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Papatriantafyllou E, Efthymiou D, Felekkis K, Solmi M, Correll CU, Thompson T, Estradé A, Tsokani S, Kontouli KM, Seitidis G, Koutsiouroumpa O, Mavridis D, Christogiannis C, Vassilopoulou E. The Collaborative Outcome Study on Health and Functioning during Infection Times (COH-FIT): Results from Cyprus. J Clin Med 2024; 13:5395. [PMID: 39336883 PMCID: PMC11432565 DOI: 10.3390/jcm13185395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Revised: 08/29/2024] [Accepted: 09/07/2024] [Indexed: 09/30/2024] Open
Abstract
Many studies have shown that COVID-19 caused many problems in mental health. This paper presents the results of the Cyprus sample, part of the global initiative named "The Collaborative Outcomes Study on Health and Functioning during Infection Times" (COH-FIT). Methods: The study took place from April 2019 to January 2022, using the Greek version of the online standard COH-FIT questionnaire on 917 Cypriot adults. Weighted t-tests were applied to test the differences between pre-pandemic and intra-pandemic scores using the anesrake package. Results: Participant responses indicated a significant negative impact of the pandemic on measures of mental health (-7.55; 95% CI: -9.01 to -6.07), with worsening in the scores for anxiety (12.05; 95% CI: 9.33 to 14.77), well-being (-11.06; 95% CI: -12.69 to -9.45) and depression (4.60; 95% CI: 2.06 to 7.14). Similar negative effects were observed for feelings of anger (12.92; 95% CI: 10.54 to 15.29), helplessness (9.66; 95% CI: 7.25 to 12.07), fear (22.25; 95% CI: 19.25 to 25.26), and loneliness (12.52; 95% CI: 9.94 to15.11). Increased use of social media (0.89; 95% CI: 0.71 to 1.09), internet (0.86; 95% CI: 0.67 to 1.04), and substance consumption (0.06; 95% CI: 0.00 to 0.11) were reported, along with a significant decrease in physical health (-3.45; 95% CI: -4.59 to -2.32), self-care (-7.10; 95% CI: -9.00 to -5.20), and social function (-11.27; 95% CI: -13.19 to -9.35), including support (-0.72; 95% CI: -1.09 to -0.34) and family function (-7.97; 95% CI: -9.90 to -6.05). Conclusions: The COVID-19 pandemic significantly affected the daily life and emotional well-being of Cypriots. Identifying factors that influence vulnerability and resilience is essential to prioritize mental health support and address the long-term effects of the pandemic.
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Affiliation(s)
- Evangelia Papatriantafyllou
- Department of Nutrition and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Dimitris Efthymiou
- Nous Thrapy Center, 54621 Thessaloniki, Greece
- Department of Life Sciences, School of Life and Health Sciences, Universiy of Nicosia, Nicosia 2417, Cyprus
| | - Kyriakos Felekkis
- Department of Life Sciences, School of Life and Health Sciences, Universiy of Nicosia, Nicosia 2417, Cyprus
| | - Marco Solmi
- Department of Psychiatry, Faculty of Medicine, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Department of Mental Health, The Ottawa Hospital, Ottawa, ON K1H 8L6, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), Ottawa, ON K1Z 7K4, Canada
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Christoph U Correll
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, 10117 Berlin, Germany
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY 11030, USA
- Department of Psychiatry, Northwell Health, Zucker Hillside Hospital, Glen Oaks, NY 11004, USA
- Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 11549, USA
- German Center for Mental Health (DZPG), Partner Site Berlin, 10117 Berlin, Germany
| | - Trevor Thompson
- Centre for Chronic Illness and Ageing, University of Greenwich, London SE10 9LS, UK
| | - Andrés Estradé
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AB, UK
| | - Sofia Tsokani
- Department of Primary Education, School of Education, University of Ioannina, 45110 Ioannina, Greece
| | - Katerina-Maria Kontouli
- Department of Primary Education, School of Education, University of Ioannina, 45110 Ioannina, Greece
| | - Georgios Seitidis
- Department of Psychology, School of Social Sciences, University of Ioannina, 45110 Ioannina, Greece
| | - Ourania Koutsiouroumpa
- Department of Primary Education, School of Education, University of Ioannina, 45110 Ioannina, Greece
| | - Dimitris Mavridis
- Department of Primary Education, School of Education, University of Ioannina, 45110 Ioannina, Greece
| | - Christos Christogiannis
- Department of Primary Education, School of Education, University of Ioannina, 45110 Ioannina, Greece
| | - Emilia Vassilopoulou
- Department of Nutrition and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
- Nous Thrapy Center, 54621 Thessaloniki, Greece
- Department of Life Sciences, School of Life and Health Sciences, Universiy of Nicosia, Nicosia 2417, Cyprus
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2
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Lin J, Aprahamian H, Golovko G. A proactive/reactive mass screening approach with uncertain symptomatic cases. PLoS Comput Biol 2024; 20:e1012308. [PMID: 39141678 PMCID: PMC11346970 DOI: 10.1371/journal.pcbi.1012308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 08/26/2024] [Accepted: 07/09/2024] [Indexed: 08/16/2024] Open
Abstract
We study the problem of mass screening of heterogeneous populations under limited testing budget. Mass screening is an essential tool that arises in various settings, e.g., the COVID-19 pandemic. The objective of mass screening is to classify the entire population as positive or negative for a disease as efficiently and accurately as possible. Under limited budget, testing facilities need to allocate a portion of the budget to target sub-populations (i.e., proactive screening) while reserving the remaining budget to screen for symptomatic cases (i.e., reactive screening). This paper addresses this decision problem by taking advantage of accessible population-level risk information to identify the optimal set of sub-populations for proactive/reactive screening. The framework also incorporates two widely used testing schemes: Individual and Dorfman group testing. By leveraging the special structure of the resulting bilinear optimization problem, we identify key structural properties, which in turn enable us to develop efficient solution schemes. Furthermore, we extend the model to accommodate customized testing schemes across different sub-populations and introduce a highly efficient heuristic solution algorithm for the generalized model. We conduct a comprehensive case study on COVID-19 in the US, utilizing geographically-based data. Numerical results demonstrate a significant improvement of up to 52% in total misclassifications compared to conventional screening strategies. In addition, our case study offers valuable managerial insights regarding the allocation of proactive/reactive measures and budget across diverse geographic regions.
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Affiliation(s)
- Jiayi Lin
- Department of Industrial and Systems Engineering, Texas A&M University College Station, Texas, United States of America
| | - Hrayer Aprahamian
- Department of Industrial and Systems Engineering, Texas A&M University College Station, Texas, United States of America
| | - George Golovko
- Department of Pharmacology and Toxicology, The University of Texas Medical Branch Galveston, Texas, United States of America
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3
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Lin J, Aprahamian H, Golovko G. An optimization framework for large-scale screening under limited testing capacity with application to COVID-19. Health Care Manag Sci 2024; 27:223-238. [PMID: 38656689 DOI: 10.1007/s10729-024-09671-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 02/27/2024] [Indexed: 04/26/2024]
Abstract
We consider the problem of targeted mass screening of heterogeneous populations under limited testing capacity. Mass screening is an essential tool that arises in various settings, e.g., ensuring a safe supply of blood, reducing prevalence of sexually transmitted diseases, and mitigating the spread of infectious disease outbreaks. The goal of mass screening is to classify whole population groups as positive or negative for an infectious disease as efficiently and accurately as possible. Under limited testing capacity, it is not possible to screen the entire population and hence administrators must reserve testing and target those among the population that are most in need or most susceptible. This paper addresses this decision problem by taking advantage of accessible population-level risk information to identify the optimal set of sub-populations to target for screening. We conduct a comprehensive analysis that considers the two most commonly adopted schemes: Individual testing and Dorfman group testing. For both schemes, we formulate an optimization model that aims to minimize the number of misclassifications under a testing capacity constraint. By analyzing the formulations, we establish key structural properties which we use to construct efficient and accurate solution techniques. We conduct a case study on COVID-19 in the United States using geographic-based data. Our results reveal that the considered proactive targeted schemes outperform commonly adopted practices by substantially reducing misclassifications. Our case study provides important managerial insights with regards to optimal allocation of tests, testing designs, and protocols that dictate the optimality of schemes. Such insights can inform policy-makers with tailored and implementable data-driven recommendations.
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Affiliation(s)
- Jiayi Lin
- Department of Industrial and Systems Engineering, Texas A &M University, College Station, 77843, TX, USA.
| | - Hrayer Aprahamian
- Department of Industrial and Systems Engineering, Texas A &M University, College Station, 77843, TX, USA
| | - George Golovko
- Department of Pharmacology and Toxicology, The University of Texas Medical Branch, Galveston, 77555, TX, USA
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4
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Rossis C, Michail KA, Middleton N, Karanikola M, Papathanassoglou E, Mpouzika M. Knowledge on Stroke Recognition and Management among Emergency Department Healthcare Professionals in the Republic of Cyprus. Healthcare (Basel) 2023; 12:77. [PMID: 38200983 PMCID: PMC10778653 DOI: 10.3390/healthcare12010077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/20/2023] [Accepted: 12/25/2023] [Indexed: 01/12/2024] Open
Abstract
Stroke is a global leading cause of death and disability. Knowledge of related guidelines is crucial for emergency department (ED) staff, influencing early diagnosis and timely treatment. We investigated Greek Cypriot ED healthcare professionals' (nurses and physicians) knowledge in recognizing and managing stroke. A descriptive cross-sectional study spanned November 2019 to April 2020, encompassing four private and seven public EDs in the Republic of Cyprus. The data were collected through a self-reported questionnaire developed by the research team, consisting of 37 questions. Eight questions focused on sociodemographic and employment characteristics, twenty-eight assessed knowledge in stroke recognition and management (each item was equally weighted without deliberate prioritization), and one question addressed self-assessment of knowledge in stroke care. A total of 255 nurses (response rate (RR): 74.1%) and 26 physicians (RR: 47.3%) completed the questionnaire. The average correct response rate was 12.9 out of 28 statements (SD: 4.2), with nurses and physicians scoring 12.6 (SD: 4.1) and 15.7 (SD: 4), respectively. Work experience significantly influenced stroke knowledge, with all groups demonstrating superiority over those with less than one year of experience. Participants with previous training scored an average of 1.45 additional correct answers while educational attainment did not significantly influence stroke knowledge. Investigating stroke knowledge among emergency department nurses and physicians in the Republic of Cyprus revealed significant deficits. This study stresses targeted interventions, including education, yearly examinations, workshops with hands-on training, and repeated training, to address these gaps and enhance the overall stroke care capabilities of the healthcare professionals.
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Affiliation(s)
| | - Koralia A. Michail
- Department of Nursing, Cyprus University of Technology, 3041 Limassol, Cyprus; (K.A.M.); (N.M.); (M.K.)
| | - Nicos Middleton
- Department of Nursing, Cyprus University of Technology, 3041 Limassol, Cyprus; (K.A.M.); (N.M.); (M.K.)
| | - Maria Karanikola
- Department of Nursing, Cyprus University of Technology, 3041 Limassol, Cyprus; (K.A.M.); (N.M.); (M.K.)
| | | | - Meropi Mpouzika
- Department of Nursing, Cyprus University of Technology, 3041 Limassol, Cyprus; (K.A.M.); (N.M.); (M.K.)
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5
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Kyprianidou M, Konstantinou P, Alvarez-Galvez J, Ceccarelli L, Gruszczyńska E, Mierzejewska-Floreani D, Loumba N, Montagni I, Tavoschi L, Karekla M, Kassianos AP. Profiling Hesitancy to COVID-19 Vaccinations in Six European Countries: Behavioral, Attitudinal and Demographic Determinants. Behav Med 2023; 49:362-373. [PMID: 35546258 DOI: 10.1080/08964289.2022.2071198] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 04/06/2022] [Accepted: 04/22/2022] [Indexed: 11/02/2022]
Abstract
Vaccination hesitancy is an important barrier for the effective control of the COVID-19 pandemic. Identifying determinants of COVID-19 vaccination hesitancy is essential in order to reduce mortality rates. Further, given the variability of the factors and the different recommendations used in each country, it is important to conduct cross-country research to profile individuals who are hesitant toward COVID-19 vaccinations. This cross-sectional study aimed to examine cross-country differences and the behavioral, attitudinal and demographic characteristics of vaccine hesitant individuals. Adults living in six European countries (Cyprus, France, Germany, Italy, Poland, and Spain) were eligible to participate. A total of 832 individuals completed the online survey, with 17.9% reporting being hesitant to COVID-19 vaccination. Vaccine accepters were significantly older (M = 38.9, SD = 14.3), more educated (master/postgraduate studies) and lived in a place with a higher number of residents (>500,000 people) compared to those hesitant to COVID-19 vaccination. Discriminant analysis confirmed that the hesitant profile includes a person of younger age, living alone in smaller communities, and without children. Additionally, hesitant participants reported COVID-19-specific characteristics such as lower institutional trust, less adherence to COVID-19 protective behaviors and higher pandemic fatigue. When tackling COVID-19 vaccination hesitancy both socio-demographic and behavioral/attitudinal aspects should be taken into account. Stakeholders are advised to implement targeted vaccination programs while at the same time building trust with population illness cognitions addressed in order to reduce hesitancy rates. Further, stakeholders and public health authorities in each country are suggested to target interventions according to different population characteristics as behavioral and attitudinal determinants of COVID-19 vaccination hesitancy differed between countries.
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Affiliation(s)
| | | | - Javier Alvarez-Galvez
- Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, Cadiz, Spain
| | - Luca Ceccarelli
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Ewa Gruszczyńska
- SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | | | | | - Ilaria Montagni
- Bordeaux Population Health Research Center UMRS1219, University of Bordeaux - Inserm, Bordeaux, France
| | - Lara Tavoschi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Maria Karekla
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
| | - Angelos P Kassianos
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
- Department of Applied Health Research, UCL, London, UK
- Department of Nursing, Cyprus University of Technology, Limassol, Cyprus
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6
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Psichoudaki M, Mina T, Savvidou M, Mina C, Michael C, Fatta-Kassinos D. Wastewater-based monitoring of illicit drugs in Cyprus by UPLC-MS/MS: The impact of the COVID-19 pandemic. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 854:158747. [PMID: 36108831 PMCID: PMC9467927 DOI: 10.1016/j.scitotenv.2022.158747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/09/2022] [Accepted: 09/09/2022] [Indexed: 05/14/2023]
Abstract
The outbreak and spread of COVID-19 impacted through various ways the lives of millions of humans globally. In this work, wastewater-based epidemiology (WBE) was applied to investigate the effect of the actions taken by the Republic of Cyprus to confine COVID-19 on the use of illicit stimulant drugs. Daily influent samples were collected from the six main wastewater treatment plants (WWTPs) of the country i) before lockdown (3-9 April 2019), ii) during lockdown (21-27 April 2020), iii) during the post-lockdown period (14-20 July 2020), and, iv) during each season of the following year (20-26 April 2021, 19-25 July 2021, 11-17 October 2021, 25 December 2021-2 January 2022), and analyzed for amphetamine, methamphetamine, MDMA and cocaine. In most areas, amphetamine and methamphetamine use was not affected during the confinement period, but as availability of the substances decreased with time, a drop in their use was observed when most restriction measures were eased (up to 9- and 22-fold decrease, respectively). The limitations on social interactions and events during the quarantine period seem to have led to the reduction of MDMA and cocaine and driven a sharp decrease of their use in most areas studied (up to 11 and 6 times lower, respectively). However, the re-opening of activities led to a pronounced consumption increase, reaching maximum daily values of 800 and 2691 mg/1000 inhabitants/day, respectively. In 2021, drug use was re-established to lower levels. The examination of weekly patterns during this year revealed higher weekend use of methamphetamine, MDMA and cocaine. Our results suggest that both the implementation and the easing of COVID-19 related measures affected the availability and the use of drugs. This study also provides the first insight on the consumption of illicit drugs in the Republic of Cyprus during pre-, post- and pandemic times and demonstrates the importance of WBE.
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Affiliation(s)
- M Psichoudaki
- Nireas-International Water Research Centre, University of Cyprus, P.O. Box 20537, 1678 Nicosia, Cyprus
| | - T Mina
- Nireas-International Water Research Centre, University of Cyprus, P.O. Box 20537, 1678 Nicosia, Cyprus; Department of Civil and Environmental Engineering, School of Engineering, University of Cyprus, P.O. Box 20537, 1678, Nicosia, Cyprus
| | - M Savvidou
- Cyprus National Addictions Authority, 2027 Nicosia, Cyprus
| | - C Mina
- Cyprus National Addictions Authority, 2027 Nicosia, Cyprus
| | - C Michael
- Nireas-International Water Research Centre, University of Cyprus, P.O. Box 20537, 1678 Nicosia, Cyprus
| | - D Fatta-Kassinos
- Nireas-International Water Research Centre, University of Cyprus, P.O. Box 20537, 1678 Nicosia, Cyprus; Department of Civil and Environmental Engineering, School of Engineering, University of Cyprus, P.O. Box 20537, 1678, Nicosia, Cyprus.
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7
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Andrianou XD, Konstantinou C, Rodríguez-Flores MA, Papadopoulos F, Makris KC. Population-wide measures due to the COVID-19 pandemic and exposome changes in the general population of Cyprus in March-May 2020. BMC Public Health 2022; 22:2279. [PMID: 36471295 PMCID: PMC9724426 DOI: 10.1186/s12889-022-14468-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 10/27/2022] [Indexed: 12/12/2022] Open
Abstract
Non-pharmacological interventions (e.g., stay-at-home orders, school closures, physical distancing) implemented during the COVID-19 pandemic are expected to have modified routines and lifestyles, eventually impacting key exposome parameters, including, among others, physical activity, diet and cleaning habits. The objectives were to describe the exposomic profile of the general Cypriot population and compliance to the population-wide measures implemented during March-May 2020 to lower the risk of SARS-CoV-2 transmission, and to simulate the population-wide measures' effect on social contacts and SARS-CoV-2 spread. A survey was conducted in March-May 2020 capturing different exposome parameters, e.g., individual characteristics, lifestyle/habits, time spent and contacts at home/work/elsewhere. We described the exposome parameters and their correlations. In an exposome-wide association analysis, we used the number of hours spent at home as an indicator of compliance to the measures. We generated synthetic human proximity networks, before and during the measures using the dynamic-[Formula: see text]1 model and simulated SARS-CoV-2 transmission (i.e., to identify possible places where higher transmission/number of cases could originate from) on the networks with a dynamic Susceptible-Exposed-Infectious-Recovered model. Overall, 594 respondents were included in the analysis (mean age 45.7 years, > 50% in very good health and communicating daily with friends/family via phone/online). The median number of contacts at home and at work decreased during the measures (from 3 to 2 and from 12 to 0, respectively) and the hours spent at home increased, indicating compliance with the measures. Increased time spent at home during the measures was associated with time spent at work before the measures (β= -0.87, 95% CI [-1.21,-0.53]) as well as with being retired vs employed (β= 2.32, 95% CI [1.70, 2.93]). The temporal network analysis indicated that most cases originated at work, while the synthetic human proximity networks adequately reproduced the observed SARS-CoV-2 spread. Exposome approaches (i.e., holistic characterization of the spatiotemporal variation of multiple exposures) would aid the comprehensive description of population-wide measures' impact and explore how behaviors and networks may shape SARS-CoV-2 transmission.
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Affiliation(s)
- Xanthi D. Andrianou
- grid.15810.3d0000 0000 9995 3899Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Corina Konstantinou
- grid.15810.3d0000 0000 9995 3899Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Marco A. Rodríguez-Flores
- grid.15810.3d0000 0000 9995 3899Department of Electrical and Computer Engineering, Cyprus University of Technology, Limassol, Cyprus
| | - Fragkiskos Papadopoulos
- grid.15810.3d0000 0000 9995 3899Department of Electrical and Computer Engineering, Cyprus University of Technology, Limassol, Cyprus
| | - Konstantinos C. Makris
- grid.15810.3d0000 0000 9995 3899Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
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Berrig C, Andreasen V, Frost Nielsen B. Heterogeneity in testing for infectious diseases. ROYAL SOCIETY OPEN SCIENCE 2022; 9:220129. [PMID: 35600424 PMCID: PMC9114977 DOI: 10.1098/rsos.220129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/28/2022] [Indexed: 05/03/2023]
Abstract
Testing strategies have varied widely between nation states during the COVID-19 pandemic, in intensity as well as methodology. Some countries have mainly performed diagnostic testing while others have opted for mass-screening for the presence of SARS-CoV-2 as well. COVID passport solutions have been introduced, in which access to several aspects of public life requires either testing, proof of vaccination or a combination thereof. This creates a coupling between personal activity levels and testing behaviour which, as we show in a mathematical model, leverages heterogeneous behaviours in a population and turns this heterogeneity from a disadvantage to an advantage for epidemic control.
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Affiliation(s)
- Christian Berrig
- Department of Science and Environment, Roskilde University, Universitetsvej 1, 4000 Roskilde, Denmark
| | - Viggo Andreasen
- Department of Science and Environment, Roskilde University, Universitetsvej 1, 4000 Roskilde, Denmark
| | - Bjarke Frost Nielsen
- Department of Science and Environment, Roskilde University, Universitetsvej 1, 4000 Roskilde, Denmark
- Niels Bohr Institute, University of Copenhagen, Blegdamsvej 17, 2100 Copenhagen, Denmark
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Krashias G, Deeba E, Constantinou A, Hadjiagapiou M, Koptides D, Richter J, Tryfonos C, Bashiardes S, Lambrianides A, Loizidou MA, Hadjisavvas A, Panayiotidis MI, Christodoulou C. Characterization of IgG Antibody Response against SARS-CoV-2 (COVID-19) in the Cypriot Population. Microorganisms 2021; 10:85. [PMID: 35056533 PMCID: PMC8777616 DOI: 10.3390/microorganisms10010085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 12/16/2021] [Accepted: 12/30/2021] [Indexed: 12/13/2022] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has hit its second year and continues to damage lives and livelihoods across the globe. There continues to be a global effort to present serological data on SARS-CoV-2 antibodies in different individuals. As such, this study aimed to characterize the seroprevalence of SARS-CoV-2 antibodies in the Cypriot population for the first time since the pandemic started. Our results show that a majority of people infected with SARS-CoV-2 developed IgG antibodies against the virus, whether anti-NP, anti-S1RBD, or both, at least 20 days after their infection. Additionally, the percentage of people with at least one antibody against SARS-CoV-2 in the group of volunteers deemed SARS-CoV-2 negative via RT-PCR or who remain untested/undetermined (14.43%) is comparable to other reported percentages worldwide, ranging anywhere from 0.2% to 24%. We postulate that these percentages reflect the underreporting of true infections in the population, and also show the steady increase of herd immunity. Additionally, we showed a significantly marked decrease in anti-NP IgG antibodies in contrast to relatively stable levels of anti-S1RBD IgG antibodies in previously infected individuals across time.
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Affiliation(s)
- George Krashias
- Cyprus School of Molecular Medicine, Nicosia 2371, Cyprus; (M.H.); (A.L.); (M.A.L.); (A.H.); (M.I.P.); (C.C.)
- Department of Molecular Virology, The Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus; (E.D.); (A.C.); (D.K.); (J.R.); (C.T.); (S.B.)
| | - Elie Deeba
- Department of Molecular Virology, The Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus; (E.D.); (A.C.); (D.K.); (J.R.); (C.T.); (S.B.)
| | - Astero Constantinou
- Department of Molecular Virology, The Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus; (E.D.); (A.C.); (D.K.); (J.R.); (C.T.); (S.B.)
| | - Maria Hadjiagapiou
- Cyprus School of Molecular Medicine, Nicosia 2371, Cyprus; (M.H.); (A.L.); (M.A.L.); (A.H.); (M.I.P.); (C.C.)
- Department of Neuroimmunology, The Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus
| | - Dana Koptides
- Department of Molecular Virology, The Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus; (E.D.); (A.C.); (D.K.); (J.R.); (C.T.); (S.B.)
| | - Jan Richter
- Department of Molecular Virology, The Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus; (E.D.); (A.C.); (D.K.); (J.R.); (C.T.); (S.B.)
| | - Christina Tryfonos
- Department of Molecular Virology, The Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus; (E.D.); (A.C.); (D.K.); (J.R.); (C.T.); (S.B.)
| | - Stavros Bashiardes
- Department of Molecular Virology, The Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus; (E.D.); (A.C.); (D.K.); (J.R.); (C.T.); (S.B.)
| | - Anastasia Lambrianides
- Cyprus School of Molecular Medicine, Nicosia 2371, Cyprus; (M.H.); (A.L.); (M.A.L.); (A.H.); (M.I.P.); (C.C.)
- Department of Neuroimmunology, The Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus
| | - Maria A. Loizidou
- Cyprus School of Molecular Medicine, Nicosia 2371, Cyprus; (M.H.); (A.L.); (M.A.L.); (A.H.); (M.I.P.); (C.C.)
- Department of Cancer Genetics, Therapeutics and Ultrastructural Pathology, The Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus
| | - Andreas Hadjisavvas
- Cyprus School of Molecular Medicine, Nicosia 2371, Cyprus; (M.H.); (A.L.); (M.A.L.); (A.H.); (M.I.P.); (C.C.)
- Department of Cancer Genetics, Therapeutics and Ultrastructural Pathology, The Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus
| | - Mihalis I. Panayiotidis
- Cyprus School of Molecular Medicine, Nicosia 2371, Cyprus; (M.H.); (A.L.); (M.A.L.); (A.H.); (M.I.P.); (C.C.)
- Department of Cancer Genetics, Therapeutics and Ultrastructural Pathology, The Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus
| | - Christina Christodoulou
- Cyprus School of Molecular Medicine, Nicosia 2371, Cyprus; (M.H.); (A.L.); (M.A.L.); (A.H.); (M.I.P.); (C.C.)
- Department of Molecular Virology, The Cyprus Institute of Neurology and Genetics, Nicosia 2371, Cyprus; (E.D.); (A.C.); (D.K.); (J.R.); (C.T.); (S.B.)
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10
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Mamais I, Malatras A, Papagregoriou G, Giallourou N, Kakouri AC, Karayiannis P, Koliou M, Christaki E, Nikolopoulos GK, Deltas C. Circulating IgG Levels in SARS-CoV-2 Convalescent Individuals in Cyprus. J Clin Med 2021; 10:jcm10245882. [PMID: 34945178 PMCID: PMC8708243 DOI: 10.3390/jcm10245882] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/08/2021] [Accepted: 12/10/2021] [Indexed: 12/14/2022] Open
Abstract
Long-term persistence and the heterogeneity of humoral response to SARS-CoV-2 have not yet been thoroughly investigated. The aim of this work is to study the production of circulating immunoglobulin class G (IgG) antibodies against SARS-CoV-2 in individuals with past infection in Cyprus. Individuals of the general population, with or without previous SARS-CoV-2 infection, were invited to visit the Biobank at the Center of Excellence in Biobanking and Biomedical Research of the University of Cyprus. Serum IgG antibodies were measured using the SARS-CoV-2 IgG and the SARS-CoV-2 IgG II Quant assays of Abbott Laboratories. Antibody responses to SARS-CoV-2 were also evaluated against participants’ demographic and clinical data. All statistical analyses were conducted in Stata 16. The median levels of receptor binding domain (RBD)-specific IgG in 969 unvaccinated individuals, who were reportedly infected between November 2020 and September 2021, were 432.1 arbitrary units (AI)/mL (interquartile range—IQR: 182.4–1147.3). Higher antibody levels were observed in older participants, males, and those who reportedly developed symptoms or were hospitalized. The RBD-specific IgG levels peaked at three months post symptom onset and subsequently decreased up to month six, with a slower decay thereafter. IgG response to the RBD of SARS-CoV-2 is bi-phasic with considerable titer variability. Levels of IgG are significantly associated with several parameters, including age, gender, and severity of symptoms.
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Affiliation(s)
- Ioannis Mamais
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia 2404, Cyprus;
| | - Apostolos Malatras
- Biobank.cy Center of Excellence in Biobanking and Biomedical Research, University of Cyprus, Nicosia 1678, Cyprus; (A.M.); (G.P.); (N.G.); (A.C.K.)
| | - Gregory Papagregoriou
- Biobank.cy Center of Excellence in Biobanking and Biomedical Research, University of Cyprus, Nicosia 1678, Cyprus; (A.M.); (G.P.); (N.G.); (A.C.K.)
| | - Natasa Giallourou
- Biobank.cy Center of Excellence in Biobanking and Biomedical Research, University of Cyprus, Nicosia 1678, Cyprus; (A.M.); (G.P.); (N.G.); (A.C.K.)
| | - Andrea C. Kakouri
- Biobank.cy Center of Excellence in Biobanking and Biomedical Research, University of Cyprus, Nicosia 1678, Cyprus; (A.M.); (G.P.); (N.G.); (A.C.K.)
| | - Peter Karayiannis
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia 1700, Cyprus;
| | - Maria Koliou
- Medical School, University of Cyprus, Nicosia 1678, Cyprus; (M.K.); (E.C.)
| | - Eirini Christaki
- Medical School, University of Cyprus, Nicosia 1678, Cyprus; (M.K.); (E.C.)
| | - Georgios K. Nikolopoulos
- Biobank.cy Center of Excellence in Biobanking and Biomedical Research, University of Cyprus, Nicosia 1678, Cyprus; (A.M.); (G.P.); (N.G.); (A.C.K.)
- Medical School, University of Cyprus, Nicosia 1678, Cyprus; (M.K.); (E.C.)
- Correspondence: (G.K.N.); (C.D.); Tel.: +357-2289-5223 (G.K.N.); +357-2289-2882 (C.D.)
| | - Constantinos Deltas
- Biobank.cy Center of Excellence in Biobanking and Biomedical Research, University of Cyprus, Nicosia 1678, Cyprus; (A.M.); (G.P.); (N.G.); (A.C.K.)
- Medical School, University of Cyprus, Nicosia 1678, Cyprus; (M.K.); (E.C.)
- Correspondence: (G.K.N.); (C.D.); Tel.: +357-2289-5223 (G.K.N.); +357-2289-2882 (C.D.)
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11
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Gountas I, Quattrocchi A, Mamais I, Tsioutis C, Christaki E, Fokianos K, Nikolopoulos G. Effect of public health interventions during the first epidemic wave of COVID-19 in Cyprus: a modelling study. BMC Public Health 2021; 21:1898. [PMID: 34666740 PMCID: PMC8526096 DOI: 10.1186/s12889-021-11945-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 10/08/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Cyprus addressed the first wave of SARS CoV-2 (COVID-19) by implementing non-pharmaceutical interventions (NPIs). The aims of this study were: a) to estimate epidemiological parameters of this wave including infection attack ratio, infection fatality ratio, and case ascertainment ratio, b) to assess the impact of public health interventions and examine what would have happened if those interventions had not been implemented. METHODS A dynamic, stochastic, individual-based Susceptible-Exposed-Infected-Recovered (SEIR) model was developed to simulate COVID-19 transmission and progression in the population of the Republic of Cyprus. The model was fitted to the observed trends in COVID-19 deaths and intensive care unit (ICU) bed use. RESULTS By May 8th, 2020, the infection attack ratio was 0.31% (95% Credible Interval [CrI]: 0.15, 0.54%), the infection fatality ratio was 0.71% (95% CrI: 0.44, 1.61%), and the case ascertainment ratio was 33.2% (95% CrI: 19.7, 68.7%). If Cyprus had not implemented any public health measure, the healthcare system would have been overwhelmed by April 14th. The interventions averted 715 (95% CrI: 339, 1235) deaths. If Cyprus had only increased ICU beds, without any social distancing measure, the healthcare system would have been overwhelmed by April 19th. CONCLUSIONS The decision of the Cypriot authorities to launch early NPIs limited the burden of the first wave of COVID-19. The findings of these analyses could help address the next waves of COVID-19 in Cyprus and other similar settings.
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Affiliation(s)
- Ilias Gountas
- Medical School, University of Cyprus, Palaios dromos Lefkosias Lemesou No.215/6, P.O.Box 20537, Nicosia, Cyprus.
| | - Annalisa Quattrocchi
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - Ioannis Mamais
- School of Sciences, European University, Nicosia, Cyprus
| | | | - Eirini Christaki
- Medical School, University of Cyprus, Palaios dromos Lefkosias Lemesou No.215/6, P.O.Box 20537, Nicosia, Cyprus
| | | | - Georgios Nikolopoulos
- Medical School, University of Cyprus, Palaios dromos Lefkosias Lemesou No.215/6, P.O.Box 20537, Nicosia, Cyprus
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12
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Kapetanos K, Mazeri S, Constantinou D, Vavlitou A, Karaiskakis M, Kourouzidou D, Nikolaides C, Savvidou N, Katsouris S, Koliou M. Exploring the factors associated with the mental health of frontline healthcare workers during the COVID-19 pandemic in Cyprus. PLoS One 2021; 16:e0258475. [PMID: 34648565 PMCID: PMC8516220 DOI: 10.1371/journal.pone.0258475] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 09/28/2021] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION The spread of COVID-19 into a global pandemic has negatively affected the mental health of frontline healthcare-workers. This study is a multi-centre, cross-sectional epidemiological study that uses nationwide data to assess the prevalence of stress, anxiety, depression and burnout among health care workers managing COVID-19 patients in Cyprus. The study also investigates the mechanism behind the manifestation of these pathologies, as to allow for the design of more effective protective measures. METHODS Data on the mental health status of the healthcare workers were collected from healthcare professionals from all over the nation, who worked directly with Covid patients. This was done via the use of 64-item, self-administered questionnaire, which was comprised of the DASS21 questionnaire, the Maslach Burnout Inventory and a number of original questions. Multivariable logistic regression models were used to investigate factors associated with each of the mental health measures. RESULTS The sample population was comprised of 381 healthcare professionals, out of which 72.7% were nursing staff, 12.9% were medical doctors and 14.4% belonged to other occupations. The prevalence of anxiety, stress and depression among the sample population were 28.6%, 18.11% and 15% respectively. The prevalence of burnout was 12.3%. This was in parallel with several changes in the lives of the healthcare professionals, including; working longer hours, spending time in isolation and being separated from family. DISCUSSION This study indicates that the mental health of a significant portion of the nation's workforce is compromised and, therefore, highlights the need for an urgent intervention particularly since many countries, including Cyprus, are suffering a second wave of the pandemic. The identified risk factors should offer guidance for employers aiming to protect their frontline healthcare workers from the negative effects of the COVID-19 pandemic.
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Affiliation(s)
| | - Stella Mazeri
- The Roslin Institute and The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh, United Kingdom
| | - Despo Constantinou
- Infection Control Services, Nicosia General Hospital, Lemesou, Cyprus
- Cyprus Nurses and Midwives Association, Nicosia, Cyprus
| | - Anna Vavlitou
- Intensive Care Unit, Nicosia General Hospital, Nicosia, Cyprus
| | | | | | - Christoforos Nikolaides
- Cyprus Nurses and Midwives Association, Nicosia, Cyprus
- Infection Control Services, Limassol General Hospital, Nikaias, Kato Polemidia, Cyprus
| | - Niki Savvidou
- Infection Control Services, Paphos General Hospital, Paphos, Cyprus
| | - Savvas Katsouris
- Infection Control Services, Larnaca General Hospital, Larnaca, Cyprus
| | - Maria Koliou
- Department of Pediatrics, School of Medicine, University of Cyprus, Nicosia, Cyprus
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13
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Richter J, Fanis P, Tryfonos C, Koptides D, Krashias G, Bashiardes S, Hadjisavvas A, Loizidou M, Oulas A, Alexandrou D, Kalakouta O, Panayiotidis MI, Spyrou GM, Christodoulou C. Molecular epidemiology of SARS-CoV-2 in Cyprus. PLoS One 2021; 16:e0248792. [PMID: 34288921 PMCID: PMC8294526 DOI: 10.1371/journal.pone.0248792] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/22/2021] [Indexed: 12/14/2022] Open
Abstract
Whole genome sequencing of viral specimens following molecular diagnosis is a powerful analytical tool of molecular epidemiology that can critically assist in resolving chains of transmission, identifying of new variants or assessing pathogen evolution and allows a real-time view into the dynamics of a pandemic. In Cyprus, the first two cases of COVID-19 were identified on March 9, 2020 and since then 33,567 confirmed cases and 230 deaths were documented. In this study, viral whole genome sequencing was performed on 133 SARS-CoV-2 positive samples collected between March 2020 and January 2021. Phylogenetic analysis was conducted to evaluate the genomic diversity of circulating SARS-CoV-2 lineages in Cyprus. 15 different lineages were identified that clustered into three groups associated with the spring, summer and autumn/winter wave of SARS-CoV-2 incidence in Cyprus, respectively. The majority of the Cypriot samples belonged to the B.1.258 lineage first detected in September that spread rapidly and largely dominated the autumn/winter wave with a peak prevalence of 86% during the months of November and December. The B.1.1.7 UK variant (VOC-202012/01) was identified for the first time at the end of December and spread rapidly reaching 37% prevalence within one month. Overall, we describe the changing pattern of circulating SARS-CoV-2 lineages in Cyprus since the beginning of the pandemic until the end of January 2021. These findings highlight the role of importation of new variants through travel towards the emergence of successive waves of incidence in Cyprus and demonstrate the importance of genomic surveillance in determining viral genetic diversity and the timely identification of new variants for guiding public health intervention measures.
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Affiliation(s)
- Jan Richter
- Molecular Virology Department, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- The Cyprus School of Molecular Medicine, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Pavlos Fanis
- The Cyprus School of Molecular Medicine, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- Molecular Genetics, Function & Therapy Department, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Christina Tryfonos
- Molecular Virology Department, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- The Cyprus School of Molecular Medicine, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Dana Koptides
- Molecular Virology Department, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- The Cyprus School of Molecular Medicine, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - George Krashias
- Molecular Virology Department, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- The Cyprus School of Molecular Medicine, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Stavros Bashiardes
- Molecular Virology Department, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- The Cyprus School of Molecular Medicine, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Andreas Hadjisavvas
- The Cyprus School of Molecular Medicine, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- Cancer Genetics, Therapeutics & Ultrastructural Pathology Department, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Maria Loizidou
- The Cyprus School of Molecular Medicine, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- Cancer Genetics, Therapeutics & Ultrastructural Pathology Department, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Anastasis Oulas
- The Cyprus School of Molecular Medicine, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- Bioinformatics Department, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Denise Alexandrou
- Medical and Public Health Services, Ministry of Health, Nicosia, Cyprus
| | - Olga Kalakouta
- Medical and Public Health Services, Ministry of Health, Nicosia, Cyprus
| | - Mihalis I. Panayiotidis
- The Cyprus School of Molecular Medicine, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- Cancer Genetics, Therapeutics & Ultrastructural Pathology Department, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - George M. Spyrou
- The Cyprus School of Molecular Medicine, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- Bioinformatics Department, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Christina Christodoulou
- Molecular Virology Department, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
- The Cyprus School of Molecular Medicine, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
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14
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Fteropoulli T, Kalavana TV, Yiallourou A, Karaiskakis M, Koliou Mazeri M, Vryonides S, Hadjioannou A, Nikolopoulos GK. Beyond the physical risk: Psychosocial impact and coping in healthcare professionals during the COVID-19 pandemic. J Clin Nurs 2021:10.1111/jocn.15938. [PMID: 34231263 PMCID: PMC8447326 DOI: 10.1111/jocn.15938] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 05/12/2021] [Accepted: 06/22/2021] [Indexed: 12/29/2022]
Abstract
AIMS AND OBJECTIVES This study aimed to examine the psychosocial impact and identify risk factors for poor psychosocial outcomes in healthcare professionals during the Coronavirus disease 2019 (COVID-19) pandemic in Cyprus. BACKGROUND Healthcare professionals are in the forefront of the COVID-19 pandemic facing an unprecedented global health crisis, which can have consequences on their psychosocial health. There is a need to identify risk factors for poor psychosocial outcomes to inform the design of tailored psychological interventions. DESIGN Cross-sectional online study. METHODS A total of 1071 healthcare professionals completed self-report questionnaires. Measures included sociodemographic information, COVID-19-related characteristics, quality of life (Brief World Health Organization Quality of Life; WHOQOL-Bref), anxiety (Generalized Anxiety Disorder-7; GAD-7), depression (Patient Health Questionnaire-8; PHQ-8), occupational burnout (Copenhagen Burnout Inventory; CBI), and coping (Brief Coping Orientation to Problems Experienced; Brief COPE). This article follows the STROBE reporting guidelines. RESULTS The prevalence of moderate to severe anxiety and clinically significant depression was 27.6% and 26.8%, respectively. Significant risk factors for poor psychological outcomes included being female, being a nurse or doctor (vs non-medical professional), working in frontline units (inpatient, intensive care), perceptions of inadequate workplace preparation to deal with the pandemic, and using avoidance coping. Depression and occupational burnout were significant risk factors for poor quality of life. CONCLUSION The findings suggest several individual, psychosocial, and organisational risk factors for the adverse psychological outcomes observed in healthcare professionals during the COVID-19 pandemic. RELEVANCE TO CLINICAL PRACTICE This study highlights the urgent need for screening for anxiety and depression and psychological interventions to combat an imminent mental health crisis in healthcare professionals during the COVID-19 pandemic. Pandemic response protocols and public health initiatives aiming to improve and prevent mental health problems in healthcare professionals during the current and future health crises, need to account for the various factors at play.
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Affiliation(s)
- Theodora Fteropoulli
- Medical SchoolUniversity of CyprusNicosiaCyprus
- Health Services Research, CityUniversity of LondonLondonUnited Kingdom
| | | | - Anneza Yiallourou
- Medical SchoolUniversity of CyprusNicosiaCyprus
- Breast UnitNicosia General HospitalNicosiaCyprus
| | - Marios Karaiskakis
- University of Nicosia Medical SchoolNicosiaCyprus
- General SurgeryYgia PolyclinicLimassolCyprus
| | - Maria Koliou Mazeri
- Medical SchoolUniversity of CyprusNicosiaCyprus
- Pediatric DepartmentArchbishop Makarios HospitalNicosiaCyprus
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15
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Chrysostomou AC, Vrancken B, Koumbaris G, Themistokleous G, Aristokleous A, Masia C, Eleftheriou C, Iοannou C, Stylianou DC, Ioannides M, Petrou P, Georgiou V, Hatziyianni A, Lemey P, Vandamme AM, Patsalis PP, Kostrikis LG. A Comprehensive Molecular Epidemiological Analysis of SARS-CoV-2 Infection in Cyprus from April 2020 to January 2021: Evidence of a Highly Polyphyletic and Evolving Epidemic. Viruses 2021; 13:1098. [PMID: 34207490 PMCID: PMC8227210 DOI: 10.3390/v13061098] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 05/28/2021] [Accepted: 06/04/2021] [Indexed: 12/19/2022] Open
Abstract
The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) resulted in an extraordinary global public health crisis. In early 2020, Cyprus, among other European countries, was affected by the SARS-CoV-2 epidemic and adopted lockdown measures in March 2020 to limit the initial outbreak on the island. In this study, we performed a comprehensive retrospective molecular epidemiological analysis (genetic, phylogenetic, phylodynamic and phylogeographic analyses) of SARS-CoV-2 isolates in Cyprus from April 2020 to January 2021, covering the first ten months of the SARS-CoV-2 infection epidemic on the island. The primary aim of this study was to assess the transmissibility of SARS-CoV-2 lineages in Cyprus. Whole SARS-CoV-2 genomic sequences were generated from 596 clinical samples (nasopharyngeal swabs) obtained from community-based diagnostic testing centers and hospitalized patients. The phylogenetic analyses revealed a total of 34 different lineages in Cyprus, with B.1.258, B.1.1.29, B.1.177, B.1.2, B.1 and B.1.1.7 (designated a Variant of Concern 202012/01, VOC) being the most prevalent lineages on the island during the study period. Phylodynamic analysis showed a highly dynamic epidemic of SARS-CoV-2 infection, with three consecutive surges characterized by specific lineages (B.1.1.29 from April to June 2020; B.1.258 from September 2020 to January 2021; and B.1.1.7 from December 2020 to January 2021). Genetic analysis of whole SARS-CoV-2 genomic sequences of the aforementioned lineages revealed the presence of mutations within the S protein (L18F, ΔH69/V70, S898F, ΔY144, S162G, A222V, N439K, N501Y, A570D, D614G, P681H, S982A and D1118H) that confer higher transmissibility and/or antibody escape (immune evasion) upon the virus. Phylogeographic analysis indicated that the majority of imports and exports were to and from the United Kingdom (UK), although many other regions/countries were identified (southeastern Asia, southern Europe, eastern Europe, Germany, Italy, Brazil, Chile, the USA, Denmark, the Czech Republic, Slovenia, Finland, Switzerland and Pakistan). Taken together, these findings demonstrate that the SARS-CoV-2 infection epidemic in Cyprus is being maintained by a continuous influx of lineages from many countries, resulting in the establishment of an ever-evolving and polyphyletic virus on the island.
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Affiliation(s)
- Andreas C. Chrysostomou
- Department of Biological Sciences, University of Cyprus, Aglantzia, Nicosia 2109, Cyprus; (A.C.C.); (A.A.); (D.C.S.); (V.G.)
| | - Bram Vrancken
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium; (B.V.); (P.L.); (A.-M.V.)
| | - George Koumbaris
- NIPD Genetics Limited, Nicosia 2409, Cyprus; (G.K.); (M.I.); (P.P.P.)
| | - George Themistokleous
- Medical Laboratory of Ammochostos General Hospital, Ammochostos General Hospital, Paralimni 5386, Cyprus; (G.T.); (C.M.); (C.I.); (P.P.); (A.H.)
| | - Antonia Aristokleous
- Department of Biological Sciences, University of Cyprus, Aglantzia, Nicosia 2109, Cyprus; (A.C.C.); (A.A.); (D.C.S.); (V.G.)
| | - Christina Masia
- Medical Laboratory of Ammochostos General Hospital, Ammochostos General Hospital, Paralimni 5386, Cyprus; (G.T.); (C.M.); (C.I.); (P.P.); (A.H.)
| | - Christina Eleftheriou
- Department of Health and Safety, University of Cyprus, Aglantzia, Nicosia 2109, Cyprus;
| | - Costakis Iοannou
- Medical Laboratory of Ammochostos General Hospital, Ammochostos General Hospital, Paralimni 5386, Cyprus; (G.T.); (C.M.); (C.I.); (P.P.); (A.H.)
| | - Dora C. Stylianou
- Department of Biological Sciences, University of Cyprus, Aglantzia, Nicosia 2109, Cyprus; (A.C.C.); (A.A.); (D.C.S.); (V.G.)
| | - Marios Ioannides
- NIPD Genetics Limited, Nicosia 2409, Cyprus; (G.K.); (M.I.); (P.P.P.)
| | - Panagiotis Petrou
- Medical Laboratory of Ammochostos General Hospital, Ammochostos General Hospital, Paralimni 5386, Cyprus; (G.T.); (C.M.); (C.I.); (P.P.); (A.H.)
| | - Vasilis Georgiou
- Department of Biological Sciences, University of Cyprus, Aglantzia, Nicosia 2109, Cyprus; (A.C.C.); (A.A.); (D.C.S.); (V.G.)
| | - Amalia Hatziyianni
- Medical Laboratory of Ammochostos General Hospital, Ammochostos General Hospital, Paralimni 5386, Cyprus; (G.T.); (C.M.); (C.I.); (P.P.); (A.H.)
| | - Philippe Lemey
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium; (B.V.); (P.L.); (A.-M.V.)
| | - Anne-Mieke Vandamme
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium; (B.V.); (P.L.); (A.-M.V.)
- Center for Global Health and Tropical Medicine, Unidade de Microbiologia, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, 1349-008 Lisbon, Portugal
| | - Philippos P. Patsalis
- NIPD Genetics Limited, Nicosia 2409, Cyprus; (G.K.); (M.I.); (P.P.P.)
- Medical School, University of Nicosia, Nicosia 2417, Cyprus
| | - Leondios G. Kostrikis
- Department of Biological Sciences, University of Cyprus, Aglantzia, Nicosia 2109, Cyprus; (A.C.C.); (A.A.); (D.C.S.); (V.G.)
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16
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Kolokotroni O, Mosquera MC, Quattrocchi A, Heraclides A, Demetriou C, Philippou E. Lifestyle habits of adults during the COVID-19 pandemic lockdown in Cyprus: evidence from a cross-sectional study. BMC Public Health 2021; 21:786. [PMID: 33892688 PMCID: PMC8064698 DOI: 10.1186/s12889-021-10863-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 04/13/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic and the widespread adoption of virus control measures have inevitably disrupted efforts to address lifestyle risk factors for non-communicable diseases (NCD). This study aimed to explore the effects of COVID-19 lockdown on all lifestyle medicine pillars, namely diet, physical activity, sleep, stress, social support and use of risky substances. METHODS This was a cross-sectional study on a convenient sample of adults who resided in Cyprus during the Spring 2020 lockdown. Participants completed an anonymous online questionnaire comprised of six validated tools regarding the following lifestyle behaviours before and during lockdown: adherence to the Mediterranean diet, physical activity, stress and social support levels, sleep pattern and use of risky substances such as smoking and alcohol. Paired before and during lockdown comparisons for each lifestyle pillar were undertaken using Wilcoxon Signed-Rank test and Bowker symmetry Test where response was numerical (non-parametric data) and categorical respectively. Furthermore, stratified analyses for sociodemographic characteristics were performed. RESULTS Out of 745 participants, 74% were female and median age was 39 years. Overall participants reported significantly higher perceived stress score (22 v 25, p < 0.01), lower social support score (71 v 68, p < 0.001), and worse sleep quality score (4 v 5, p < 0.01) during lockdown. Mediterranean diet (MD) adherence was moderate and increased significantly only in those practicing religious fasting (score of 6 v 7, p < 0.01). Total minutes spent sitting increased (120 v 180, p < 0.01) although overall physical activity score did not significantly change. Smoking intensity increased during lockdown whilst frequency of alcohol consumption decreased (ptrend = 0.03 and < 0.01, respectively). CONCLUSION Various lifestyle factors were adversely affected by the COVID-19 lockdown in Cyprus. Evidence from this study supports development of holistic lifestyle interventions during and following the pandemic to reduce short and long-term NCD risks by building on lifestyle behaviour strengths and addressing longstanding and emerging gaps and needs.
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Affiliation(s)
- Ourania Kolokotroni
- Department of Primary Care and Population Health, Medical School, University of Nicosia, 21 Ilia Papakyriakou, 2414, Engomi, P.O. Box 24005, CY-1700, Nicosia, Cyprus.
| | - Maria C Mosquera
- Department of Primary Care and Population Health, Medical School, University of Nicosia, 21 Ilia Papakyriakou, 2414, Engomi, P.O. Box 24005, CY-1700, Nicosia, Cyprus
| | - Annalisa Quattrocchi
- Department of Primary Care and Population Health, Medical School, University of Nicosia, 21 Ilia Papakyriakou, 2414, Engomi, P.O. Box 24005, CY-1700, Nicosia, Cyprus
| | - Alexandros Heraclides
- Department of Primary Care and Population Health, Medical School, University of Nicosia, 21 Ilia Papakyriakou, 2414, Engomi, P.O. Box 24005, CY-1700, Nicosia, Cyprus
| | - Christiana Demetriou
- Department of Primary Care and Population Health, Medical School, University of Nicosia, 21 Ilia Papakyriakou, 2414, Engomi, P.O. Box 24005, CY-1700, Nicosia, Cyprus
| | - Elena Philippou
- Department of Life and Health Sciences, School of Sciences and Engineering, University of Nicosia, Nicosia, Cyprus
- Department of Nutritional Sciences, King's College London, London, UK
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Trends of Online Search of COVID-19 Related Terms in Cyprus. EPIDEMIOLGIA (BASEL, SWITZERLAND) 2021; 2:36-45. [PMID: 36417188 PMCID: PMC9620905 DOI: 10.3390/epidemiologia2010004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/04/2021] [Accepted: 01/15/2021] [Indexed: 12/14/2022]
Abstract
Knowledge of trends in web searches provides useful information for various purposes, including responses to public health emergencies. This work aims to analyze the popularity of internet search queries for Coronavirus Disease 2019 (COVID-19) and COVID-19 symptoms in Cyprus. Query data for the term Coronavirus were retrieved from Google Trends website between 19 January and 30 June 2020. The study focused on Cyprus and the four most populated cities: Nicosia, Limassol, Larnaca, and Paphos. COVID-19 symptoms including fever, cough, sore throat, shortness of breath, and myalgia were considered in the analysis. Daily and weekly search volumes were described, and their correlation with the evolution of the COVID-19 pandemic and important announcements or events were examined. Three periods of interest peaks were identified in Cyprus. The highest interest in COVID-19-related terms was found in the city of Paphos. The most popular symptoms were fever and cough, and the symptom with the highest increase in popularity was myalgia. At the beginning of the pandemic, the search volume of COVID-19 grew substantially when governments, major organizations, and high-profile figures, globally and locally, made important announcements regarding COVID-19. Health authorities in Cyprus and elsewhere could benefit from constantly monitoring the online interest of the population in order to get timely information that could be used in public health planning and response.
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