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1.
Viruses ; 13(12)2021 12 02.
Article in English | MEDLINE | ID: covidwho-1554951

ABSTRACT

During COVID-19 pandemics, the availability of testing has often been a limiting factor during patient admissions into the hospital. To circumvent this problem, we adapted an existing diagnostic assay, Seegene Allplex SARS-CoV-2, into a point-of-care-style direct qPCR (POC dqPCR) assay and implemented it in the Emergency Department of Clinical Hospital Center Rijeka, Croatia. In a 4-month analysis, we tested over 10,000 patients and demonstrated that POC-dqPCR is robust and reliable and can be successfully implemented in emergency departments and similar near-patient settings and can be performed by medical personnel with little prior experience in qPCR.


Subject(s)
COVID-19 Nucleic Acid Testing/methods , COVID-19/diagnosis , Emergency Service, Hospital , Point-of-Care Testing , SARS-CoV-2/isolation & purification , COVID-19/epidemiology , Croatia/epidemiology , Humans , RNA, Viral/genetics , Reproducibility of Results , SARS-CoV-2/genetics , Sensitivity and Specificity
2.
Arh Hig Rada Toksikol ; 72(3): 240-243, 2021 Sep 28.
Article in English | MEDLINE | ID: covidwho-1444009

ABSTRACT

The coronavirus disease 19 (COVID-19) pandemic has had a tremendous impact on every facet of private life and work organisation in virtually all social and economic sectors worldwide. People who stand on the first line of defence are healthcare workers (HCWs) risking exposure to infected patients. However, even though they are often affected by COVID-19 and associated somatic and mental health problems, COVID-19 as a new illness was not immediately acknowledged as occupational disease. This is why several groups of HCWs contacted their occupational medicine physicians in 2020 with a request to register the infection with SARS-CoV-2 as occupational disease. In an attempt to support their appeals and show that hospital workers have a high occupational risk of COVID-19, this study presents COVID-19 incidence and symptoms in 100 employees working at 11 clinics of the Clinical Hospital Centre (CHC) Rijeka, Croatia from 1 June to end December 2020. All of them were infected with SARS-CoV-2 and took sick leave, which lasted 13.6±2.6 days in average. This study also looks into the role of occupational medicine physicians in prospective monitoring of acute and long-acting consequences of COVID-19 that might occur in HCWs.


Subject(s)
COVID-19 , Occupational Diseases , Croatia/epidemiology , Health Personnel , Hospitals , Humans , Occupational Diseases/epidemiology , Prospective Studies , SARS-CoV-2
3.
Front Public Health ; 9: 720948, 2021.
Article in English | MEDLINE | ID: covidwho-1441157

ABSTRACT

Background: The COVID-19 pandemic disrupted hospital care, as hospitals had to deal with a highly infectious virus, while at the same time continuing to fulfill the ongoing health service needs of their communities. This study examines the direct effects of COVID-19 on the delivery of inpatient care in Croatia. Materials and Methods: The research is a retrospective, comparative analysis of the hospital admission rate across all Diagnosis Related Group (DRG) classes before and during the pandemic. It is based on DRG data from all non-specialized acute hospitals in Croatia, which account for 96% of national inpatient activity. The study also used COVID-19 data from the Croatian Institute of Public Health (CIPH). Results: The results show a 21% decrease in the total number of admissions [incident rate ratio (IRR) 0.8, p < 0.0001] across the hospital network during the pandemic in 2020, with the greatest drop occurring in April, when admissions plunged by 51%. The decrease in activity occurred in non-elective DRG classes such as cancers, stroke, major chest procedures, heart failure, and renal failure. Coinciding with this reduction however, there was a 37% increase (IRR 1.39, p < 0.0001) in case activity across six COVID-19 related DRG classes. Conclusions: The reduction in hospital inpatient activity during 2020, can be attributed to a number of factors such as lock-downs and quarantining, reorganization of hospital operations, the rationing of the medical workforce, and the reluctance of people to seek hospital care. Further research is needed to examine the consequences of disruption to hospital care in Croatia. Our recommendation is to invest multidisciplinary effort in reviewing response procedures to emergencies such as COVID-19 with the aim of minimizing their impact on other, and equally important community health care needs.


Subject(s)
COVID-19 , Pandemics , Communicable Disease Control , Croatia/epidemiology , Hospitals , Humans , Retrospective Studies , SARS-CoV-2
5.
Front Public Health ; 9: 708907, 2021.
Article in English | MEDLINE | ID: covidwho-1354898

ABSTRACT

Aim: To explore the clinical presentation and epidemiological history of the subjects who underwent SARS-CoV-2 antigen testing. Methods: We included 1,000 consecutive subjects who presented themselves at the diagnostic clinic in Croatia and analyzed their symptoms and epidemiological history. All subjects were classified into three groups, according to their reason of arrival; symptomatic, contacts of confirmed patients, and those who were tested due to administrative reasons. Results: On average, there were 24% of positive antigen results; the positivity rate was 51% among symptomatic, 16% in contacts, and 5% of administrative patients. The commonest symptoms of the disease included febrility and anosmia. We developed a clinical score to predict SARS-CoV-2 positivity, which had an area under the curve of 79.3 [95% confidence intervals (CI) 75.8-82.8]. Contact with the isolated person [odds ratio 0.54 (95% CI 0.31-0.94)] and international travel had a protective effect [0.20 (0.09-0.43)], suggesting that risk perception and mandatory pretravel measures had a key role in the determination of the infection risk. Conclusions: A combination of clinical symptoms can have reasonable predictive power for an antigen-positive test result. Risk perception seems to have a role in the epidemic spread, probably via stricter adherence to personal preventative measures.


Subject(s)
COVID-19 , Epidemics , Croatia/epidemiology , Humans , Perception , SARS-CoV-2
6.
Public Health ; 198: 164-170, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1336867

ABSTRACT

OBJECTIVES: COVID-19 pandemic affected majority of students worldwide because school closures were one of the first and frequently taken measures in tackling epidemic. This study analyzed trends in COVID-19 morbidity and mortality from the beginning of pandemic in Croatia, in relation to schools opening and closing. STUDY DESIGN: Retrospective data review. METHODS: Data on COVID-19 positive patients in Croatia from week 9 of 2020 to week 10 of 2021 in Croatia were analyzed using joinpoint regression. Analysis also included hospitalizations and mortality trends for age groups 26 to 65 and 66+ from week 30 of 2020. RESULTS: Schools opened in fall after the summer holidays in week 37. Joinpoint regression analysis revealed a statistically significant increase in cumulative incidence rates of COVID-19 in all age groups until 50th week, except in the 19-25 age group which saw an increase until 49th week. During the period of increase, there were periods of moderate increases and rapid increases in incidence that were present between 39/41 week and 43/44 week in all age groups except in those 0-6 years [from 40th till 43rd week in age groups 7-14 and 15-18, average percentage change (APC) = 87.41, P = 0.035, and APC = 83.47, P = 0.013; from 39th till 43rd in 19-25, APC = 91.90, P = 0.002; from 40th till 44th in 26-65, APC = 74.79, P < 0.001; from 41st till 44th in 66+, APC = 81.95, P = 0.004]. Steeper increase in hospitalizations was seen in 40th week for age groups 26 to 65 (40th to 45th week APC = 34.67, P < 0.001) and 66+ (40th to 45th week APC = 38.76, P < 0.001). Steeper increase in mortality started in 41st week for both age groups 26 to 65 and 66+ (41st to 46th week APC = 59.59, P < 0.001 and 41st to 45th week APC = 70.28, P < 0.001). Schools were closed for winter holidays in week 51. A steep decrease occurred in week 50 for cases and in week 51 for mortality and hospitalizations. There was no significant increase in hospitalizations and mortality after schools were re-opened in week 03 of 2021 (primary schools) and week 07 (secondary schools). CONCLUSION: COVID-19 morbidity and mortality trends in Croatia observed in fall 2020 in Croatia perhaps cannot completely exclude potential association of school opening in all age groups. However, in winter 2021 effect was completely lacking and numbers were independent of schools' dynamics. The observed inconsistent pattern indicates that there were no association of school openings and COVID-19 morbidity and mortality trends in Croatia and that other factors were leading to increasing and decreasing numbers. This emphasizes the need to consider the introduction of other effective and less harmful measures by stakeholders, or at least to use school closures as a last resort.


Subject(s)
COVID-19 , Pandemics , Child , Child, Preschool , Croatia/epidemiology , Hospitalization , Humans , Incidence , Infant , Infant, Newborn , Retrospective Studies , SARS-CoV-2 , Schools
7.
Eur J Gen Pract ; 27(1): 184-190, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1334099

ABSTRACT

BACKGROUND: Healthcare professionals (HCPs) in family medicine (FM) in Croatia work in a demanding environment caused by the SARS-CoV-2 pandemic. Besides particular circumstances in healthcare, an unknown virus, social distancing, and homeschooling, the capital was hit with the earthquake during the lockdown. OBJECTIVES: To assess the prevalence of stress, anxiety, depression, posttraumatic stress disorder (PTSD) and the influence of demographic characteristics, professional differences, medical history, and specific stressors on the psychological outcomes. METHODS: A cross-sectional study with the online questionnaire containing the Depression, Anxiety and Stress Scale (DASS-21) and the Impact of Event Scale-Revised (IES-R) was conducted from 1st to 15 May 2020 in FM. RESULTS: HCPs (534, 35% response rate), predominantly female (84.5%), participated in the research. High prevalence of stress (30.9%), anxiety (33.1%), depression (30.7%), and PTSD (33.0%) were found. Female participants had higher results in the anxiety subscale of DASS-21 and IES-R scores. Pre-existing conditions were associated with higher levels of stress, anxiety, depression, and PTSD. The IES-R score for PTSD showed borderline correlation (p = 0.053) with working in regions with the highest incidence of COVID-19. Having schoolchildren made a difference on a stress subscale in DASS-21 (p < 0.043), but the earthquake did not have an impact. CONCLUSION: Family physicians and nurses in FM in Croatia are under a great mental load during the COVID-19 outbreak. Results suggest that HCPs of the female sex, with pre-existing chronic conditions, work in regions with a high incidence of SARS-CoV-2 or have schoolchildren at greater risk of the poor psychological outcome.


Subject(s)
Anxiety/etiology , COVID-19/psychology , Depression/etiology , Nurses/psychology , Occupational Stress/etiology , Physicians, Family/psychology , Stress Disorders, Post-Traumatic/etiology , Adolescent , Adult , Anxiety/diagnosis , Anxiety/epidemiology , COVID-19/epidemiology , COVID-19/prevention & control , Croatia/epidemiology , Cross-Sectional Studies , Depression/diagnosis , Depression/epidemiology , Disasters , Disease Outbreaks/prevention & control , Earthquakes , Female , Health Surveys , Humans , Logistic Models , Male , Middle Aged , Occupational Stress/diagnosis , Occupational Stress/epidemiology , Prevalence , Psychological Tests , Risk Factors , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/epidemiology , Young Adult
8.
Viruses ; 13(8)2021 07 22.
Article in English | MEDLINE | ID: covidwho-1325789

ABSTRACT

Over a year into the COVID-19 pandemic, there is growing evidence that SARS-CoV-2 infections among dogs are more common than previously thought. In this study, the prevalence of SARS-CoV-2 antibodies was investigated in two dog populations. The first group was comprised of 1069 dogs admitted to the Veterinary Teaching Hospital for any given reason. The second group included dogs that shared households with confirmed COVID-19 cases in humans. This study group numbered 78 dogs. In COVID-19 infected households, 43.9% tested ELISA positive, and neutralising antibodies were detected in 25.64% of dogs. Those data are comparable with the secondary attack rate in the human population. With 14.69% of dogs in the general population testing ELISA positive, there was a surge of SARS-CoV-2 infections within the dog population amid the second wave of the pandemic. Noticeably seroprevalence of SARS-CoV-2 in the dog and the human population did not differ at the end of the study period. Male sex, breed and age were identified as significant risk factors. This study gives strong evidence that while acute dog infections are mostly asymptomatic, they can pose a significant risk to dog health. Due to the retrospective nature of this study, samples for viral isolation and PCR were unavailable. Still, seropositive dogs had a 1.97 times greater risk for developing central nervous symptoms.


Subject(s)
COVID-19/veterinary , Communicable Diseases, Emerging/veterinary , Dog Diseases/epidemiology , SARS-CoV-2/isolation & purification , Animals , Antibodies, Viral/blood , COVID-19/blood , COVID-19/epidemiology , COVID-19/virology , Communicable Diseases, Emerging/blood , Communicable Diseases, Emerging/epidemiology , Communicable Diseases, Emerging/virology , Croatia/epidemiology , Dog Diseases/blood , Dog Diseases/diagnosis , Dog Diseases/virology , Dogs , Enzyme-Linked Immunosorbent Assay , Female , Humans , Male , Pandemics , Retrospective Studies , SARS-CoV-2/immunology , Seroepidemiologic Studies
9.
Med Arch ; 75(2): 144-148, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1296132

ABSTRACT

Background: In the year 2020 we observe the world adapting to "new normal" due to the COVID-19 pandemic, ways of which include physical distancing, hand hygiene, and wearing a face mask. There is no conclusive evidence about ocular manifestations of the new coronavirus infection, but cases of conjunctivitis, keratitis, and episcleritis have been reported in infected individuals. Objective: Determining if wearing a face mask during COVID-19 pandemic causes a new onset or deterioration of previously existing dry eye disease (DED). Methods: A prospective cohort study included 203 participants, all using surgical facemasks daily due to new regulations during COVID-19 pandemic. Participants completed a survey, containing modified Ocular Surface Disease Index (OSDI) questionnaire. They were divided into groups according to: sex, age, duration of face mask-wear, and existence of prior DED history. Results: Our results indicate that women have a statistically higher OSDI score compared to men (14.4 (IQR = 2.4 - 41.7) vs. 5.0 (IQR = 0.0 - 24.4); P = .004). Age did not significantly affect OSDI median values. Group that used masks from 3 to 6 hours/day demonstrated significantly higher OSDI scores compared to <3 hour/day group (15.3 (IQR = 8.3 - 47.7) vs. 8.3 (IQR = 0.0 - 35.1); P = .001). OSDI score was significantly greater in participants with prior DED history compared to those without it (36.1 (IQR = 14.1 - 61.6) vs. 4.2 (IQR = 2.3 - 8.3); P <.001). Participants with prior DED exhibited greater worsening of their disturbances during mask wearing period compared to the ones without previous DED (54.8% vs. 17.7%, Chi-Square 28.3 DF1; P <.001), regardless of daily mask wear duration. Conclusion: Our study confirmed the existence of mask-associated dry eye (MADE), most profoundly in females, subjects with a history of prior DED, and if wearing a face mask lasts longer than 3 hours per day. Ophthalmologists should advise their patients of the potential ocular surface health risks related to inadequately fitted facemasks.


Subject(s)
COVID-19/prevention & control , Dry Eye Syndromes/epidemiology , Masks , Adult , Age Factors , Cohort Studies , Croatia/epidemiology , Dry Eye Syndromes/etiology , Dry Eye Syndromes/physiopathology , Female , Humans , Male , Masks/adverse effects , Middle Aged , Prospective Studies , SARS-CoV-2 , Sex Factors , Surveys and Questionnaires , Time Factors
10.
Biochem Med (Zagreb) ; 31(2): 020706, 2021 Jun 15.
Article in English | MEDLINE | ID: covidwho-1290873

ABSTRACT

Introduction: The study aimed to investigate the prevalence and titres of anti-SARS-CoV-2 antibodies in children treated at the Children's Hospital Zagreb in the first and the second wave of the COVID-19 pandemic. Statistical significance of difference at two time points was done to determine how restrictive epidemiological measures and exposure of children to COVID-19 infection affect this prevalence in different age groups. Materials and methods: At the first time point (13th to 29th May 2020), 240 samples and in second time point (24th October to 23rd November 2020), 308 serum samples were tested for anti-SARS-CoV-2 antibodies by enzyme-linked immunosorbent assay (ELISA) and electrochemiluminescence immunoassay (ECLIA). Confirmation of results and titre determination was done using virus micro-neutralization test. Subjects were divided according to gender, age and epidemiological history. Results: Seroprevalence of anti-SARS-CoV-2 antibodies differs significantly in two time points (P = 0.010). In first time point 2.9% of seropositive children were determined and in second time point 8.4%. Statistically significant difference (P = 0.007) of seroprevalence between two time points was found only in a group of children aged 11-19 years. At the first time point, all seropositive children were asymptomatic with titre < 8. At the second time point, 69.2% seropositive children were asymptomatic with titre ≥ 8. Conclusions: The prevalence of anti-SARS-CoV-2 antibodies was significantly lower at the first time point than at the second time point. Values of virus micro-neutralization test showed that low titre in asymptomatic children was not protective at the first time point but in second time point all seropositive children had protective titre of anti-SARS-CoV-2 antibodies.


Subject(s)
Antibodies, Viral/blood , COVID-19/diagnosis , SARS-CoV-2/immunology , Adolescent , COVID-19/epidemiology , COVID-19/virology , Child , Child, Preschool , Croatia/epidemiology , Enzyme-Linked Immunosorbent Assay , Female , Hospitals , Humans , Infant , Male , Pandemics , SARS-CoV-2/isolation & purification
11.
BMJ Open ; 11(6): e049590, 2021 06 29.
Article in English | MEDLINE | ID: covidwho-1288395

ABSTRACT

OBJECTIVES: To evaluate the impact of the first COVID-19 lockdown in 2020 on the burnout and study satisfaction of medical students. DESIGN: A cross-sectional study with a presurvey and postsurvey. SETTING: University of Split School of Medicine (USSM), Split, Croatia. The lockdown in the COVID-19 pandemic lasted from late March to mid-May 2020. There was a full switch to e-learning at the USSM during this period, and all clinical teaching was stopped. PARTICIPANTS: Students enrolled in the 2019/2020 academic year. Data were collected before lockdown in December 2019 and January 2020 and again after the end of lockdown in June 2020. PRIMARY AND SECONDARY OUTCOME MEASURES: Study satisfaction was assessed using the study satisfaction survey. Burnout was assessed using two instruments: Oldenburg Burnout Inventory and Copenhagen Burnout Inventory. We used Bayesian statistics to compare before-and-after differences. RESULTS: 437 independent responses (77.2% response rate) were collected before and 235 after lockdown (41.5% response rate). 160 participant responses were eligible for pairing. There was no significant difference for both paired and unpaired participants in study satisfaction before (3.38 on a 1-5 scale; 95% credible interval (95% CrI) 3.32 to 3.44) and after (3.49, 95% CrI 3.41 to 3.57) lockdown. We found no evidence (Bayes factor (BF10) >3.00 as a cut-off value) for an increase in the level of burnout before and after lockdown, both in independent and paired samples. CONCLUSIONS: It seems that the first pandemic-related lockdown and a switch to e-learning did not affect burnout levels among medical students or their perception of their study programme. More insight is needed on the short-term and long-term effects of the COVID-19 pandemic on medical students and their education. Well-structured longitudinal studies on medical student burnout during the COVID-19 pandemic are needed.


Subject(s)
COVID-19 , Students, Medical , Bayes Theorem , Burnout, Psychological , Communicable Disease Control , Croatia/epidemiology , Cross-Sectional Studies , Humans , Pandemics , Personal Satisfaction , SARS-CoV-2 , Surveys and Questionnaires
13.
J Trauma Stress ; 34(4): 691-700, 2021 08.
Article in English | MEDLINE | ID: covidwho-1267467

ABSTRACT

The present study aimed to identify the contributions of sociodemographic factors, psychological hardiness, and pandemic-related stressors to the development of peritraumatic distress and posttraumatic stress symptoms (PTSS) during the peak of the COVID-19 pandemic. We also examined the mediating contribution of peritraumatic distress with respect to the associations between PTSS and (a) individual characteristics and (b) pandemic-related stressors. A total of 1,238 participants (82.1% women, 17.9% men) aged 18-75 years were included in the study. Participants completed the Dispositional Resilience Scale, Peritraumatic Distress Inventory, and Posttraumatic Stress Disorder (PTSD) Checklist. The results showed that 11.5% of participants scored above the clinical cutoff for peritraumatic distress, and 12.8% of participants scored above the clinical cutoff for PTSS. Regression models showed that higher levels of peritraumatic distress were statistically predicted by female gender, ß = -.12, p < .001; exposure to more than one stressor, ß = .21, p < .001; lower levels of commitment to people and activities, ß = -.12, p = .002; and resistance to challenges, ß = -.17, p < .001. Additionally, male gender, ß = .05, p = .007; younger age, ß = -.05, p = .005; lower levels of commitment to people and activities, ß = -.11, p < .001; lower ratings of hardiness with regard to challenge, ß = -.04, p = .043; and more severe peritraumatic distress, ß = .75, p < .001, predicted more severe PTSS during the pandemic. Peritraumatic distress mediated the associations between PTSS and both the number of experienced stressors and psychological hardiness.


Subject(s)
COVID-19/psychology , Psychological Distress , Resilience, Psychological , Social Isolation/psychology , Stress Disorders, Post-Traumatic/psychology , Adult , COVID-19/epidemiology , Croatia/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Pandemics , SARS-CoV-2 , Sex Distribution , Stress Disorders, Post-Traumatic/epidemiology , Surveys and Questionnaires
14.
Oncologist ; 26(7): e1156-e1160, 2021 07.
Article in English | MEDLINE | ID: covidwho-1184611

ABSTRACT

BACKGROUND: Our objective was to assess the effects of COVID-19 antiepidemic measures and subsequent changes in the function of the health care system on the number of newly diagnosed breast cancers in the Republic of Croatia. SUBJECTS, MATERIALS, AND METHODS: We performed a retrospective, population- and registry-based study during 2020. The comparator was the number of patients newly diagnosed with breast cancer during 2017, 2018, and 2019. The outcome was the change in number of newly diagnosed breast cancer cases. RESULTS: The average monthly percent change after the initial lockdown measures were introduced was -11.0% (95% confidence interval - 22.0% to 1.5%), resulting in a 24% reduction of the newly diagnosed breast cancer cases in Croatia during April, May, and June compared with the same period of 2019. However, during 2020, only 1% fewer new cases were detected than in 2019, or 6% fewer than what would be expected based on the linear trend during 2017-2019. CONCLUSION: It seems that national health care system measures for controlling the spread of COVID-19 had a detrimental effect on the number of newly diagnosed breast cancer cases in Croatia during the first lockdown. As it is not plausible to expect an epidemiological change to occur at the same time, this may result in later diagnosis, later initiation of treatment, and less favorable outcomes in the future. However, the effect weakened after the first lockdown and COVID-19 control measures were relaxed, and it has not reoccurred during the second COVID-19 wave. Although the COVID-19 lockdown affected the number of newly diagnosed breast cancers, the oncology health care system has shown resilience and compensated for these effects by the end of 2020. IMPLICATIONS FOR PRACTICE: It is possible to compensate for the adverse effects of COVID-19 pandemic control measures on breast cancer diagnosis relatively promptly, and it is of crucial importance to do it as soon as possible. Moreover, as shown by this study's results on the number of newly diagnosed breast cancer cases during the second wave of the pandemic, these adverse effects are preventable to a non-negligible extent.


Subject(s)
Breast Neoplasms , COVID-19 , Breast Neoplasms/diagnosis , Breast Neoplasms/epidemiology , Communicable Disease Control , Croatia/epidemiology , Female , Humans , Pandemics , Registries , Retrospective Studies , SARS-CoV-2
15.
Arh Hig Rada Toksikol ; 72(1): 36-41, 2021 Mar 01.
Article in English | MEDLINE | ID: covidwho-1161088

ABSTRACT

Healthcare workers (HCWs) are considered to run a higher occupational risk of becoming infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and develop coronavirus disease (COVID-19) than the rest of the population. The aim of this study was to describe and analyse the characteristics of work-related COVID-19 in Croatian HCWs. Study participants were HCWs who contacted their occupational physician between 1 May 2020 and 12 November 2020 with a request for the registration of COVID-19 as an occupational disease. All participants filled out our online Occupational COVID-19 in Healthcare Workers Questionnaire. The study included 59 HCWs (median age 45.0, interquartile range 36.0-56.0 years). Most (78 %) were nurses or laboratory technicians, and almost all (94.9 %) worked in hospitals. Hierarchical cluster analysis revealed three clusters of COVID-19-related symptoms: 1) elevated body temperature with general weakness and fatigue, 2) diarrhoea, and 3) headache, muscle and joint pain, anosmia, ageusia, and respiratory symptoms (nasal symptoms, burning throat, cough, dyspnoea, tachypnoea). Almost half (44.6 %) reported comorbidities. Only those with chronic pulmonary conditions were more often hospitalised than those without respiratory disorders (57.1 % vs. 2.5 %, respectively; P=0.001). Our findings suggest that work-related COVID-19 among Croatian HCWs is most common in hospital nurses/laboratory technicians and takes a mild form, with symptoms clustering around three clinical phenotypes: general symptoms of acute infection, specific symptoms including neurological (anosmia, ageusia) and respiratory symptoms, and diarrhoea as a separate symptom. They also support evidence from other studies that persons with chronic pulmonary conditions are at higher risk for developing severe forms of COVID-19.


Subject(s)
COVID-19/epidemiology , Health Personnel/statistics & numerical data , Occupational Diseases/epidemiology , Risk Assessment/statistics & numerical data , Adult , Croatia/epidemiology , Female , Humans , Male , Middle Aged , SARS-CoV-2
16.
Arch Virol ; 166(6): 1735-1739, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1147594

ABSTRACT

We developed a next-generation SARS-CoV-2 sequencing platform and obtained the first SARS-CoV-2 sequences from patients in Croatia at the beginning of the COVID-19 outbreak in the spring of 2020. Integrating the sequencing and the epidemiological data, we show that patients were infected with different SARS-CoV-2 variants belonging to different clades (mostly G and GH). This result confirms that there was widespread virus transmission early in 2020. Interestingly, we identified a unique mutation resulting in a V13I substitution in Nsp5A, the main viral protease, in a patient who had not received antiviral therapy.


Subject(s)
COVID-19/epidemiology , COVID-19/virology , Genetic Variation , SARS-CoV-2/genetics , Coronavirus 3C Proteases/chemistry , Croatia/epidemiology , Genome, Viral , Humans , Models, Molecular , Phylogeny , Protein Conformation , Whole Genome Sequencing
17.
Epilepsy Behav ; 116: 107790, 2021 03.
Article in English | MEDLINE | ID: covidwho-1065672

ABSTRACT

The aim of our study was to gather information on how people with epilepsy (PwE) responded to the COVID-19 pandemic during the national lockdown. An online questionnaire was therefore offered to the visitors of the Croatian Association for Epilepsy's website. The 22-items questionnaire was designed to acquire information from adults with epilepsy living in Croatia on demographic data, cognitive, emotional and behavioral responses to the pandemic, and communication problems between patients and their neurologists during the lockdown. Perceived anxiety and fears were expressed with the Likert scale (1-5) and the results of specific fears added to make the Total Fear Score. Results: Out of 186 respondents in total, only 2.8% did not comply with the lockdown measures, and all of those respondents stated that they did not feel any anxiety related to COVID-19. A canceled neurologist examination during the lockdown was significantly associated with pandemic-related anxiety (2.9 ±â€¯1.28 vs. 2.3 ±â€¯1.19, U = 3039, p = 0.001) and fears (Total Fear Score 31.4 ±â€¯9.70 vs. 28.4 ±â€¯9.79, U = 3341, p = 0.036), and 87.4% of respondents expressed the wish to communicate with their neurologist, either by phone/video call (53.0%) or email (34.4%). Conclusion: We think the results of our survey show that the responses from PwE point to a social responsibility appropriate for the existing situation. During future pandemics, telemedicine could have an important role in tackling the fears and anxieties caused by the cancelation of examinations, which corresponds to the wishes expressed by the great majority of our respondents.


Subject(s)
COVID-19/epidemiology , Epilepsy/epidemiology , Quarantine/trends , Surveys and Questionnaires , Telemedicine/trends , Adult , Anxiety/epidemiology , Anxiety/psychology , Anxiety/therapy , COVID-19/prevention & control , COVID-19/psychology , Communicable Disease Control , Croatia/epidemiology , Epilepsy/psychology , Epilepsy/therapy , Female , Humans , Male , Middle Aged , Pandemics/prevention & control , Quarantine/psychology
18.
PLoS One ; 15(12): e0243704, 2020.
Article in English | MEDLINE | ID: covidwho-1060412

ABSTRACT

The global epidemic of (mis)information, spreading rapidly via social media platforms and other outlets, can be a risk factor for the development of anxiety disorders among vulnerable individuals. Cyberchondria can be a vulnerability factor for developing anxiety in a pandemic situation, particularly when the Internet is flooded with (mis)information. The aim of our study was to examine how cyberchondria is related to changes in levels of COVID-19 concern and safety behaviours among persons living in Croatia during the period in which the first COVID-19 case was identified and when the country recorded its first fatality. Repeated cross-sectional data collection was conducted during two waves over a period of three weeks (N1 = 888; N2 = 966). The first began on the day of the first confirmed case of COVID-19 in Croatia (February 24th, 2020) and the second wave began three weeks later, on the day the first COVID-19 fatality was recorded in Croatia (March 19th, 2020). Participants completed an online questionnaire regarding various COVID-19 concerns and safety behaviours aimed at disease prevention (information seeking, avoidance and hygiene) and a measure of cyberchondria (Short Cyberchondria Scale, SCS). We analysed whether changes to the epidemiological situation during the period between the two waves of data collection led to an increase in COVID-19 related behaviour directly and indirectly via an increase in COVID-19 concerns. The results indicated that, between the two waves of research, there was a pronounced increase in concerns regarding COVID-19 (b = 1.11, p < .001) as well as significant behavioural changes (b = 1.18-2.34, p < .001). Also, results demonstrated that cyberchondria plays a moderating role in these changes. In the first wave, persons with severe cyberchondria were already intensely concerned with safety behaviours. High cyberchondria and high levels of concern about the COVID-19 are associated with intense avoidance behaviours, R2 = .63, p < .001. A moderated partial mediation model was confirmed, in which the effect of the epidemiological situation was weaker for those with higher results on the SCS (as indicated by index of moderated mediation between -.10 and -.15, p < .05). As such, cyberchondria is a contributing factor to long-term anxiety and its impact during pandemic on the general mental health burden should therefore be further investigated.


Subject(s)
Anxiety Disorders , COVID-19 , Hypochondriasis , Information Seeking Behavior , Internet , SARS-CoV-2 , Social Media , Adolescent , Adult , Aged , Anxiety Disorders/epidemiology , Anxiety Disorders/psychology , COVID-19/epidemiology , COVID-19/psychology , Croatia/epidemiology , Cross-Sectional Studies , Female , Humans , Hypochondriasis/epidemiology , Hypochondriasis/psychology , Male , Middle Aged
19.
Spat Spatiotemporal Epidemiol ; 36: 100402, 2021 02.
Article in English | MEDLINE | ID: covidwho-1014823

ABSTRACT

A crisis is an immediate threat to the functioning of society, while disaster is an actual manifestation of a crisis. Both are now even more critically socially constructed. In the middle of battle with the COVID-19 pandemic, the Republic of Croatia's capital of Zagreb was afflicted with another disaster - two severe earthquakes. Restrictive public health measures were already in place, including restriction on public transport, travel between regions, closure of educational and other public institutions, alongside measures of physical distancing. Most previous cases of COVID-19 were centered in Zagreb, leading to concern of spreading the disease into disease-free communities. It seems that earthquakes did not have an effect on disease transmission - the number of COVID-19 cases remained stable through the 14-day incubation period, with a linear pandemic curve in Croatia in April, and flattened in May. This leads to a conclusion that the earthquake did not have a direct effect on disease spread. Despite the fact that the current pandemic and its responses are unique, this paradox can have interesting repercussions on how we conceptualize and approach notions as vulnerability and resilience.


Subject(s)
COVID-19/epidemiology , COVID-19/transmission , Earthquakes , Pandemics , Public Health Practice , Croatia/epidemiology , Humans , Risk Factors , SARS-CoV-2
20.
Croat Med J ; 61(6): 491-500, 2020 Dec 31.
Article in English | MEDLINE | ID: covidwho-1012028

ABSTRACT

AIM: To describe epidemiological and clinical features of Croatian children and adolescents with a polymerase chain reaction (PCR)-confirmed coronavirus disease 2019. METHODS: Data on patients aged ≤19 years with a positive SARS-CoV-2 PCR test recorded in the period March 12-May 12 (first wave) and June 19-July 19, 2020 (second wave) were retrospectively analyzed. The periods were separated by several weeks with no incident cases. RESULTS: We analyzed data on 289 children and adolescents (6.5% of all cases; incidence rate [IR]=3.54, 95% confidence interval [CI] 3.14-3.97/million person-days), 124 in the first wave (IR=2.27) and 165 in the second wave (IR=6.37): IRR second/first=2.71 (2.13-3.44). During the first wave, the incidence was highest in infants (IR=3.48), while during the second wave it progressively increased to IR = 7.37 in 15-19-year olds. Family members were the key epidemiological contacts (72.6% cases), particularly during the first wave (95.8% vs 56.3%). Overall, 41.3% patients were asymptomatic, 25.3% in the first and 52.6% in the second wave. Age 15-19 years (vs younger) was associated with a higher (RR = 1.26, 1.02-1.54) and infection in the second wave with a lower probability (RR=0.66, 0.53-0.81) of being symptomatic. The most common symptoms were fever, cough, and rhinorrhea. In children aged ≥7 years, headache, anosmia/ageusia, and sore throat were also recorded. Only one child suffered a severe disease. All but 18 (7.8%) children were treated only symptomatically, and all fully recovered. CONCLUSION: A large proportion of SARS-CoV-2 PCR-positive children/adolescents were asymptomatic. The associated disease was predominantly mild, comparably so in the first and second pandemic wave.


Subject(s)
Asymptomatic Infections , COVID-19/diagnosis , COVID-19/epidemiology , Adolescent , COVID-19 Nucleic Acid Testing , Child , Child, Preschool , Croatia/epidemiology , Female , Humans , Incidence , Infant , Infant, Newborn , Male , Multivariate Analysis , Polymerase Chain Reaction , Probability , Retrospective Studies , Treatment Outcome , Young Adult
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