personal, occupational, and work environment-related conditions and preventive behaviors, the collected data were subjected to statistical analysis. For this purpose, descriptive and analytical statistics (significance of differences in χ2 test) were used. RESULTS: Almost half (42.6%) of subjects were infected with coronavirus, most frequently care assistants (57.1%) and paramedics (50%). People suffering from chronic diseases were infected significantly more often (p < 0.001). The majority of the infected HCWs declared previous contact with COVID-19 patients (56.3%). Unfortunately, 10.3% of respondents refused to be vaccinated against COVID-19, most often care assistants (38.1%) and nurses (10.6%). The determinants such as sex, age, occupation, place of work (ward), participation in occupational safety and health training, use of personal protective equipment (PPE), or preventive behaviors did not significantly affect the risk of infection (p > 0.05). CONCLUSIONS: Even though the PPE was used and the percentage of fully vaccinated HCWs against COVID-19 was high (89.7%), the frequency of SARS-CoV-2 infected HCWs remains high at 42.6% (95% CI: 40.7-44.5%). The main determinants of SARS-CoV-2 infection risk among HCWs were previous contact with infected individuals and the presence of chronic disease. Int J Occup Med Environ Health. 2023;36(2):201-13.

Situation of Pediatric Patients with Testicular Torsion in Times of COVID-19.

PURPOSE: To assess whether the COVID-19 pandemic had an influence on presentation of testicular torsion and/or increase in the frequency of orchiectomy. Patients and Methods. This retrospective study included boys under 18 years of age with testicular torsion divided in two groups: pre-COVID operated in 2019 vs. COVID-19 group from 2020. We compared demographic data as well as local and general symptoms. We analyzed additional tests, intraoperative findings, length of operation and hospitalization, and followup. Results. We analyzed the data collected from 44 patients (24 boys from first group vs. 20 boys from second group). The median age was 13.4 years vs. 14.5 years in the latter. The median time of symptoms duration was 6.5 hours and 8.5 hours, respectively. The main manifestation was testicular pain without additional signs. The results of the laboratory tests did not reflect local advancement. In the 2019 group, Doppler ultrasound showed absent blood flow in the affected testicle in 62% vs. 80% in 2020. The mean time from admission to surgery was virtually identical: 75 minutes in 2019 vs. 76 minutes in 2020. The mean duration of scrotal revision was similar in both groups. There was only one significant difference: the degree of twisting. In 2019, the mean was 360° vs. 540° in 2020. Incidence of orchiectomy also did not significantly vary between the analyzed time periods, with 21% during the pandemic and 35% during the pre-COVID-19 period. Conclusion. We did not observe an increase in the number of testicular torsion cases during the COVID-19 pandemic. Most importantly, the rates of orchiectomy did not significantly differ between the patients with testicular torsion presenting during the COVID-19 outbreak.

Readiness for Telemedical Services in Patients With Cardiovascular Diseases: Cross-sectional Study.

BACKGROUND: Telemedicine solutions, especially in the face of epidemiological emergencies such as the COVID-19 pandemic, played an important role in the remote communication between patients and medical providers. However, the implementation of modern technologies should rely on patients' readiness toward new services to enable effective cooperation with the physician. Thus, successful application of patient-centric telehealth services requires an in-depth analysis of users' expectations. OBJECTIVE: This study aimed to evaluate factors determining readiness for using telehealth solutions among patients with cardiovascular diseases. METHODS: We conducted a cross-sectional study based on an investigator-designed, validated questionnaire that included 19 items (demographics, health status, medical history, previous health care experience, expected telehealth functionalities, and preferred remote communication methods). Multivariate logistic regression was applied to assess the relationship between readiness and their determinants. RESULTS: Of the 249 respondents, 83.9% (n=209) consented to the use of telemedicine to contact a cardiologist. The nonacceptance of using telemedicine was 2 times more frequent in rural dwellers (odds ratio [OR] 2.411, 95% CI 1.003-5.796) and patients without access to the internet (OR 2.432, 95% CI 1.022-5.786). In comparison to participants living in rural areas, city dwellers demonstrated a higher willingness to use telemedicine, including following solutions: issuing e-prescriptions (19/31, 61.3% vs 141/177, 79.7%; P=.02); alarming at the deterioration of health (18/31, 58.1% vs 135/177, 76.3%; P=.03); and arranging or canceling medical visits (16/31, 51.6% vs 126/176, 71.6%; P=.03). Contact by mobile phone was preferred by younger patients (OR 2.256, 95% CI 1.058-4.814), whereas older patients and individuals who had no previous difficulties in accessing physicians preferred landline phone communication. CONCLUSIONS: During a nonpandemic state, 83.9% of patients with cardiovascular diseases declared readiness to use telemedicine solutions.

The Association between COVID-19 Pandemic and the Quality of Life of Medical Students in Silesian Voivodeship, Poland.

(1) Background: Since the COVID-19 pandemic spread rapidly in 2020, medical universities have been affected by a particular crisis. Due to the increased risk of SARS CoV-2 transmission, the authorities of medical faculties all over the world, including Poland, started to minimize direct contact between students. The objective of the paper is to identify and assess determinants of the quality of life among medical students in Poland before and during the COVID-19 pandemic. (2) Methods: We analyzed data obtained in a cross-sectional study performed among three groups of students tested in three consecutive research periods: period before the COVID-19 pandemic, the COVID-19 pandemic lockdown period and the COVID-19 pandemic period following lockdown. (3) Results: The total number of participants was 1098. We identified that the research period before the COVID-19 pandemic was the risk factor for lower quality of life in terms of the somatic and environmental domains. It was also confirmed that determinants such as poor financial situation, low frequency of physical activity and bad self-declared health status harmed the QoL scores in all domains. (4) Conclusions: The obtained results confirmed that better financial situation, higher physical activity and better self-declared health status were statistically significant factors improving the quality of life of first-year medical students in Poland. The findings of our study also showed that the declared somatic and environmental domains of QoL among medical students were better during the COVID-19 pandemic period. Our observations confirmed that the immediate implementation of e-learning could protect against the deterioration of mental health and quality of life in first-year medical students during possible future epidemic crises.

Spatial Variability of COVID-19 Hospitalization in the Silesian Region, Poland.

Assessment of regional variation in the COVID-19 epidemic is an important task for the implementation of effective action in public health, especially in densely populated regions. In this descriptive study, the temporal and spatial variability of morbidity and in-hospital mortality of COVID-19 in the Silesian Voivodship (Poland) was analyzed. Secondary epidemiological data of hospitalized patients due to COVID-19 from 1 March to 31 December 2020 and from 1 January to 31 December 2021 were obtained from the regional registry of the Silesian Voivodship Office in Katowice. A year by year (2020 versus 2021) comparative analysis showed a similar course pattern of the COVID-19 pandemic in the Silesian Voivodeship; with the worst situation occurring in the colder months of the year. The percentage of in-hospital mortality remained at a high level, close to 20% during the second year of observation. The risk of death in patients hospitalized due to COVID-19 increased with the number of comorbidities. The highest number of patients was documented in densely inhabited regions with intensive population movement (Czestochowa and border counties). The epidemiological 'map' facilitates the generation of hypotheses needed for the explanation of the observed epidemic hazard in one of the most populated regions of Poland.

Hospitalization and in-hospital mortality due to COVID-19 in the Silesian Voivodeship during the first year of epidemic.

INTRODUCTION: The Silesian Voivodeship is the region with the highest population density in Poland, three times higher than the national average. These are important circumstances that may favor the transmission of the SARS-CoV-2 virus and, due to the severe course of the disease in many patients, contribute to overloading the healthcare system. AIM: The aim of the study was to evaluate the temporal and territorial variability of hospitalized morbidity and in-hospital mortality in COVID-19 patients treated in the study region. MATERIAL AND METHODS: The research was an epidemiological descriptive study. Secondary epidemiological data were obtained from the registry of the Health Department of the Silesian Voivodeship Office in Katowice. Crude and standardized hospitalized morbidity rates, as well as COVID-19 in-hospital mortality, were calculated. Results were presented in particular poviats and subsequent months of the 2020 year. The capabilities of the ArcGIS 9.2 geographic information system and Statistica 13.3 software were used. RESULTS: The largest number of patients hospitalized due to COVID-19 and the number of deaths occurred in autumn and spring, in both periods in-hospital mortality was over 24%. The poviats with the highest standardized hospitalized prevalence rate were located in the southern part of the Silesian Voivodeship. The highest in-hospital mortality (exceeding 24%) was recorded in Gliwice, Myslowice, Tychy, Bytom and in the Lubliniec poviat. Older people (65+), usually with diagnosed comorbidities, including chronic respiratory and cardiovascular diseases, died more often. CONCLUSIONS: The highest number of patients and deaths due to COVID-19 occurred in autumn. A significant territorial diversification of hospitalized morbidity and in-hospital mortality was demonstrated, the worst situation concerned densely populated poviats and cities. Worse prognosis applied to older patients with comorbidities.

Impact of the SARS-CoV-2 pandemic on the course and treatment of appendicitis in the pediatric population.

SARS-CoV-2 is a highly contagious virus causing mainly respiratory track disease called COVID-19, which dissemination in the whole world in the 2020 has resulted in World Health Organisation (WHO) announcing the pandemic. As a consequence Polish Government made a decision to go into a lockdown in order to secure the population against SARS-CoV-2 outbreak what had its major influence on the Polish Health Care System. All of the social and medical factors caused by the pandemic might influence children's health care, including urgent cases. The aim of this survey was the analysis of medical charts with focus on the course and results of surgical treatment of children who underwent appendectomy before and during the COVID-19 pandemic. Material and methods: We performed analysis of charts of 365 subjects hospitalized in the Pediatric Surgery Department from 1st January 2019 to 31st December 2020 because of acute appendicitis. Patients were divided into two groups-those treated in 2019-before pandemic outbreak, and those treated in 2020 in the course of pandemic. Results: the most common type of appendicitis was phlegmonous (61% of cases in 2019 and 51% of cases in 2020). Followed by diffuse purulent peritonitis (18% of cases in 2019 vs 31% of cases in 2020), gangrenous (19% of cases in 2019 vs 15% of cases in 2020) and simple superficial appendicitis (1% of cases in 2019 vs 3% of cases in 2020). There was statistically significant difference in the length of hospitalization: in 2019 the mean length of hospi-talization was 4.761 vs 5.634 in 2020. Laparoscopic appendectomy was performed more frequently before the COVID period (63% of cases treated in 2019 vs 61% of cases treated in 2020). In the pandemic year 2020, there was double increase in the number of conversion from the laparoscopic approach to the classic open surgery. In the year 2019 drainage of abdominal cavity was necessary in 22% of patients treated with appendectomy, in 2020 the amount of cases threated with appendectomy and drainage increased to 32%. Conclusions: fear of being infected, the limited availability of appointments at General Practitioners and the new organisation of the medical health care system during pandemic, delay proper diagnosis of appendicitis. Forementioned delay leads to higher number of complicated cases treated with open appendectomy and drainage of abdominal cavity, higher number of conversions from the laparoscopic to classic open technique, and longer hospitalization of children treated with appendectomy in the year of pandemic.

Impact of Two Different Recruitment Procedures (Random vs. Volunteer Selection) on the Results of Seroepidemiological Study (SARS-CoV-2).

The proper recruitment of subjects for population-based epidemiological studies is critical to the external validity of the studies and, above all, to the sound and correct interpretation of the findings. Since 2020, the novel coronavirus SARS-CoV-2 pandemic has been a new factor that has been, additionally, hindering studies. Therefore, the aim of our study is to compare demographic, socio-economic, health-related characteristics and the frequency of SARS-CoV-2 infection occurrence among the randomly selected group and the group composed of volunteers. We compare two groups of participants from the cross-sectional study assessing the seroprevalence of SARS-CoV-2 coronavirus, which was conducted in autumn 2020, in three cities of the Silesian Voivodeship in Poland. The first group consisted of a randomly selected, nationally representative, age-stratified sample of subjects (1167 participants, "RG" group) and was recruited using personal invitation letters and postal addresses obtained from a national registry. The second group (4321 volunteers, "VG" group) included those who expressed their willingness to participate in response to an advertisement published in the media. Compared with RG subjects, volunteers were more often females, younger and professionally active, more often had a history of contact with a COVID-19 patient, post-contact nasopharyngeal swab, fewer comorbidities, as well as declared the occurrence of symptoms that might suggest infection with SARS-CoV-2. Additionally, in the VG group the percentage of positive IgG results and tuberculosis vaccination were higher. The findings of the study confirm that surveys limited to volunteers are biased. The presence of the bias may seriously affect and distort inference and make the generalizability of the results more than questionable. Although effective control over selection bias in surveys, including volunteers, is virtually impossible, its impact on the survey results is impossible to predict. However, whenever possible, such surveys could include a small component of a random sample to assess the presence and potential effects of selection bias.

[Infection fatality rate (IFR) during the course of COVID-19 pandemic in Upper Silesia Metropolitan Area (Poland) in 2020]. / Wskaznik smiertelnosci infekcji (IFR) w przebiegu pandemii COVID-19 w Aglomeracji Górnoslaskiej w 2020 r.

BACKGROUND: During the course of COVID-19 pandemic, a wide range of scientific projects was implemented worldwide, including studies focusing on infection fatality rate (IFR). The value of IFR depends on the number of COVID-19 deaths in a population in a given period and the number of infected people in this population, usually provided by seropepidemiological studies (anti-SARS-CoV-2 IgG in the case of COVID-19). The objective of our study was to estimate IFR in the course of COVID-19 pandemic in 2020, in the general population of Upper Silesia Metropolitan Area (USMA). MATERIAL AND METHODS: The seroepidemiological study was conducted in October-November 2020. Among randomly selected inhabitants of Katowice, Gliwice, and Sosnowiec (N = 1167), the presence of SARS-CoV-2 virus infection was assessed based on a positive IgG test result performed with the ELISA method. Data on deaths due to COVID-19 were obtained from the Registry Offices of each city. The infection fatality rate was calculated using the formula IFR (%) = [number of deaths/number of infected] × 100. RESULTS: Results of our study showed the prevalence of infection at 11.4% (95% CI: 9.5-13.2). In three examined towns, in the period January-November 2020, there was a total of 516 COVID-19 deaths. The resulting crude IFR was 0.65% (95% CI: 0.56-0.78). The IgG test had 88% sensitivity and 99% specificity and these figures were used to adjust IFR. The adjusted IFR value was similar to the crude value: IFR = 0.62% (95% CI: 0.53-0.74). CONCLUSIONS: The value of IFR estimated for the USMA population was similar to average values obtained in other countries and can be used as the background for monitoring the course and impact of COVID-19 pandemic in the Upper Silesian Industrial Area. Med Pr. 2021;72(6):671-6.

Determinants of Alcohol Consumption among Medical Students: Results from POLLEK Cohort Study.

BACKGROUND: The use of alcohol is a serious public health concern all over the world, especially among young people, including students. Medical students are often exposed to higher levels of distress, which may lead to a higher prevalence of psychoactive substance use and psychiatric co-morbidities. Alcohol abuse can be one of the detrimental methods of coping with distress. The aim of this study was to assess the prevalence of alcohol use among medical students in Poland. METHODS: We analyzed data from the POLLEK cohort study on alcohol consumption and possible influencing factors. RESULTS: Among the 540 students included, 167 (30.9%) were hazardous drinkers (HAZ) according to the AUDIT test. The main identified risk factors of hazardous/harmful drinking were male gender and smoking cigarettes. CONCLUSIONS: Given the fairly widespread alcohol abuse among medical students, it is necessary to implement screening (and intervention in the next stage) programs in these groups.

Association between Influenza Vaccination and Positive SARS-CoV-2 IgG and IgM Tests in the General Population of Katowice Region, Poland.

The explanation of the potential interaction between the influenza vaccine and SARS-CoV-2 infection is urgently needed in the public health. The objective of the study is to compare the occurrence of positive SARS-CoV-2 IgG and IgM tests in subjects with and without recent (last year) seasonal influenza vaccinations. In a cross-sectional study located in three large towns of Silesian Voivodeship (Poland), we studied 5479 subjects in which 1253 (22.9%) had a positive anti-SARS-CoV-2 IgG test and 400 (7.3%) had a positive anti-SARS-CoV-2 IgM test. Seasonal influenza vaccination remains an independent factor protecting against positive IgG tests (OR = 0.68; 0.55-0.83). The effect is not apparent with IgM antibodies. The obtained results confirmed that the serological status of SARS-CoV-2 infection depends on vaccination against seasonal influenza.

Prevalence of SARS-CoV-2 infection and risk factors in health care workers.

The COVID-19 pandemic verifies the preparation of medical care in individual countries in terms of the fluent of guaranteed medical services provided to the people in need. Due to the easy spread of SARS-CoV-2 virus when in direct contact with the patients, health care workers are at an increased risk of infection. Nurses and auxiliary staff, as well as medical doctors, were most frequently infected. The prevalence of infection depends on the adopted reporting method, including the diagnostic test used to recognize the infection, the nature of the work performed, but also on the gender, knowledge, and individual behavior of employees while performing their professional duties. It ranges from 5-30% depending on the country and the occupational group, and the highest rates were recorded in the initial phase of the pandemic. A review of the literature shows the lack of a uniform, transparent system of reporting infections in health care workers, which makes a reliable assessment of the epidemiological situation in this area difficult.

COVID-19-related risk of in-hospital death in Silesia, Poland.

INTRODUCTION: The situation regarding COVID­19 in Poland is rapidly evolving. Because of this, it is important to investigate COVID­19 mortality and its predictors in one of the most densely populated regions of the country, Silesia Province. OBJECTIVES: The goals of this study were to assess in­hospital mortality due to COVID­19 and the impact of sex, age, and coexisting diseases on the risk of death. PATIENTS AND METHODS: The data analysis was based on discharge reports of patients with COVID­19 hospitalized between March and June 2020 in all hospitals in the region. Age, sex, hospital discharge status, and the presence of coexisting diseases were abstracted from the charts. RESULTS: In a group of 2830 in­patients with COVID­19, 325 died during hospitalization. COVID­19 deaths were associated with male sex (odds ratio [OR], 1.52; 95% CI, 1.17-1.96), older age (OR, 6.11; 95% CI, 4.5-8.31), and the presence of 3 or more coexisting diseases (OR, 4.78; 95% CI, 3.52-6.49). The most prevalent comorbidities were chronic cardiovascular and respiratory diseases. CONCLUSIONS: The estimated in­hospital fatality rate for COVID­19 was 11.5%, which is lower than the average COVID­19 fatality rate in other European countries. The risk of in­hospital death was associated with sex, age, and the number of coexisting diseases, such as chronic cardiovascular and respiratory diseases.

Seroprevalence of Anti-SARS-CoV-2 Antibodies in a Random Sample of Inhabitants of the Katowice Region, Poland.

Lack of knowledge around seroprevalence levels of COVID-19 in Poland was the reason for the implementation of a seroepidemiological study in the Katowice Region (2,100,000 inhabitants). In October-November 2020, a questionnaire examination and measurement of anti-SARS-CoV-2 IgG and IgM antibodies were performed in a random sample of the general population (n = 1167). The objectives of the study were to estimate the prevalence of IgG and IgM antibodies and to assess their host-related correlates. The prevalence of IgG seropositivity was 11.4% (95% CI: 9.5-13.2%) and IgM seropositivity was 4.6% (95% CI: 3.5-5.8%). Diagnosis of COVID-19 was found in 4.8% of subjects. A positive IgG test was statistically significantly associated with age (inverse relationship), a person's contact with a COVID-19 patient, quarantine, and two symptoms in the past: fever and loss of smell/taste. Positive IgG tests were less prevalent in subjects who had diagnoses of arterial hypertension, diabetes, or rheumatologic disorders. IgM test positivity was associated with quarantine and loss of smell/taste only with no effect of chronic diseases found. In Poland, in the period October-November 2020, the prevalence of SARS-CoV-2 infection was larger than earlier estimates obtained in other European countries, probably reflecting the measurements obtained during the "second wave" of the epidemic.

Spatial variability of SARS-CoV-2 infection in the Silesian voivodeship, Poland.

INTRODUCTION: SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) and related to infection COVID-19 (coronavirus disease 2019) remain a new and global challenge for public health. Due to the location, specifics of employment, and the high density of population in the Silesia voivodeship it is appropriate to study the available epidemiological data in a region with a potentially higher risk of infection. MATERIAL AND METHODS: In the descriptive model of the study, data on the number of infected, hospitalized, and dead people due to SARS-CoV-2 infection were analyzed. The source of information was daily reports conducted by the Provincial Sanitary and Epidemiological Station in Katowice, in the period from March 5 to August 18, 2020. RESULTS: Results of antigenic molecular tests for SARS-CoV-2 infection in the Silesian voivodeship indicate that in the first half of 2020, the infection rate was approximately 5% and the symptomatic form of the disease was approximately 20%. CONCLUSIONS: The analysis of the frequency of infection and mortality in the poviats reveals a large variation in the occurrence of both phenomena, but the explanation of this difference is not possible due to the descriptive nature of the analysis and the secondary form of epidemiological data.