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1.
Expert Rev Vaccines ; 21(6): 853-859, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1772530

ABSTRACT

OBJECTIVES: Our aim was to estimate vaccination and susceptibility rates against vaccine-preventable diseases among healthcare personnel (HCP) in eight hospitals. METHODS: Cross-sectional survey. RESULTS: A total of 1284 HCP participated (physicians: 31.3%, nursing personnel: 36.6%, paramedical personnel: 11.1%, administrative personnel: 13.2%, supportive personnel: 7.3%). Vaccination rates were 32.9% against measles and mumps, 38.1% against rubella, 5.7% against varicella, 9.2% against hepatitis A, 65.8% against hepatitis B, 31.8% against tetanus-diphtheria, 7.1% against pertussis, 60.2% against influenza, and 80.1% against COVID-19. Susceptibility rates were as follows: 27.8% for measles, 39.6% for mumps, 33.4% for rubella, 22.2% for varicella, 86.3% for hepatitis A, 34.2% for hepatitis B, 68.2% for tetanus-diphtheria, and 92.9% for pertussis. Older HCP had higher susceptibility rates against mumps, rubella, varicella, hepatitis A, hepatitis B, tetanus-diphtheria, and pertussis (p-values <0.001 for all). Mandatory vaccinations were supported by 81.85% of HCP. CONCLUSIONS: Although most HCPs supported mandatory vaccinations, significant vaccination gaps, and susceptibility rates were recorded. The proportion of susceptible HCP to measles, mumps, rubella, and varicella has increased in the past decade, mostly because of reduction in acquired cases of natural illness. Vaccination programs for HCP should be developed. A national registry to follow HCP's vaccination rates is urgently needed.


Subject(s)
COVID-19 , Chickenpox , Diphtheria , Hepatitis A , Hepatitis B , Measles , Mumps , Rubella , Tetanus , Whooping Cough , Attitude , Cross-Sectional Studies , Delivery of Health Care , Greece/epidemiology , Humans , Measles/epidemiology , Measles/prevention & control , Mumps/epidemiology , Mumps/prevention & control , Tertiary Care Centers , Vaccination , Vaccination Coverage
2.
Travel Med Infect Dis ; 48: 102321, 2022.
Article in English | MEDLINE | ID: covidwho-1773809

ABSTRACT

BACKGROUND: We aimed to elucidate which vaccines were accepted by European countries as valid proof of vaccination against COVID-19 for international travelers. METHOD: On 27-September-2021 a cross-sectional study was conducted on VisaGuide.World, that reports on valid vaccines for international travelers. Other databases, lay press and regulatory agencies were also checked. The main outcome measure was which of the vaccines included on the WHO emergency use listing (EUL) [ChAdOx1 (Vaxzevria, Covishield),BNT162b2,mRNA-1273,Ad26.CoV2.S,BBIBP-CorV,CoronaVac] and Sputnik V, were accepted in each country. The influence of the vaccines approved for COVID-19 vaccination programs on the vaccines recognized as proof of vaccination was assessed. RESULTS: There was a remarkable heterogeneity on the vaccines accepted as proof of vaccination among 46 countries. Russia accepted only one. Cyprus, Greece and Slovenia accepted all vaccines considered. Eleven countries accepted the seven WHO EUL vaccines: eight EU countries, plus Iceland, Norway and Switzerland. Seven EU countries accepted only the four EMA-authorized vaccines. Considering Covishield as equivalent to Vaxzevria, 69% of countries recognized only vaccinated travelers who received any of the vaccines approved for vaccination programs in the country of arrival as valid. CONCLUSION: Vaccines accepted as proof of vaccination should be harmonized. Accepting any of the WHO EUL vaccines would be a scientifically sound objective.


Subject(s)
COVID-19 , Vaccines , Ad26COVS1 , BNT162 Vaccine , COVID-19/prevention & control , COVID-19 Vaccines , ChAdOx1 nCoV-19 , Cross-Sectional Studies , Health Policy , Humans
3.
Hormones (Athens) ; 21(2): 221-227, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1682540

ABSTRACT

PURPOSE: Our aim was to study patients with diabetes mellitus and SARS-CoV-2-infection diagnosed during the first pandemic wave in Greece. METHODS: Cases were retrieved from the national database of SARS-CoV-2 infections. RESULTS: We studied 2624 SARS-CoV-2 infected cases, including 157 with diabetes. Patients with diabetes more often had other comorbidities (68.8 vs. 24.1%; p-value < 0.001). Among patients with diabetes, 149 (94.9%) developed symptomatic disease (COVID-19) compared to 1817 patients (73.7%) without diabetes (p-value < 0.001). A total of 126 patients with diabetes and COVID-19 were hospitalized and 41 died (27.5% case-fatality rate compared to 7.5% among patients without diabetes; p-value < 0.001). Patients with diabetes more often were hospitalized, developed complications, were admitted to the intensive care unit (ICU), received invasive mechanical ventilation, and died compared to patients without diabetes (p-values < 0.001 to 0.002 for all comparisons). Multivariate logistic regression analyses revealed that diabetes, having other comorbidities, and older age were significantly associated with higher risk for hospitalization, ICU admission, invasive mechanical ventilation, and death, and that obesity was significantly associated with higher risk for hospitalization, ICU admission, and mechanical intubation, while female gender protected against these outcomes. CONCLUSION: COVID-19 is associated with increased rates of serious morbidity and adverse outcome in patients with diabetes and represents a severe illness for them.


Subject(s)
COVID-19 , Diabetes Mellitus , COVID-19/epidemiology , COVID-19/therapy , Diabetes Mellitus/epidemiology , Female , Hospitalization , Humans , Intensive Care Units , Pandemics , Retrospective Studies , SARS-CoV-2
4.
Travel Med Infect Dis ; 46: 102278, 2022.
Article in English | MEDLINE | ID: covidwho-1677191

ABSTRACT

Vaccinations are an important component of travel medicine. Beyond protection of travelers, vaccines are administered to prevent the importation of vaccine-preventable diseases at home and at destination. Proof of immunization to travel dates back to the first smallpox vaccine, developed by Edward Jenner in 1796. However, it took one century to generate the next vaccines against cholera, rabies, and typhoid fever. During the 20th century the armamentarium of vaccines used in travelers largely expanded with yellow fever, poliomyelitis, tetravalent meningococcal, and hepatitis A vaccines. The International Certificate of Inoculation and Vaccination was implemented in 1933. Currently there are vaccines administered to travelers following risk assessment, but also vaccines required according to the 2005 International Health Regulations and vaccines required at certain countries. Finally, within less than one year after the declaration of the coronavirus disease 2019 (COVID-19) pandemic, the first COVID-19 vaccines were launched and approved for emergency use to control the pandemic. Despite practical and ethical challenges, COVID-19 vaccine verifications have been widely used since spring 2021 in many activities, including international travel. In this article, we review the course of development of travel vaccines focusing on those for which a proof of vaccination has been or is required.


Subject(s)
COVID-19 , Meningococcal Vaccines , Vaccines , Yellow Fever , COVID-19/prevention & control , COVID-19 Vaccines , Humans , SARS-CoV-2 , Travel , Vaccination , Yellow Fever/prevention & control
6.
Vaccines (Basel) ; 9(5)2021 May 12.
Article in English | MEDLINE | ID: covidwho-1227074

ABSTRACT

Post-COVID syndrome is increasingly recognized as a new clinical entity in the context of SARS-CoV-2 infection. Symptoms persisting for more than three weeks after the diagnosis of COVID-19 characterize the post-COVID syndrome. Its incidence ranges from 10% to 35%, however, rates as high as 85% have been reported among patients with a history of hospitalization. Currently, there is no consensus on the classification of post-COVID syndrome. We reviewed the published information on post-COVID syndrome, putting emphasis on its pathogenesis. The pathogenesis of post-COVID syndrome is multi-factorial and more than one mechanism may be implicated in several clinical manifestations. Prolonged inflammation has a key role in its pathogenesis and may account for some neurological complications, cognitive dysfunction, and several other symptoms. A multisystem inflammatory syndrome in adults (MIS-A) of all ages has been also described recently, similarly to multisystem inflammatory syndrome in children (MIS-C). The post-infectious inflammatory pathogenetic mechanism of MIS-A is supported by the fact that its diagnosis is established through serology in up to one third of cases. Other pathogenetic mechanisms that are implicated in post-COVID syndrome include immune-mediated vascular dysfunction, thromboembolism, and nervous system dysfunction. Although the current data are indicating that the overwhelming majority of patients with post-COVID syndrome have a good prognosis, registries to actively follow them are needed in order to define the full clinical spectrum and its long-term outcome. A consensus-based classification of post-COVID syndrome is essential to guide clinical, diagnostic, and therapeutic management. Further research is also imperative to elucidate the pathogenesis of post-COVID syndrome.

7.
Emerg Infect Dis ; 27(7): 1927-1930, 2021 07.
Article in English | MEDLINE | ID: covidwho-1225856

ABSTRACT

We describe response measures to an outbreak involving 128 (33.4%) coronavirus disease cases (46.1% asymptomatic) among 383 persons onboard a passenger ship. Multivariate analysis indicated that dining in certain rooms and bar areas, nationality, working department (for crew members), and quarantining onboard the ship were significantly associated with infection.


Subject(s)
COVID-19 , Ships , Disease Outbreaks , Greece/epidemiology , Humans , Quarantine , SARS-CoV-2
8.
Arch Med Res ; 52(6): 575-581, 2021 08.
Article in English | MEDLINE | ID: covidwho-1213040

ABSTRACT

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.


Subject(s)
COVID-19 , COVID-19/complications , COVID-19/diagnosis , Humans , Incidence , Primary Health Care
10.
Infect Dis Health ; 26(3): 189-197, 2021 08.
Article in English | MEDLINE | ID: covidwho-1163834

ABSTRACT

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.


Subject(s)
COVID-19 Vaccines/administration & dosage , COVID-19/prevention & control , COVID-19/psychology , Health Personnel/psychology , Adult , Aged , Attitude of Health Personnel , Cross-Sectional Studies , Female , Greece , Humans , Intention , Male , Middle Aged , Surveys and Questionnaires , Vaccination/psychology , Young Adult
11.
Travel Med Infect Dis ; 38: 101882, 2020.
Article in English | MEDLINE | ID: covidwho-773219

ABSTRACT

BACKGROUND: The emergence in China in late 2019 and subsequent progression of a pandemic of a respiratory disease named coronavirus disease 2019 (COVID-19) was highly facilitated by international travel. We present 5 cases of probable in-flight transmission in Greece. METHODS: We studied international passengers arriving to or departing from Greece from February 26 through March 9, 2020. Contact tracing extended up to 4 days before the onset of symptoms and focused on close contacts. Close contacts were defined as persons sitting within a distance of <2 m for >15 min, including passengers seated two seats around the index case and all crew members and persons who had close contact with the index case. RESULTS: We investigated 18 international flights with 2224 passengers and 110 crew members. Main countries of departure included Northern Italy, Israel and the United Kingdom. In accordance with the national surveillance investigation, in these flights there were 21 index cases and 891 contact traced cases. Six index cases were symptomatic during the flight. Of the 891 contact traced cases, 4 passengers and 1 crew member developed laboratory-confirmed infection (3 with COVID-19 and 2 with asymptomatic infection); they travelled on the same flight with two COVID-19 cases. CONCLUSIONS: Air travel has played a central role in the progression of the COVID-19 pandemic. However, there are scarce data about in-flight transmission. Our extensive investigation showed five cases of probable in-flight transmission. Efforts should be placed in order to ensure the prompt implementation of appropriate infection control measures on board.


Subject(s)
Air Travel , COVID-19/transmission , SARS-CoV-2 , COVID-19/epidemiology , COVID-19/prevention & control , Contact Tracing , Epidemiologic Studies , Greece/epidemiology , Humans
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