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1.
Rural Remote Health ; 22(1): 6985, 2022 01.
Article in English | MEDLINE | ID: covidwho-1789840

ABSTRACT

INTRODUCTION: Primary health care (PHC), the cornerstone of health systems, has an important role in infectious disease control. The SARS-CoV-2 (COVID-19) pandemic has put a burden on health systems worldwide and especially on healthcare workers at the first line delivering their services in remote areas of Greece. This study investigates preparedness and awareness level of primary healthcare workers (PHCWs) and their risk perception in managing the pandemic during its initial phase. METHODS: A cross-sectional survey was conducted in public PHC units in Greece. A web-based 14-item questionnaire, tested in a pilot study, was administered by a pre-existing panel of the Education and Research Network in PHC of Aristotle University of Thessaloniki, Greece. Associations were assessed between epidemic response awareness, risk perception, participant demographics and work settings. Participants were grouped by profession in first-line physicians (general practitioners, internal medicine specialists, pediatricians), first-line non-physicians (nurses, health visitors, paramedics) and second-line PHCWs (dentists, microbiologists, administrators, midwifes, laboratory technicians, nutritionists and social workers). Univariate logistic regression and multivariable analysis were performed and linear regression was performed to examine the effect of participants' awareness of the preparedness plan to their working area characteristics. RESULTS: A total of 441 PHCWs participated in the survey. Risks were perceived at a lower level by second-line PHCWs than by first-line PHCWs (B=-0.78, 95% confidence interval (CI) -1.49- -0.08; p=0.028). Older PHCWs had less concerns than younger PHCWs (B=-0.04, 95%CI -0.08- -0.01; p=0.025) and more experienced participants had more concerns than less experienced (B=0.04, 95%CI 0.00,0.07; p=0.050). PHCWs in rural settings presented with more preparedness awareness, compared to PHCWs in urban areas (B=1.10, 95%CI 0.28,1.92; p=0.008), while PHCWs living with high risk individuals showed less situation awareness (-0.55, 95%CI -0.95-0.16; p=0.006). CONCLUSION: PHCWs in rural areas revealed a relatively high awareness of the response measures and management protocol requirements that were in place, compared to their colleagues in urban areas. As expected, first-line PHCWs directly exposed to emergencies expressed more concerns than second-line PHCWs. Learning from the challenges occurring during the initial phase of the pandemic could help PHC facilities address COVID-19 effectively and PHCWs' sense of security and confidence could be augmented, even when working in remote areas of the country. When planning training, distributing equipment and proposing protocols, the characteristics of the area and the needs of PHCWs, and population should be cautiously considered.


Subject(s)
COVID-19 , General Practitioners , Cross-Sectional Studies , Greece/epidemiology , Health Personnel , Humans , Pandemics , Pilot Projects , Primary Health Care , SARS-CoV-2
2.
J Nerv Ment Dis ; 210(4): 249-256, 2022 04 01.
Article in English | MEDLINE | ID: covidwho-1764699

ABSTRACT

ABSTRACT: The COVID-19 outbreak imposed stress worldwide, as daily routine changed almost overnight, with no time to prepare. A pandemic like this may trigger a chain reaction starting out as surprise, continuing to uncertainty and ending up either in adaptation or in symptoms of fear, anxiety, and/or depression. Resilience on the other hand could lessen anxiety and prove to be a prophylactic coping mechanism against distress. This study explored peritraumatic distress, intolerance of uncertainty (IU), and resilient coping in a sample of 2717 adults who voluntarily and anonymously participated in an online survey conducted in April 2020, in Greece.Results indicated a moderate pandemic-related mental burden and medium resilient coping and designated IU as a significant positive predictor of peritraumatic distress; resilient coping proved to be a significant moderator that alters the strength of the association between IU and distress reactions.


Subject(s)
COVID-19 , Pandemics , Adult , Anxiety Disorders , COVID-19/epidemiology , Greece/epidemiology , Humans , Uncertainty
3.
Chirurgia (Bucur) ; 117(1): 61-68, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1743107

ABSTRACT

Background: The coronavirus disease (COVID-19) pandemic is an ongoing crisis. In light of mounting concerns about the training of surgical residents, we examined surgical residents perceptions regarding the pandemic's impact on their training. Methods: We developed an anonymous online questionnaire comprising 15 multiple-choice questions, which we sent via email to residents educated and employed in northern Greece hospitals. Our survey took place in January and February of 2021. Results: A total of 124 residents across a broad spectrum of surgical fields completed the questionnaire. The majority (51.6%) reported a significant decline in the number of operations performed weekly during the pandemic. Approximately 38% of the respondents stated that their surgical skills have been negatively affected to a significant extent, and 35.5% reported that their theoretical knowledge had deteriorated to a moderate extent. Almost half of them reported that they were satisfied with the online courses and a total of 67.7% affirmed the need to prolong their clinical training. Conclusions: The aims and scope of a surgical department include the provision of high-quality training to young surgeons. The impact of the pandemic on routine surgical activities has been dramatic. Our results clearly indicate that young surgeons have been significantly affected in terms of their training.


Subject(s)
COVID-19 , Internship and Residency , COVID-19/epidemiology , Greece/epidemiology , Humans , Pandemics , SARS-CoV-2 , Surveys and Questionnaires , Treatment Outcome
5.
Nat Commun ; 13(1): 482, 2022 01 25.
Article in English | MEDLINE | ID: covidwho-1655580

ABSTRACT

The impact of the COVID-19 pandemic on excess mortality from all causes in 2020 varied across and within European countries. Using data for 2015-2019, we applied Bayesian spatio-temporal models to quantify the expected weekly deaths at the regional level had the pandemic not occurred in England, Greece, Italy, Spain, and Switzerland. With around 30%, Madrid, Castile-La Mancha, Castile-Leon (Spain) and Lombardia (Italy) were the regions with the highest excess mortality. In England, Greece and Switzerland, the regions most affected were Outer London and the West Midlands (England), Eastern, Western and Central Macedonia (Greece), and Ticino (Switzerland), with 15-20% excess mortality in 2020. Our study highlights the importance of the large transportation hubs for establishing community transmission in the first stages of the pandemic. Here, we show that acting promptly to limit transmission around these hubs is essential to prevent spread to other regions and countries.


Subject(s)
Bayes Theorem , COVID-19/mortality , Pandemics/statistics & numerical data , SARS-CoV-2/isolation & purification , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , COVID-19/virology , Cause of Death , England/epidemiology , Female , Geography , Greece/epidemiology , Humans , Italy/epidemiology , Male , Middle Aged , Pandemics/prevention & control , SARS-CoV-2/physiology , Spain/epidemiology , Survival Rate , Switzerland/epidemiology
6.
J Cell Mol Med ; 26(5): 1445-1455, 2022 03.
Article in English | MEDLINE | ID: covidwho-1642687

ABSTRACT

There is an unmet need of models for early prediction of morbidity and mortality of Coronavirus disease-19 (COVID-19). We aimed to a) identify complement-related genetic variants associated with the clinical outcomes of ICU hospitalization and death, b) develop an artificial neural network (ANN) predicting these outcomes and c) validate whether complement-related variants are associated with an impaired complement phenotype. We prospectively recruited consecutive adult patients of Caucasian origin, hospitalized due to COVID-19. Through targeted next-generation sequencing, we identified variants in complement factor H/CFH, CFB, CFH-related, CFD, CD55, C3, C5, CFI, CD46, thrombomodulin/THBD, and A Disintegrin and Metalloproteinase with Thrombospondin motifs (ADAMTS13). Among 381 variants in 133 patients, we identified 5 critical variants associated with severe COVID-19: rs2547438 (C3), rs2250656 (C3), rs1042580 (THBD), rs800292 (CFH) and rs414628 (CFHR1). Using age, gender and presence or absence of each variant, we developed an ANN predicting morbidity and mortality in 89.47% of the examined population. Furthermore, THBD and C3a levels were significantly increased in severe COVID-19 patients and those harbouring relevant variants. Thus, we reveal for the first time an ANN accurately predicting ICU hospitalization and death in COVID-19 patients, based on genetic variants in complement genes, age and gender. Importantly, we confirm that genetic dysregulation is associated with impaired complement phenotype.


Subject(s)
COVID-19/genetics , COVID-19/mortality , Neural Networks, Computer , COVID-19/epidemiology , Complement Activation/genetics , Complement Factor H/genetics , Complement System Proteins/genetics , Female , Greece/epidemiology , Hospitalization/statistics & numerical data , Humans , Intensive Care Units/statistics & numerical data , Male , Middle Aged , Models, Genetic , Morbidity , Polymorphism, Single Nucleotide , Thrombomodulin/genetics
8.
Psychiatriki ; 32(4): 271-281, 2021 Dec 20.
Article in English | MEDLINE | ID: covidwho-1614461

ABSTRACT

The impact of the COVID-19 pandemic on the mental health of healthcare professionals is currently under research and prevalence of mental health symptoms across the world vary a lot. Moreover, knowledge and perceptions of healthcare professionals towards the new coronavirus is yet to be explored since very few data have been published to date. Thus, we decided to conduct a cross-sectional, web-based survey to measure the levels of depressive, anxiety and stress symptoms using the Depression, Anxiety and Stress Scale-21. The knowledge and perceptions of healthcare professionals towards the new coronavirus were also examined with a self-constructed questionnaire. Data were collected between April 19th and May 31st 2020. In total, 1484 professionals participated in the survey and 1064 completed it in full; 60.8% were females, 66.5% were physicians and 24.3% were first-line healthcare workers. The prevalence of at least moderate symptoms was 13% for depression, 11.9% for anxiety, and 11.3% for stress. Women, younger participants, residents in urban areas, having lower income and worse self-reported health status had higher scores in all outcomes. First-line healthcare workers also indicated higher anxiety scores compared to those who were not first responders. Regarding knowledge and perceptions, most participants agreed with the asymptomatic nature of the virus and its heightened danger for older individuals and those with underlying health conditions. Different views were expressed regarding the possibility of airborne transmission, its similarity to common flu, and the statements that the new coronavirus is manufactured and serves a specific purpose and that it is out of control. In conclusion, the results of our study suggest that the prevalence of depressive, anxiety and stress symptoms in Greek healthcare professionals is placed in the lower end of the range reported from various recent studies across the world. Nevertheless, professionals at risk should be monitored closely and supported when needed.airborne transmission, its similarity to common flu, and the statements that the new coronavirus is manufactured and serves a specific purpose and that it is out of control. In conclusion, the results of our study suggest that the prevalence of depressive, anxiety and stress symptoms in Greek healthcare professionals is placed in the lower end of the range reported from various recent studies across the world. Nevertheless, professionals at risk should be monitored closely and supported when needed.


Subject(s)
COVID-19 , Anxiety/epidemiology , Cross-Sectional Studies , Delivery of Health Care , Depression/epidemiology , Female , Greece/epidemiology , Health Personnel , Humans , Pandemics , SARS-CoV-2 , Stress, Psychological/epidemiology
9.
Nutrients ; 14(1)2021 Dec 29.
Article in English | MEDLINE | ID: covidwho-1580548

ABSTRACT

The outbreak of the new coronavirus strain SARS-CoV-2 (COVID-19) highlighted the need for appropriate feeding practices among critically ill patients admitted to the intensive care unit (ICU). This study aimed to describe feeding practices of intubated COVID-19 patients during their second week of hospitalization in the First Department of Critical Care Medicine, Evaggelismos General Hospital, and evaluate potential associations with all cause 30-day mortality, length of hospital stay, and duration of mechanical ventilation. We enrolled adult intubated COVID-19 patients admitted to the ICU between September 2020 and July 2021 and prospectively monitored until their hospital discharge. Of the 162 patients analyzed (52.8% men, 51.6% overweight/obese, mean age 63.2 ± 11.9 years), 27.2% of patients used parenteral nutrition, while the rest were fed enterally. By 30 days, 34.2% of the patients in the parenteral group had died compared to 32.7% of the patients in the enteral group (relative risk (RR) for the group receiving enteral nutrition = 0.97, 95% confidence interval = 0.88-1.06, p = 0.120). Those in the enteral group demonstrated a lower duration of hospital stay (RR = 0.91, 95% CI = 0.85-0.97, p = 0.036) as well as mechanical ventilation support (RR = 0.94, 95% CI = 0.89-0.99, p = 0.043). Enteral feeding during second week of ICU hospitalization may be associated with a shorter duration of hospitalization and stay in mechanical ventilation support among critically ill intubated patients with COVID-19.


Subject(s)
COVID-19/mortality , COVID-19/therapy , Critical Care/methods , Enteral Nutrition/statistics & numerical data , Parenteral Nutrition/statistics & numerical data , Respiration, Artificial/mortality , Critical Illness , Enteral Nutrition/methods , Enteral Nutrition/mortality , Female , Greece/epidemiology , Humans , Length of Stay/statistics & numerical data , Male , Middle Aged , Parenteral Nutrition/methods , Parenteral Nutrition/mortality , Prospective Studies , Respiration, Artificial/methods , SARS-CoV-2 , Time Factors , Treatment Outcome
10.
Viruses ; 14(1)2021 12 24.
Article in English | MEDLINE | ID: covidwho-1580409

ABSTRACT

Health-Care-Workers (HCWs) are considered at high risk for SARS-CoV-2 infection. We sought to compare rates and severity of Coronavirus disease 2019 (COVID-19) among vaccinated and unvaccinated HCWs conducting a retrospective cohort study in two tertiary Academic Hospitals, namely Laiko and Attikon, in Athens, Greece. Vaccinated by BNT162b2 Pfizer-BioNTech COVID-19 mRNA vaccine and unvaccinated HCWs were included and data were collected between 1 January 2021 and 15 September 2021. Overall, 2921 of 3219 HCWs without a history of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection were fully vaccinated during the study period (90.7% at each Hospital). Demographic characteristics were comparable between 102/2921 (3.5%) vaccinated and 88/298 (29.5%) unvaccinated HCWs with COVID-19, although age and occupation differed significantly. None were in need of hospital admission in the vaccinated Group, whereas in the unvaccinated Group 4/88 (4.5%) were hospitalized and one (1.1%) died. Multivariable logistic regression analysis revealed that lack of vaccination was an independent risk factor for COVID-19 with an odds ratio 11.54 (95% CI: 10.75-12.40). Vaccination hesitancy among HCWs resulted to highly increased COVID-19 rates; almost one in three unvaccinated HCWs was SARS-CoV-2 infected during the 9-month period. The absolute need of vaccination of HCWs, including boosting dose, is highlighted. Evidence should be used appropriately to overcome any hesitancy.


Subject(s)
COVID-19/epidemiology , Health Personnel/statistics & numerical data , /statistics & numerical data , Adult , COVID-19/prevention & control , Female , Greece/epidemiology , Humans , Male , Middle Aged , Retrospective Studies , Risk , SARS-CoV-2/immunology , Severity of Illness Index , Tertiary Care Centers , Vaccination/statistics & numerical data
11.
Int J Environ Res Public Health ; 19(1)2021 Dec 31.
Article in English | MEDLINE | ID: covidwho-1580777

ABSTRACT

BACKGROUND: In this work, we aimed to evaluate antibody-response longevity to SARS-CoV-2 infection and/or vaccination in one of the Greek communities that was worst hit by the pandemic, Deskati, five months after a previous serosurveillance and nine months after the pandemic wave initiation (October 2020). METHODS: The SARS-CoV-2 IgG II Quant method (Architect, Abbott, IL, USA) was used for antibody testing. RESULTS: A total of 69 subjects, who previously tested positive or negative for COVID-19 antibodies, participated in the study. We found that 48% of participants turned positive due to vaccination. 27% of participants were both previously infected and vaccinated. However, all previously infected participants retained antibodies to the virus, irrespective of their vaccination status. The antibody titers were significantly higher in previously infected participants that had been vaccinated than those who were unvaccinated and in those that had been previously hospitalized for COVID-19 than those with mild disease. CONCLUSIONS: Antibody responses to SARS-CoV-2 infection were maintained nine months after the pandemic. Vaccination alone had generated an immune response in almost half of the population. Higher antibody titers were found in the case of vaccination in previously infected subjects and especially in those with severe disease leading to hospitalization.


Subject(s)
COVID-19 , Antibodies, Viral , Greece/epidemiology , Humans , SARS-CoV-2 , Seroepidemiologic Studies , Vaccination
12.
Front Public Health ; 9: 775374, 2021.
Article in English | MEDLINE | ID: covidwho-1555368

ABSTRACT

Background-Aim: Medical students have been greatly affected by the COVID-19 pandemic due to their educational program, which comprises theoretical knowledge and also clinical duties, making them vulnerable to viral exposures and possibly affecting their everyday life. The aim of this study was to explore changes in sleep and mental health parameters among medical students in Greece during the second year of the pandemic. Methods: This cross-sectional study comprised students of all medical schools in Greece (n = 7), using an anonymous online survey. Participants completed the following questionnaires: Pittsburgh Sleep Quality Index (PSQI), Athens Insomnia Scale (AIS), Fatigue Severity Scale (FSS), General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9). Statistical analysis was conducted with the use of SPSS v.26 (IBM SPSS, Armonk NY, USA). Results: Out of the 562 received responses, 559 met the inclusion criteria. The largest proportion of the respondents came from 4th-year (27.8%) and the majority of the sample were females (69.8%). Only 5.9% of the participants reported having been infected by SARS-COV-2. Most of the respondents experienced insomnia (65.9%, mean AIS score: 7.59 ± 4.24), poor sleep quality (52.4%, mean PSQI score: 6.6 ± 3.25) and increased fatigue (48.5%, mean 35.82 ± 11.74). Moderate to severe symptoms of anxiety (mean 9.04 ± 5.66) and depression (mean 9.36 ± 6.15) were noted. Suicidal ideation was found in 16.7% of the sample, while use of sleeping pills in the previous month was reported by 8.8% (n = 47). Further analysis revealed independent associations between sleep and mental health parameters. Higher AIS score was associated with greater FSS score; higher PSQI scores with higher GAD-7 and PHQ-9 scores. Additionally, female students were found to be significantly more affected than males by the COVID-19 pandemic, displaying higher levels of insomnia, sleep disturbances, anxiety and depression. In addition, those with a history of COVID-19 infection or in close proximity with a positive case reported significantly more significant post-traumatic symptoms in IES-COVID-19 questionnaire. Conclusions: In the aftermath of the COVID-19 pandemic, prevalence of sleep and mental health disorders among Greek medical students is significant, highlighting the need for better surveillance of students' wellbeing and subsequent counseling, with special focus on female students and other affected groups.


Subject(s)
COVID-19 , Students, Medical , Cross-Sectional Studies , Female , Greece/epidemiology , Humans , Male , Mental Health , Pandemics , SARS-CoV-2
13.
Psychiatriki ; 32(4): 328-332, 2021 Dec 20.
Article in English | MEDLINE | ID: covidwho-1552030

ABSTRACT

Everyday human life has recently been affected worldwide by the SARS-CoV-2 pandemic. Medical students were found to be a vulnerable population, facing many challenges with the temporary suspension of clinical activities, as well as their confrontation with violent changes in their chosen profession. The purpose of the present study is to record and detect possible signs of emotional burden on the psychological profile of northern Greek medical students in the second wave of the European pandemic at the hitherto culmination point. 342 medical students completed a questionnaire investigating some very rough and easily self-reported affective psychiatric symptoms and their responses were statistically evaluated. The results disclosed experienced emotional burden among medical students with a general exacerbation of various non-specific affective symptoms, but a decrease in suicidal ideation and auto-destructiveness was nevertheless observed. On the contrary, a moderate increase in wishes for illness was noted among medical students. Findings of emotional burden were disclosed among medical students with a general worsening of various non-specific affective symptoms in turn connoting feelings of discomfort in adapting to the multiple constraints and fear of insecurity for the newly-formed reality created by the outbreak of the new coronavirus pandemic.


Subject(s)
COVID-19 , Students, Medical , Emotions , Greece/epidemiology , Humans , Pandemics , SARS-CoV-2
14.
Psychiatriki ; 32(4): 267-270, 2021 Dec 20.
Article in Greek, English | MEDLINE | ID: covidwho-1552029

ABSTRACT

More than a year has passed since World Health Organization (WHO) declared COVID-19 as a pandemic, and during this period over 237 million cases and more than 4.8 million deaths have occurred worldwide due to COVID-19.1 This unprecedented pandemic not only has burdened health systems but it also constitutes a major stressful event both due to the threat of illness and death that it poses, and to the drastic impact on human relations, financial activity, access to health services, etc. Additional factors that may contribute to stress include the protection measures against COVID-19, social distancing, and mobility restrictions. The impact of the pandemic on suicidal behavior, especially on the Greek population, is of critical importance, due to the increase in suicidality during the recent financial crisis in the country.2 The impressive decline in the GDP during the first months of the COVID-19 pandemic (-9% of GDP),3 unemployment, isolation, reduced social contacts, problems in accessing mental health services, and also the limitations in terms of psychological support may increase the risk of suicidal behavior.4 With a view to investigating the psychosocial effects of the COVID-19 pandemic, an online questionnaire was developed in March 2020 by the Second Department of Psychiatry of the National and Kapodistrian University of Athens (NKUA) and the Postgraduate Program "Liaison Psychiatry: Integrated Care of Physical and Mental Health" of NKUA. This questionnaire included items regarding demographic characteristics, physical and mental health data, and issues related to the pandemic and the imposed restriction measures, such as perceived changes in participants' biorhythms, habits, and relationships with their colleagues, friends, and family. In addition, participants were asked to complete psychometric scales with regard to anxiety, depression and suicidal ideation, family functioning, anger and resilience. During the first national lockdown in Greece (April 7 to May 3) a total of 5,748 adults from the community participated in the survey by anonymously completing the aforementioned questionnaire on a secure website of NKUA. A considerable effort was devoted to make the sample as representative as possible and to include members of the community who do not usually participate in such surveys, as individuals of older age or individuals with health conditions. The 5.20% two-week prevalence of suicidal ideation found in our study is an intermediate rate with respect to the 2.4% one-month prevalence in 2008, the 6.7% in 2011 and the 2.6% prevalence in 2013.5 Among the respondents, 14.1% were potential cases of anxiety, while 26.5% of depression. Independent risk factors for suicidal ideation included anxiety, depression, impaired family functioning, being unmarried or divorced, having a mental health history, as well as a poor perceived quality of physical health. In contrast, higher resilience, positive feelings with regard to the lockdown measures, relationship with friends, and faith in a Supreme Being emerged as protective factors for suicidal ideation.6 Investigating the risk and protective factors for suicidal ideation is especially important during this difficult period of the pandemic. There was an additional significant finding in this study: individuals who completed the questionnaire during the last two weeks of the first lockdown reported statistically significantly higher suicidal ideation, depression, and anxiety than those who completed it in the previous two weeks, while a similar finding was revealed in a study from USA.7 Therefore, we were looking forward to the results of our survey conducted during the second lockdown.8 From the 5,116 individuals who had fully completed our questionnaire with respect to suicidal ideation during the first lockdown, 811 fully completed it for the second time from November 22 to December 21, 2020. Suicidal ideation was not found significantly different compared to the first lockdown. Independent risk factors for suicidal ideation during the second lockdown were depression, anxiety, living with a person with frail health and vulnerable for COVID-19 and suicidal ideation during the first lockdown. It is noted that during the second lockdown the rates of potential depression cases remained unchanged, whereas anxiety rates increased. Greater accessibility to health services, state financial support and increased mobility might have contributed to the stability of suicidal ideation despite the greater severity of the second wave of the COVID-19 pandemic. The aforementioned studies determined the prevalence of suicidal ideation and its association with various demographic, clinical, social, familial, and psychopathological factors in a cohort context at different stages of the COVID-19 pandemic, with the relevant literature being rather poor. We consider that the provision of such data is critical for the plans of health system in pandemic conditions, while this longitudinal study is in progress during the subsequent waves of the pandemic.


Subject(s)
COVID-19 , Suicidal Ideation , Aged , Anxiety , Communicable Disease Control , Depression , Greece/epidemiology , Humans , Longitudinal Studies , Pandemics , SARS-CoV-2
16.
Acta Med Acad ; 50(2): 252-263, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1547637

ABSTRACT

OBJECTIVE: The present study aims to evaluate the symptoms of psychological distress during the COVID-19 pandemic, in Greek primary healthcare workers, correlating them with their individual characteristics. MATERIALS AND METHODS: The research is based on a self-report questionnaire distributed to primary HCWs of Thessaloniki's public health care units. A sample of 143 respondents was gathered. The questionnaire consists of 21 items: 6 demographic questions, 9 on personal distress, 5 on work-related distress and 1 on one dominant feeling of the participants. These items were based on existing validated measures, such as the "Depression Anxiety Stress Scale-21", the "Kessler Psychological Distress Scale-10", "General Health Questionnaire- 28" and "Hospital Anxiety and Depression Scale". The associations between participants' gender, education, specialty and parenthood were determined with Pearson's chi-squared (χ2) test. RESULTS: Overall, 70.4% of HCWs were generally affected by the pandemic. The personal distress factors revealed that the majority (67%) experienced distress due to routine changes. The effects on health behavior (sleep, eating behavior and substance use) were not high. Psychological/psychiatric needs were relatively low, while negative emotions and need of social support were high. 31.4% displayed intense emotional instability. All work-related distress factors were rated high. Worry about contracting COVID-19 in the workplace scored the highest (82.6%). Almost half of the participants felt exposed to COVID-19 infection (47.0%). Anxiety (47.2%) and burn-out (78.4%) symptoms were also revealed. Female participants appeared to be more anxious (P<0.01) and upset (P=0.013). CONCLUSION: The exposure to a constant risk could potentially lead to an increase in HCWs' psychological distress. Designing the right tools and organizing the right plans are of paramount importance to prevent the deterioration of their wellness and quality of life.


Subject(s)
COVID-19 , Psychological Distress , Female , Greece/epidemiology , Health Personnel , Humans , Pandemics , Quality of Life , SARS-CoV-2
17.
Pediatr Pulmonol ; 57(2): 386-394, 2022 02.
Article in English | MEDLINE | ID: covidwho-1530214

ABSTRACT

OBJECTIVES: To prospectively quantify at the community level changes in asthma symptom control and other morbidity indices, among asthmatic schoolchildren in response to coronavirus disease 2019 (COVID-19) lockdown measures. METHODS: In Spring 2019 and Spring 2020, we prospectively assessed monthly changes in pediatric asthma control test (c-ACT), asthma medication usage, infections and unscheduled visits for asthma among schoolchildren with active asthma in Cyprus and Greece. We compared asthma symptom control and other morbidity indices before and during lockdown measures, while participants' time spent at home was objectively assessed by wearable sensors. RESULTS: A total of 119 asthmatic children participated in the study during Spring 2020. Compared to a mean baseline (pre-COVID-19 lockdown) c-ACT score of 22.70, adjusted mean increases of 2.58 (95% confidence interval [CI]: 1.91, 3.26, p < 0.001) and 3.57 (95% CI: 2.88, 4.27, p < 0.001) in the 2nd and 3rd monthly assessments were observed after implementation of lockdown measures. A mean increase in c-ACT score of 0.32 (95% CI: 0.17, 0.47, p < 0.001) was noted per 10% increase in the time spent at home. Improvement was more profound in children with severe asthma, while significant reductions in infections, asthma medication usage and unscheduled visits for asthma were also observed. During Spring 2019, 39 children participated in the study in the absence of lockdown measures and no changes in c-ACT or other indices of disease severity were observed. CONCLUSIONS: Clinically meaningful improvements in asthma symptom control, among asthmatic schoolchildren were observed during the COVID-19 lockdown measures in Spring 2020. Improvements were independently associated with time spent at home and were more profound in the children with severe asthma.


Subject(s)
Asthma , COVID-19 , Asthma/drug therapy , Asthma/epidemiology , Child , Communicable Disease Control , Cyprus/epidemiology , Greece/epidemiology , Humans , Pandemics , Prospective Studies , SARS-CoV-2
18.
J Med Virol ; 94(4): 1465-1472, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1527443

ABSTRACT

We studied the third coronavirus disease 2019 (COVID-19) pandemic wave in Athens metropolitan area (3 738 901 inhabitants) through two seroepidemiological surveys. Persons presenting in 12 healthcare facilities across Athens in March and June 2021 were studied (764 and 901, respectively). Immunoglobulin G antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein were measured by a chemiluminescent microparticle immunoassay. In March the seroprevalence rate was 11.6%, meaning that 435 208 residents of Athens had evidence of immunity. The respective values in June were 55.7% and 2 082 568 residents. The highest seroprevalence rates attributed to SARS-CoV-2 infection were recorded in persons <18 years (16.3% in March and 31.6% in June), while immunity was mainly vaccine-induced in persons 18-64 years and >65 years. Infection-attributed immunity also increased in older-age groups. Wide ranges in seroprevalence rates were noted across areas in March and June. The highest seroprevalence rates were recorded in Piraeus (47.2%) and West Attica (37.5%). However, the highest increase (>5 times) occurred in Piraeus and the South Section of Athens, which are among the most densely populated areas in Athens. In both study periods, history of COVID-19 or febrile episode, and having a cohabitant with COVID-19 were associated with increased risk for seropositivity among unvaccinated persons (p values <0.001 for all). Residing in Piraeus, the South Section or West Attica was associated with increased risk for seropositivity in June (p values <0.001). Wide heterogeneity in seroprevalence rates was found across areas in Athens, which is mainly attributed to population density. The impact of population mobility and socioeconomic status should be explored.


Subject(s)
Antibodies, Viral/blood , COVID-19/blood , COVID-19/epidemiology , SARS-CoV-2/immunology , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Cross-Sectional Studies , Female , Greece/epidemiology , Humans , Infant , Male , Middle Aged , Prevalence , Seroepidemiologic Studies , Young Adult
20.
Infect Dis (Lond) ; 54(3): 186-195, 2022 03.
Article in English | MEDLINE | ID: covidwho-1505665

ABSTRACT

BACKGROUND: Understanding the factors that affect the transmissibility of SARS-CoV-2 remains important to keep transmission low and maximize the health benefits of vaccination. We assessed the factors associated with the transmissibility of SARS-CoV-2 based on contact tracing data. METHODS: From 1 October to 9 December 2020, 29,385 laboratory-confirmed SARS-CoV-2 cases (index cases, i.e. the first identified laboratory-confirmed cases or with the earliest symptom onset in a setting) and 64,608 traced contacts were identified in Greece. We assessed the prevalence of symptoms in cases, calculated secondary attack rates and assessed factors associated with infectivity and susceptibility to infection. RESULTS: There were 11,232 contacts secondarily infected (secondary attack rate: 17.4%, 95% CI:17.0-17.8). Contacts aged 0-11 and 12-17 years were less susceptible to infection than adults 65 years or older (odds ratio (OR) [95% CI]: 0.28 [0.26-0.32] and 0.44 [0.40-0.49], respectively). Index cases aged 65 years or older were more likely to infect their contacts than other adults or children/adolescents. The odds of infection [95% CI] were higher in contacts exposed within the household (1.71 [1.59-1.85] vs. other) and in cases with cough (1.17 [1.11-1.25] vs. no cough). There was an interaction between the age of the index and the age of the contact with contacts 65 years or older having a higher probability of infection when exposed to cases of similar age than to children. CONCLUSIONS: Our findings highlight the role of age and age mixing in infectivity and susceptibility to SARS-CoV-2 infection. Precautions are necessary for individuals 65 or older as they have higher infectivity and susceptibility in contact with their peers.


Subject(s)
COVID-19 , Contact Tracing , Adolescent , Adult , Aged , Child , Greece/epidemiology , Humans , Risk Factors , SARS-CoV-2
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