Insights in paediatric virology during the COVID-19 era (Review)

The present article provides an overview of the key messages of the topics discussed at the ‘7th Workshop on Paediatric Virology', which was organised virtually on December 20, 2021 by the Institute of Paediatric Virology, located on the Island of Euboea in Greece. The workshop's plenary lectures were on: i) viral pandemics and epidemics in the ancient Mediterranean;ii) the impact of obesity on the outcome of viral infections in children and adolescents;and iii) COVID-19 and artificial intelligence. Despite the scarcity of evidence from fossils and remnants, viruses have been recognised as significant causes of several epidemics in the ancient Mediterranean. Paediatric obesity, a modifiable critical health risk factor, has been shown to impact on the development, progression and severity of viral infections. Thus, the prevention of paediatric obesity should be included in formulating public health policies and decision-making strategies against emerging global viral threats. During the current COVID-19 pandemic, artificial intelligence has been used to facilitate the identification, monitoring and prevention of SARS-CoV-2. In the future, it will play a fundamental role in the surveillance of epidemic-prone infectious diseases, in the repurposing of older therapies and in the design of novel therapeutic agents against viral infections. The collaboration between different medical specialties and other diverse scientific fields, including archaeology, history, epidemiology, nutritional technologies, mathematics, computer technology, engineering, medical law and ethics is essential for the successful management of paediatric viral infections. The current COVID-19 pandemic has underscored this need, which should be further encouraged in modern medical education.

Post-COVID Syndrome: Incidence, Clinical Spectrum, and Challenges for Primary Healthcare Professionals.

Post-COVID syndrome also known as long COVID refers to symptoms persisting for more than three weeks after the diagnosis of COVID-19. We reviewed the current evidence on post-COVID syndrome, focusing on its clinical manifestations and addressing the challenges for its management in primary healthcare. The incidence of post-COVID syndrome is estimated at 10-35%, while for hospitalized patients it may reach 85%. Fatigue is the most common symptom reported in 17.5-72% of post-COVID cases, followed by residual dyspnea with an incidence ranging from 10-40%. Mental problems, chest pain, and olfactory and gustatory dysfunction may affect up to 26, 22 and 11% of patients, respectively. More than one third of patients with post-COVID syndrome have pre-existing comorbidities, hypertension and diabetes mellitus being the most common. Beyond the prolonged duration of symptoms, the scarce published data indicate that most patients with post-COVID syndrome have a good prognosis with no further complications or fatal outcomes reported. Given the clinical spectrum of patients with post-COVID syndrome, most of them will be managed by primary healthcare professionals, in conjunction with pre-existing or new co-morbidities, which, in turn, may increase the burden of COVID-19 on primary healthcare. In conclusion approximately 10% of patients with COVID-19 may have symptoms persisting beyond three weeks, fulfilling the criteria of post-COVID syndrome. Primary healthcare professionals have a key role in the management of patients with post-COVID syndrome. Research is needed to elucidate the pathogenesis, clinical spectrum, and prognosis of post-COVID syndrome.

Determinants of intention to get vaccinated against COVID-19 among healthcare personnel in hospitals in Greece.

BACKGROUND: To investigate intention rates to get vaccinated against COVID-19 among healthcare personnel (HCP) in Greece. METHODS: Cross-sectional survey. RESULTS: The response rate was 14.5%. Of 1521 HCP with a known profession, 607 (39.9%) were nursing personnel, 480 (31.6%) physicians, 171 (11.2%) paramedical personnel, 72 (4.7%) supportive personnel, and 191 (12.6%) administrative personnel. Overall, 803 of 1571 HCP (51.1%) stated their intention to get vaccinated while 768 (48.9%) stated their intention to decline vaccination. Most HCP (71.3%) who reported intent to get vaccinated noted contributing to the control of the pandemic and protecting their families and themselves as their reasons, while the most common reason for reporting intent to decline vaccination was inadequate information about the vaccines (74.9%), followed by concerns about vaccine safety (36.2%). Logistic regression analysis revealed that the probability of intending to get vaccinated increased with male gender, being a physician, history of complete vaccination against hepatitis B, history of vaccination against pandemic A (H1N1) in 2009-2010, belief that COVID-19 vaccination should be mandatory for HCP, and increased confidence in vaccines in general during the COVID-19 pandemic. The following factors were associated with a lower intention to get vaccinated: no vaccination against influenza the past season, no intention to get vaccinated against influenza in 2020-2021, and no intention to recommend COVID-19 vaccination to high-risk patients. CONCLUSION: There is an urgent need to built safety perception towards COVID-19 vaccines and raise vaccine uptake rates by HCP, and thus to protect the healthcare workforce and the healthcare services.

The foundation of the Institute of Paediatric Virology on the island of Euboea, Greece (Review).

The Institute of Paediatric Virology, founded on October 2019 on the island of Euboea in Greece, introduces medical students, paediatric and neonatal trainees, postgraduate students, virologists, paediatric and allied health professionals to the bold, new, scientific field of paediatric virology. The institute is committed to medical education and is the sequel of the Paediatric Virology Study Group (PVSG), which was formed in 2007 in the United Kingdom by a group of young paediatric trainees and junior researchers. The main mission of the institute is to provide an educational e-platform on neonatal and paediatric viral infections, to facilitate scientific discussion between virologists and paediatric health professionals and to develop an international network aiming to the promotion of children's health by the prevention and treatment of viral infectious diseases. The foundation of the institute is dedicated to three children from a small fishing village at the south of the island of Euboea in Greece, who survived the 1918 Spanish flu pandemic.

COVID-19 and paediatric challenges: An interview with Professor of Paediatrics Vana Papaevangelou (University of Athens School of Medicine).

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus, which causes coronavirus disease 2019 (COVID-19) and affects children less frequently than adults. According to Professor Vana Papaevangelou, Professor of Paediatrics at the University of Athens School of Medicine, children comprise only 2-6% of COVID-19 cases, worldwide, and they are not considered as super-spreaders of this infection. SARS-CoV-2 is transmitted through droplets, fomites, aerosol and fecal-oral route, while there is no strong evidence as yet, supporting transplacental transmission. Professor Papaevangelou highlights the epidemiological differences between seasonal influenza and COVID-19 and accepts that school closure had no direct impact since children are not the main transmitters of SARS-CoV-2. On the other hand, social distancing clearly limited the transmission of SARS-CoV-2, while quarantine seemed necessary during the first wave of this pandemic. She refers to antivirals, as well as other therapeutic agents able to diminish the immune response producing multisystem inflammatory syndrome, which is associated with increased mortality, and she notes that these agents were rarely used in children with COVID-19, while in most cases supportive treatment sufficed. She finishes with the ongoing scientific efforts for the development of an effective and safe vaccine against SARS-CoV-2 indicating that so far the most promising vaccine developments include vaccines that use viral vectors.