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Bogogiannidou Z, Koureas M, Mouchtouri VA, Dadouli K, Kyritsi MA, Vontas A, Anagnostopoulos L, Mina P, Matziri A, Vachtsioli E, Papagiannakis A, Archontakis Z, Leotsinidis M, Theodoridou K, Manios G, Gikas A, Speletas M, Hadjichristodoulou C. Does tourism affect the long term course of COVID-19 pandemic in a country of destination? Evidence from a popular Greek island in 2020 where control measures were implemented. Front Epidemiol 2023; 3:1149706. [PMID: 38516333 PMCID: PMC10955759 DOI: 10.3389/fepid.2023.1149706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 06/13/2023] [Indexed: 03/23/2024]
Abstract
Greece opened its points of entry on July 1, 2020, with specific guidelines for travellers arriving by sea, air or land. The aim of this article is to examine the effect of tourism on the long term course of the Coronavirus Disease 2019 (COVID-19) pandemic during the pre-vaccination era (June to December 2020) on the popular Greek island of Crete. To achieve this, a cross-sectional serosurvey, repeated at monthly intervals, was conducted to compare the seroprevalence in Crete with seroprevalence in the mainland of Greece. Crete welcomed nearly 2,000,000 travellers during the 2020 summer season. Left-over serum samples were collected and obtained from public and private laboratories located in Greece, including the island of Crete. These samples were tested for the presence of anti-SARS-CoV-2 IgG antibodies. A total of 55,938 samples were collected, 3,785 of which originated from Crete. In Crete, the seroprevalence ranged between 0% (June 2020) and 2.58% (December 2020), while the corresponding seroprevalence in Greece was 0.19% and 10.75%, respectively. We identified 4.16 times lower seropositivity in Crete (2.58%) in comparison with the mainland of Greece (10.75%) during December 2020. Moreover, the monthly infection fatality rate (IFR) in Crete was calculated at 0.09%, compared with 0.21% in mainland Greece for December 2020. The island of Crete presented more than four times lower seroprevalence than the mainland of Greece, despite being a highly attractive tourist destination. This evidence supports the idea that tourism may not have affected the long term course of the COVID-19 pandemic in Greece. However, due to contradicting results from previous studies, further investigation is needed.
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Affiliation(s)
- Zacharoula Bogogiannidou
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Michalis Koureas
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Varvara A Mouchtouri
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Katerina Dadouli
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Maria A Kyritsi
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Alexandros Vontas
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Lemonia Anagnostopoulos
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Paraskevi Mina
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Alexia Matziri
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Evangelia Vachtsioli
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | | | | | - Michael Leotsinidis
- Laboratory of Public Health, School of Medicine, University of Patras, Patras, Greece
| | - Kalliopi Theodoridou
- Department of Microbiology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - George Manios
- Department of Computer Science and Biomedical Informatics, University of Thessaly, Lamia, Greece
| | - Achilleas Gikas
- Internal Medicine Department, Infectious Diseases Unit, University Hospital of Heraklion, School of Medicine, University of Crete, Heraklion, Greece
| | - Matthaios Speletas
- Department of Immunology and Histocompatibility, Faculty of Medicine, University of Thessaly, Larissa, Greece
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Koureas M, Mellou K, Vontas A, Kyritsi M, Panagoulias I, Koutsolioutsou A, Mouchtouri VA, Speletas M, Paraskevis D, Hadjichristodoulou C. Wastewater Levels of Respiratory Syncytial Virus Associated with Influenza-like Illness Rates in Children-A Case Study in Larissa, Greece (October 2022-January 2023). Int J Environ Res Public Health 2023; 20:5219. [PMID: 36982128 PMCID: PMC10048987 DOI: 10.3390/ijerph20065219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 06/18/2023]
Abstract
The emergence of the COVID-19 pandemic has led to significant progress in the field of wastewater-based surveillance (WBS) of respiratory pathogens and highlighted its potential for a wider application in public health surveillance. This study aimed to evaluate whether monitoring of respiratory syncytial virus (RSV) in wastewater can provide a comprehensive picture of disease transmission at the community level. The study was conducted in Larissa (Central Greece) between October 2022 and January 2023. Forty-six wastewater samples were collected from the inlet of the wastewater treatment plant of Larissa and analyzed with a real-time reverse transcription polymerase chain reaction (RT-PCR) based method. RSV and SARS-CoV-2 wastewater viral loads (genome copies/100,000 inhabitants) were analyzed against sentinel surveillance data on influenza-like illness (ILI) to identify potential associations. Univariate linear regression analysis revealed that RSV wastewater viral load (lagged by one week) and ILI notification rates in children up to 14 years old were strongly associated (std. Beta: 0.73 (95% CI: 0.31-1.14), p = 0.002, R2 = 0.308). A weaker association was found between SARS-CoV-2 viral load and ILI rates in the 15+ age group (std. Beta: 0.56 (95% CI: 0.06-1.05), p = 0.032, R2 = 0.527). The results support the incorporation of RSV monitoring into existing wastewater-based surveillance systems.
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Affiliation(s)
- Michalis Koureas
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Str., 41222 Larissa, Greece
| | | | - Alexandros Vontas
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Str., 41222 Larissa, Greece
| | - Maria Kyritsi
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Str., 41222 Larissa, Greece
| | | | | | - Varvara A. Mouchtouri
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Str., 41222 Larissa, Greece
| | - Matthaios Speletas
- Department of Immunology and Histocompatibility, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece
| | | | - Christos Hadjichristodoulou
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Str., 41222 Larissa, Greece
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Chassalevris T, Chaintoutis SC, Koureas M, Petala M, Moutou E, Beta C, Kyritsi M, Hadjichristodoulou C, Kostoglou M, Karapantsios T, Papadopoulos A, Papaioannou N, Dovas CI. SARS-CoV-2 wastewater monitoring using a novel PCR-based method rapidly captured the Delta-to-Omicron ΒΑ.1 transition patterns in the absence of conventional surveillance evidence. Sci Total Environ 2022. [PMID: 35753493 DOI: 10.1101/2022.01.28.21268186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Conventional SARS-CoV-2 surveillance based on genotyping of clinical samples is characterized by challenges related to the available sequencing capacity, population sampling methodologies, and is time, labor, and resource-demanding. Wastewater-based variant surveillance constitutes a valuable supplementary practice, since it does not require extensive sampling, and provides information on virus prevalence in a timely and cost-effective manner. Consequently, we developed a sensitive real-time RT-PCR-based approach that exclusively amplifies and quantifies SARS-CoV-2 genomic regions carrying the S:Δ69/70 deletion, indicative of the Omicron BA.1 variant, in wastewater. The method was incorporated in the analysis of composite daily samples taken from the main Wastewater Treatment Plant of Thessaloniki, Greece, from 1 December 2021. The applicability of the methodology is dependent on the epidemiological situation. During Omicron BA.1 global emergence, Thessaloniki was experiencing a massive epidemic wave attributed solely to the Delta variant, according to genomic surveillance data. Since Delta does not possess the S:Δ69/70, the emergence of Omicron BA.1 could be monitored via the described methodology. Omicron BA.1 was detected in sewage samples on 19 December 2021 and a rapid increase of its viral load was observed in the following 10-day period, with an estimated early doubling time of 1.86 days. The proportion of the total SARS-CoV-2 load attributed to BA.1 reached 91.09 % on 7 January, revealing a fast Delta-to-Omicron transition pattern. The detection of Omicron BA.1 subclade in wastewater preceded the outburst of reported (presumable) Omicron cases in the city by approximately 7 days. The proposed wastewater surveillance approach based on selective PCR amplification of a genomic region carrying a deletion signature enabled rapid, real-time data acquisition on Omicron BA.1 prevalence and dynamics during the slow remission of the Delta wave. Timely provision of these results to State authorities readily influences the decision-making process for targeted public health interventions, including control measures, awareness, and preparedness.
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Affiliation(s)
- Taxiarchis Chassalevris
- Diagnostic Laboratory, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 11 Stavrou Voutyra str., 54627, Thessaloniki, Greece
| | - Serafeim C Chaintoutis
- Diagnostic Laboratory, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 11 Stavrou Voutyra str., 54627, Thessaloniki, Greece
| | - Michalis Koureas
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi str., 41222 Larissa, Greece
| | - Maria Petala
- Laboratory of Environmental Engineering & Planning, Department of Civil Engineering, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
| | - Evangelia Moutou
- Diagnostic Laboratory, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 11 Stavrou Voutyra str., 54627, Thessaloniki, Greece
| | - Christina Beta
- Laboratory of Environmental Engineering & Planning, Department of Civil Engineering, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
| | - Maria Kyritsi
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi str., 41222 Larissa, Greece
| | - Christos Hadjichristodoulou
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi str., 41222 Larissa, Greece
| | - Margaritis Kostoglou
- Laboratory of Chemical and Environmental Technology, School of Chemistry, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
| | - Thodoris Karapantsios
- Laboratory of Chemical and Environmental Technology, School of Chemistry, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
| | - Agis Papadopoulos
- EYATH S.A., Thessaloniki Water Supply and Sewerage Company S.A., 54636 Thessaloniki, Greece
| | - Nikolaos Papaioannou
- Laboratory of Pathology, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
| | - Chrysostomos I Dovas
- Diagnostic Laboratory, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 11 Stavrou Voutyra str., 54627, Thessaloniki, Greece.
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4
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Chassalevris T, Chaintoutis SC, Koureas M, Petala M, Moutou E, Beta C, Kyritsi M, Hadjichristodoulou C, Kostoglou M, Karapantsios T, Papadopoulos A, Papaioannou N, Dovas CI. SARS-CoV-2 wastewater monitoring using a novel PCR-based method rapidly captured the Delta-to-Omicron ΒΑ.1 transition patterns in the absence of conventional surveillance evidence. Sci Total Environ 2022; 844:156932. [PMID: 35753493 PMCID: PMC9225927 DOI: 10.1016/j.scitotenv.2022.156932] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 05/09/2022] [Accepted: 06/20/2022] [Indexed: 05/21/2023]
Abstract
Conventional SARS-CoV-2 surveillance based on genotyping of clinical samples is characterized by challenges related to the available sequencing capacity, population sampling methodologies, and is time, labor, and resource-demanding. Wastewater-based variant surveillance constitutes a valuable supplementary practice, since it does not require extensive sampling, and provides information on virus prevalence in a timely and cost-effective manner. Consequently, we developed a sensitive real-time RT-PCR-based approach that exclusively amplifies and quantifies SARS-CoV-2 genomic regions carrying the S:Δ69/70 deletion, indicative of the Omicron BA.1 variant, in wastewater. The method was incorporated in the analysis of composite daily samples taken from the main Wastewater Treatment Plant of Thessaloniki, Greece, from 1 December 2021. The applicability of the methodology is dependent on the epidemiological situation. During Omicron BA.1 global emergence, Thessaloniki was experiencing a massive epidemic wave attributed solely to the Delta variant, according to genomic surveillance data. Since Delta does not possess the S:Δ69/70, the emergence of Omicron BA.1 could be monitored via the described methodology. Omicron BA.1 was detected in sewage samples on 19 December 2021 and a rapid increase of its viral load was observed in the following 10-day period, with an estimated early doubling time of 1.86 days. The proportion of the total SARS-CoV-2 load attributed to BA.1 reached 91.09 % on 7 January, revealing a fast Delta-to-Omicron transition pattern. The detection of Omicron BA.1 subclade in wastewater preceded the outburst of reported (presumable) Omicron cases in the city by approximately 7 days. The proposed wastewater surveillance approach based on selective PCR amplification of a genomic region carrying a deletion signature enabled rapid, real-time data acquisition on Omicron BA.1 prevalence and dynamics during the slow remission of the Delta wave. Timely provision of these results to State authorities readily influences the decision-making process for targeted public health interventions, including control measures, awareness, and preparedness.
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Affiliation(s)
- Taxiarchis Chassalevris
- Diagnostic Laboratory, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 11 Stavrou Voutyra str., 54627, Thessaloniki, Greece
| | - Serafeim C Chaintoutis
- Diagnostic Laboratory, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 11 Stavrou Voutyra str., 54627, Thessaloniki, Greece
| | - Michalis Koureas
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi str., 41222 Larissa, Greece
| | - Maria Petala
- Laboratory of Environmental Engineering & Planning, Department of Civil Engineering, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
| | - Evangelia Moutou
- Diagnostic Laboratory, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 11 Stavrou Voutyra str., 54627, Thessaloniki, Greece
| | - Christina Beta
- Laboratory of Environmental Engineering & Planning, Department of Civil Engineering, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
| | - Maria Kyritsi
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi str., 41222 Larissa, Greece
| | - Christos Hadjichristodoulou
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi str., 41222 Larissa, Greece
| | - Margaritis Kostoglou
- Laboratory of Chemical and Environmental Technology, School of Chemistry, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
| | - Thodoris Karapantsios
- Laboratory of Chemical and Environmental Technology, School of Chemistry, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
| | - Agis Papadopoulos
- EYATH S.A., Thessaloniki Water Supply and Sewerage Company S.A., 54636 Thessaloniki, Greece
| | - Nikolaos Papaioannou
- Laboratory of Pathology, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
| | - Chrysostomos I Dovas
- Diagnostic Laboratory, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 11 Stavrou Voutyra str., 54627, Thessaloniki, Greece.
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Malissiova E, Soultani G, Kogia P, Koureas M, Hadjichristodoulou C. Analysis of 20 year data for the assessment of dietary exposure to chemical contaminants in the region of Thessaly, Greece. Food Control 2022. [DOI: 10.1016/j.foodcont.2022.108838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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6
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Avakian I, Anagnostopoulos L, Rachiotis G, Fotiadis K, Mariolis A, Koureas M, Dadouli K, Papadopoulos C, Speletas M, Bakola M, Vardaka P, Zoubounelli S, Tatsios E, Niavi F, Pouliou A, Hadjichristodoulou C, Mouchtouri VA. Prevalence and Predictors of COVID-19 Vaccination Acceptance among Greek Health Care Workers and Administrative Officers of Primary Health Care Centers: A Nationwide Study Indicating Aspects for a Role Model. Vaccines (Basel) 2022; 10:vaccines10050765. [PMID: 35632522 PMCID: PMC9142949 DOI: 10.3390/vaccines10050765] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/30/2022] [Accepted: 05/09/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Τhe study aims to identify factors associated with COVID-19 vaccine acceptance and to investigate knowledge and perceptions of Primary Health Care Centers (PHCC) personnel, who acted as pioneers in the national COVID-19 vaccination strategy. Methods and Materials: A nationwide cross-sectional survey was conducted by distributing an online anonymous questionnaire comprising 25 questions during the first semester of 2021. Results: Approximately 85.3% of the 1136 respondents (response rate 28.4%) were vaccinated or intended to be. The acceptance of seasonal flu vaccine (aOR: 3.29, 95%CI: 2.08−5.20), correct COVID-19 vaccine knowledge (aOR: 8.37, 95%CI: 4.81−14.59) and lack of concern regarding vaccine novelty (aOR: 6.18, 95%CI: 3.91−9.77) were positively correlated with vaccine acceptance. Vaccinated respondents were more likely to be physicians (aOR: 2.29, 95%CI: 1.03−5.09) or administrative staff (aOR: 2.65, 95%CI: 1.18−5.97) compared to nursing stuff. Reasons for vaccine hesitancy included inadequate information (37.8%) and vaccine safety (31.9%). Vaccine acceptance was strongly correlated (Spearman’s correlation coefficient r = 0.991, p < 0.001) between PHCC personnel and the general population of each health district. Conclusions: COVID-19 vaccine acceptance among PHCC personnel in Greece was comparably high, but specific groups (nurses) were hesitant. As the survey’s target population could serve as a role model for the community, efforts should be made to improve COVID-19 vaccine acceptance.
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Affiliation(s)
- Ioanna Avakian
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, 41222 Larissa, Greece; (I.A.); (L.A.); (G.R.); (M.K.); (K.D.); (C.H.)
| | - Lemonia Anagnostopoulos
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, 41222 Larissa, Greece; (I.A.); (L.A.); (G.R.); (M.K.); (K.D.); (C.H.)
| | - George Rachiotis
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, 41222 Larissa, Greece; (I.A.); (L.A.); (G.R.); (M.K.); (K.D.); (C.H.)
| | | | | | - Michalis Koureas
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, 41222 Larissa, Greece; (I.A.); (L.A.); (G.R.); (M.K.); (K.D.); (C.H.)
| | - Katerina Dadouli
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, 41222 Larissa, Greece; (I.A.); (L.A.); (G.R.); (M.K.); (K.D.); (C.H.)
| | | | - Matthaios Speletas
- Department of Immunology and Histocompatibility, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece;
| | - Maria Bakola
- Research Unit for General Medicine and Primary Health Care, Faculty of Medicine, School of Health Science, University of Ioannina, 45110 Ioannina, Greece;
| | - Panagiota Vardaka
- Department of General Practice, University Hospital of Larissa, 41334 Larissa, Greece; (P.V.); (S.Z.); (E.T.); (A.P.)
| | - Stamatia Zoubounelli
- Department of General Practice, University Hospital of Larissa, 41334 Larissa, Greece; (P.V.); (S.Z.); (E.T.); (A.P.)
| | - Evangelos Tatsios
- Department of General Practice, University Hospital of Larissa, 41334 Larissa, Greece; (P.V.); (S.Z.); (E.T.); (A.P.)
| | - Fevronia Niavi
- Primary Health Care Center of Palama, 43200 Palamas, Greece;
| | - Apostolia Pouliou
- Department of General Practice, University Hospital of Larissa, 41334 Larissa, Greece; (P.V.); (S.Z.); (E.T.); (A.P.)
| | - Christos Hadjichristodoulou
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, 41222 Larissa, Greece; (I.A.); (L.A.); (G.R.); (M.K.); (K.D.); (C.H.)
| | - Varvara A. Mouchtouri
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, 41222 Larissa, Greece; (I.A.); (L.A.); (G.R.); (M.K.); (K.D.); (C.H.)
- Correspondence: ; Tel.: +30-2410-565009
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7
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Koureas M, Bogogiannidou Z, Vontas A, Kyritsi MA, Mouchtouri VA, Dadouli K, Anagnostopoulos L, Mina P, Matziri A, Ntouska M, Tsigaridaki M, Gkiata V, Tsilidis KK, Ntzani EE, Prezerakos P, Tsiodras S, Speletas M, Hadjichristodoulou C. SARS-CoV-2 Sero-Surveillance in Greece: Evolution over Time and Epidemiological Attributes during the Pre-Vaccination Pandemic Era. Diagnostics (Basel) 2022; 12:diagnostics12020295. [PMID: 35204386 PMCID: PMC8871128 DOI: 10.3390/diagnostics12020295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 01/20/2022] [Accepted: 01/20/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Nation-wide SARS-CoV-2 seroprevalence surveys provide valuable insights into the course of the pandemic, including information often not captured by routine surveillance of reported cases. Methods: A serosurvey of IgG antibodies against SARS-CoV-2 was conducted in Greece between March and December 2020. It was designed as a cross-sectional survey repeated at monthly intervals. The leftover sampling methodology was used and a geographically stratified sampling plan was applied. Results: Of 55,947 serum samples collected, 705 (1.26%) were found positive for anti-SARS-CoV-2 antibodies, with higher seroprevalence (9.09%) observed in December 2020. Highest seropositivity levels were observed in the “0–29” and “30–49” year age groups. Seroprevalence increased with age in the “0–29” age group. Highly populated metropolitan areas were characterized with elevated seroprevalence levels (11.92% in Attica, 12.76% in Thessaloniki) compared to the rest of the country (5.90%). The infection fatality rate (IFR) was estimated at 0.451% (95% CI: 0.382–0.549%) using aggregate data until December 2020, and the ratio of actual to reported cases was 9.59 (7.88–11.33). Conclusions: The evolution of seroprevalence estimates aligned with the course of the pandemic and varied widely by region and age group. Young and middle-aged adults appeared to be drivers of the pandemic during a severe epidemic wave under strict policy measures.
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Affiliation(s)
- Michalis Koureas
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (A.V.); (M.A.K.); (V.A.M.); (K.D.); (L.A.); (P.M.); (A.M.)
| | - Zacharoula Bogogiannidou
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (A.V.); (M.A.K.); (V.A.M.); (K.D.); (L.A.); (P.M.); (A.M.)
| | - Alexandros Vontas
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (A.V.); (M.A.K.); (V.A.M.); (K.D.); (L.A.); (P.M.); (A.M.)
| | - Maria A. Kyritsi
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (A.V.); (M.A.K.); (V.A.M.); (K.D.); (L.A.); (P.M.); (A.M.)
| | - Varvara A. Mouchtouri
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (A.V.); (M.A.K.); (V.A.M.); (K.D.); (L.A.); (P.M.); (A.M.)
| | - Katerina Dadouli
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (A.V.); (M.A.K.); (V.A.M.); (K.D.); (L.A.); (P.M.); (A.M.)
| | - Lemonia Anagnostopoulos
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (A.V.); (M.A.K.); (V.A.M.); (K.D.); (L.A.); (P.M.); (A.M.)
| | - Paraskevi Mina
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (A.V.); (M.A.K.); (V.A.M.); (K.D.); (L.A.); (P.M.); (A.M.)
| | - Alexia Matziri
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (A.V.); (M.A.K.); (V.A.M.); (K.D.); (L.A.); (P.M.); (A.M.)
| | - Maria Ntouska
- Hematology Laboratory, Corfu General Hospital, 49100 Corfu, Greece;
| | - Maria Tsigaridaki
- Biochemical Laboratory, Venizelio Hospital, 71409 Heraklion, Greece;
| | - Vasiliki Gkiata
- Microbiological Laboratory, Kozani General Hospital” Mamatsio”, 50100 Kozani, Greece;
| | - Konstantinos K. Tsilidis
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Ioannina, 45110 Ioannina, Greece; (K.K.T.); (E.E.N.)
| | - Evangelia E. Ntzani
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Ioannina, 45110 Ioannina, Greece; (K.K.T.); (E.E.N.)
- Center for Research Synthesis in Health, Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, RI 02903, USA
- Institute of Biosciences, University Research Center of loannina, University of Ioannina, 45110 Ioannina, Greece
| | | | - Sotirios Tsiodras
- Fourth Department of Internal Medicine, School of Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece;
| | - Matthaios Speletas
- Department of Immunology and Histocompatibility, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece;
| | - Christos Hadjichristodoulou
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (A.V.); (M.A.K.); (V.A.M.); (K.D.); (L.A.); (P.M.); (A.M.)
- Correspondence:
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8
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Speletas M, Dadouli K, Syrakouli A, Gatselis N, Germanidis G, Mouchtouri VA, Koulas I, Samakidou A, Nikolaidou A, Stefos A, Mimtsoudis I, Hatzianastasiou S, Koureas M, Anagnostopoulos L, Tseroni M, Tsinti G, Metallidis S, Dalekos G, Hadjichristodoulou C. MBL deficiency-causing B allele (rs1800450) as a risk factor for severe COVID-19. Immunobiology 2021; 226:152136. [PMID: 34628288 PMCID: PMC8462051 DOI: 10.1016/j.imbio.2021.152136] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 08/29/2021] [Accepted: 09/20/2021] [Indexed: 12/12/2022]
Abstract
The COVID-19 pandemic represents one of the greatest challenges in modern medicine. The disease is characterized by a variable clinical phenotype, ranging from asymptomatic carriage to severe and/or critical disease, which bears poor prognosis and outcome because of the development of severe acute respiratory distress syndrome (SARS) requiring ICU hospitalization, multi-organ failure and death. Therefore, the determination of risk factors predisposing to disease phenotype is of outmost importance. The aim of our study was to evaluate which predisposing factors, including MBL2 genotyping, affected clinical phenotype in 264 COVID-19 patients. We demonstrated that older age along with underlying comorbidities, primarily obesity, chronic inflammatory disorders and diabetes mellitus, represent the most important risk factors related to hospitalization, the development of pneumonia and SARS. Moreover, we found that the presence of the MBL deficiency-causing B allele (rs1800450) was significantly associated with almost 2-fold increased risk for developing pneumonia and requiring hospitalization, suggesting its usage as a molecular predictor of severe disease in SARS-CoV-2 infected individuals.
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Affiliation(s)
- Matthaios Speletas
- Department of Immunology & Histocompatibility, Faculty of Medicine, University of Thessaly, Larissa, Greece.
| | - Katerina Dadouli
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Argyro Syrakouli
- Department of Immunology & Histocompatibility, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Nikolaos Gatselis
- Department of Medicine and Research Laboratory of Internal Medicine, National Expertise Center of Greece in Autoimmune Liver Diseases, General University Hospital of Larissa, Larissa, Greece
| | - Georgios Germanidis
- First Internal Medicine Department, Infectious Diseases Division, AHEPA Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | - Varvara A Mouchtouri
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Ioannis Koulas
- Department of Immunology & Histocompatibility, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Anna Samakidou
- Department of Medicine and Research Laboratory of Internal Medicine, National Expertise Center of Greece in Autoimmune Liver Diseases, General University Hospital of Larissa, Larissa, Greece
| | - Anastasia Nikolaidou
- First Internal Medicine Department, Infectious Diseases Division, AHEPA Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | - Aggelos Stefos
- Department of Medicine and Research Laboratory of Internal Medicine, National Expertise Center of Greece in Autoimmune Liver Diseases, General University Hospital of Larissa, Larissa, Greece
| | - Iordanis Mimtsoudis
- First Internal Medicine Department, Infectious Diseases Division, AHEPA Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | | | - Michalis Koureas
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Lemonia Anagnostopoulos
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | | | - Gerasimina Tsinti
- Department of Immunology & Histocompatibility, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Symeon Metallidis
- First Internal Medicine Department, Infectious Diseases Division, AHEPA Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | - George Dalekos
- Department of Medicine and Research Laboratory of Internal Medicine, National Expertise Center of Greece in Autoimmune Liver Diseases, General University Hospital of Larissa, Larissa, Greece
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9
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Papadopoulou A, Koureas M, Farmakis A, Sirakouli A, Papathanasiou IV, Gourgoulianis KI. Increased Frequency of Health Anxiety in Health Science Students: a Cross Sectional Study in a Greek University. Med Arch 2021; 75:221-228. [PMID: 34483454 PMCID: PMC8385724 DOI: 10.5455/medarh.2021.75.221-228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/11/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Ectopic Health Sciences students often experience higher level of stress due to clinical knowledge, and it has been reported that they frequently develop worries and symptoms of illness. These observations had lead to the hypothesis that studying health sciences may increase the risk for developing health anxiety. Objective: To investigate the correlation between studying health sciences and health anxiety risk in students of a Greek university. Methods: A cross-sectional study was conducted among health science and non-health science students from the University of Thessaly, Greece. The 14 item - Short Health Anxiety Inventory (SHAI) was used to measure students’ health anxiety. Univariable and multivariable logistic regression analyses were used to test the hypothesis. Results: The population sample consisted of 562 health science students and 204 agriculture and computer science students. The prevalence of health anxiety (SHAI score >14) was 18.1% (95% CI 15.4%-21.1%) while 8.3% (95% CI 6.4%-10.5%) of the participants suffered from clinical health anxiety (SHAI score >18). Health science students had higher SHAI scores compared to non-health science students. Multivariable analysis revealed an increased risk for health anxiety in health science students (OR: 2.01, 95% CI: 1.02-3.97, p=0.044). Health anxiety was also associated with sex (female) (p<0,008) and the presence of health anxiety in a family member (p<0,001). Conclusion: The current study identified studying health sciences as a determinant of health anxiety in students of a Greek university, after considering several confounding factors. This relatively neglected hypothesis should be further examined, preferably in a prospective cohort design.
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Affiliation(s)
| | - Michalis Koureas
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi str, Larissa, Greece
| | | | - Argyro Sirakouli
- Depar 1Faculty of Medicine, University of Thessaly, Larissa, Greece
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10
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Koureas M, Amoutzias GD, Vontas A, Kyritsi M, Pinaka O, Papakonstantinou A, Dadouli K, Hatzinikou M, Koutsolioutsou A, Mouchtouri VA, Speletas M, Tsiodras S, Hadjichristodoulou C. Wastewater monitoring as a supplementary surveillance tool for capturing SARS-COV-2 community spread. A case study in two Greek municipalities. Environ Res 2021; 200:111749. [PMID: 34310965 PMCID: PMC8302483 DOI: 10.1016/j.envres.2021.111749] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 07/16/2021] [Accepted: 07/16/2021] [Indexed: 05/06/2023]
Abstract
A pilot study was conducted from late October 2020 until mid-April 2021, aiming to examine the association between SARS-CoV-2 RNA concentrations in untreated wastewater and recorded COVID-19 cases in two Greek municipalities. A population of Random Forest and Linear Regression Machine Learning models was trained and evaluated incorporating the concentrations of SARS-CoV-2 RNA in 111 wastewater samples collected from the inlets of two Wastewater Treatment Plants, along with physicochemical parameters of the wastewater influent. The model's predictions were adequately associated with the 7-day cumulative cases with the correlation coefficients (after 5-fold cross validation) ranging from 0.754 to 0.960 while the mean relative errors ranged from 30.42% to 59.46%. Our results provide indications that wastewater-based predictions can be applied in diverse settings and in prolonged time periods, although the accuracy of these predictions may be mitigated. Wastewater-based epidemiology can support and strengthen epidemiological surveillance.
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Affiliation(s)
- Michalis Koureas
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi str, Larissa, Greece
| | - Grigoris D Amoutzias
- Bioinformatics Laboratory, Department of Biochemistry and Biotechnology, School of Health Sciences, University of Thessaly, Biopolis, Larissa, 41500, Greece
| | - Alexandros Vontas
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi str, Larissa, Greece
| | - Maria Kyritsi
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi str, Larissa, Greece
| | - Ourania Pinaka
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi str, Larissa, Greece
| | | | - Katerina Dadouli
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi str, Larissa, Greece
| | - Marina Hatzinikou
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi str, Larissa, Greece
| | | | - Varvara A Mouchtouri
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi str, Larissa, Greece
| | - Matthaios Speletas
- Department of Immunology and Histocompatibility, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Sotirios Tsiodras
- Hellenic National Public Health Organisation, Chimarras 6, 15125, Marousi Attica, Greece; Fourth Department of Internal Medicine, National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, Athens, Greece
| | - Christos Hadjichristodoulou
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi str, Larissa, Greece.
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Bogogiannidou Z, Speletas M, Vontas A, Nikoulis DJ, Dadouli K, Kyritsi MA, Mouchtouri VA, Mina P, Anagnostopoulos L, Koureas M, Karavasilis V, Nikou O, Pinaka O, Thomaidis PC, Kadoglou K, Bedevis K, Spyrou N, Eleftheriou AA, Papaevangelou V, Gikas A, Vatopoulos A, Ntzani EE, Prezerakos P, Tsiodras S, Hadjichristodoulou C. Repeated Leftover Serosurvey of SARS-CoV-2 IgG Antibodies in Greece, May to August 2020. Vaccines (Basel) 2021; 9:504. [PMID: 34068100 PMCID: PMC8152765 DOI: 10.3390/vaccines9050504] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/29/2021] [Accepted: 05/09/2021] [Indexed: 01/15/2023] Open
Abstract
A serosurvey of IgG antibodies against SARS-CoV-2 was conducted in Greece between May and August 2020. It was designed as a cross-sectional survey and was repeated at monthly intervals. The leftover sampling methodology was used and a geographically stratified sampling plan was applied. Of 20,110 serum samples collected, 89 (0.44%) were found to be positive for anti-SARS-CoV-2 antibodies, with higher seroprevalence (0.35%) observed in May 2020. The highest seroprevalence was primarily observed in the "30-49" year age group. Females presented higher seroprevalence compared to males in May 2020 (females: 0.58% VS males: 0.10%). This difference reversed during the study period and males presented a higher proportion in August 2020 (females: 0.12% VS males: 0.58%). Differences in the rate of seropositivity between urban areas and the rest of the country were also observed during the study period. The four-month infection fatality rate (IFR) was estimated to be 0.47%, while the respective case fatality rate (CFR) was at 1.89%. Our findings confirm low seroprevalence of COVID-19 in Greece during the study period. The young adults are presented as the most affected age group. The loss of the cumulative effect of seropositivity in a proportion of previous SARS-CoV-2 infections was indicated.
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Affiliation(s)
- Zacharoula Bogogiannidou
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (Z.B.); (A.V.); (D.J.N.); (K.D.); (M.A.K.); (V.A.M.); (P.M.); (L.A.); (M.K.); (V.K.); (O.N.); (O.P.)
| | - Matthaios Speletas
- Department of Immunology and Histocompatibility, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece;
| | - Alexandros Vontas
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (Z.B.); (A.V.); (D.J.N.); (K.D.); (M.A.K.); (V.A.M.); (P.M.); (L.A.); (M.K.); (V.K.); (O.N.); (O.P.)
| | - Dimitrios J. Nikoulis
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (Z.B.); (A.V.); (D.J.N.); (K.D.); (M.A.K.); (V.A.M.); (P.M.); (L.A.); (M.K.); (V.K.); (O.N.); (O.P.)
| | - Katerina Dadouli
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (Z.B.); (A.V.); (D.J.N.); (K.D.); (M.A.K.); (V.A.M.); (P.M.); (L.A.); (M.K.); (V.K.); (O.N.); (O.P.)
| | - Maria A. Kyritsi
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (Z.B.); (A.V.); (D.J.N.); (K.D.); (M.A.K.); (V.A.M.); (P.M.); (L.A.); (M.K.); (V.K.); (O.N.); (O.P.)
| | - Varvara A. Mouchtouri
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (Z.B.); (A.V.); (D.J.N.); (K.D.); (M.A.K.); (V.A.M.); (P.M.); (L.A.); (M.K.); (V.K.); (O.N.); (O.P.)
| | - Paraskevi Mina
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (Z.B.); (A.V.); (D.J.N.); (K.D.); (M.A.K.); (V.A.M.); (P.M.); (L.A.); (M.K.); (V.K.); (O.N.); (O.P.)
| | - Lemonia Anagnostopoulos
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (Z.B.); (A.V.); (D.J.N.); (K.D.); (M.A.K.); (V.A.M.); (P.M.); (L.A.); (M.K.); (V.K.); (O.N.); (O.P.)
| | - Michalis Koureas
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (Z.B.); (A.V.); (D.J.N.); (K.D.); (M.A.K.); (V.A.M.); (P.M.); (L.A.); (M.K.); (V.K.); (O.N.); (O.P.)
| | - Vasileios Karavasilis
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (Z.B.); (A.V.); (D.J.N.); (K.D.); (M.A.K.); (V.A.M.); (P.M.); (L.A.); (M.K.); (V.K.); (O.N.); (O.P.)
| | - Olga Nikou
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (Z.B.); (A.V.); (D.J.N.); (K.D.); (M.A.K.); (V.A.M.); (P.M.); (L.A.); (M.K.); (V.K.); (O.N.); (O.P.)
| | - Ourania Pinaka
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (Z.B.); (A.V.); (D.J.N.); (K.D.); (M.A.K.); (V.A.M.); (P.M.); (L.A.); (M.K.); (V.K.); (O.N.); (O.P.)
| | | | - Kornilia Kadoglou
- Biochemistry Laboratory, General Hospital of Kalamata, 24150 Kalamata, Greece;
| | | | - Natalia Spyrou
- Microbiological Laboratory “Bioiatriki”, 11524 Athens, Greece;
| | - Alexandros A. Eleftheriou
- Department of Hygiene and Epidemiology, University of Ioannina Faculty of Medicine, 45110 Ioannina, Greece; (A.A.E.); (E.E.N.)
| | - Vassiliki Papaevangelou
- Third Department of Paediatrics, School of Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece;
| | - Achilleas Gikas
- Internal Medicine Department, Infectious Diseases Unit, University Hospital of Heraklion, School of Medicine, University of Crete, 71500 Heraklion, Greece;
| | - Alkiviadis Vatopoulos
- Department of Public Health Policy, School of Public Health, University of West Attica, 11521 Athens, Greece;
| | - Evangelia E. Ntzani
- Department of Hygiene and Epidemiology, University of Ioannina Faculty of Medicine, 45110 Ioannina, Greece; (A.A.E.); (E.E.N.)
- Center for Evidence Synthesis in Health, Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, RI 02903, USA
- Institute of Biosciences, University Research Center of loannina, 45110 Ioannina, Greece
| | | | - Sotirios Tsiodras
- Fourth Department of Internal Medicine, School of Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece;
| | - Christos Hadjichristodoulou
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (Z.B.); (A.V.); (D.J.N.); (K.D.); (M.A.K.); (V.A.M.); (P.M.); (L.A.); (M.K.); (V.K.); (O.N.); (O.P.)
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12
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Hatzianastasiou S, Mouchtouri VA, Pavli A, Tseroni M, Sapounas S, Vasileiou C, Dadouli K, Kyritsi M, Koureas M, Prezerakos P, Speletas M, Panagiotakopoulos G, Tsiodras S, Hadjichristodoulou C. COVID-19 Outbreak on a Passenger Ship and Assessment of Response Measures, Greece, 2020. Emerg Infect Dis 2021; 27:1927-1930. [PMID: 33979565 PMCID: PMC8237900 DOI: 10.3201/eid2707.210398] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We describe response measures to an outbreak involving 128 (33.4%) coronavirus disease cases (46.1% asymptomatic) among 383 persons onboard a passenger ship. Multivariate analysis indicated that dining in certain rooms and bar areas, nationality, working department (for crew members), and quarantining onboard the ship were significantly associated with infection.
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13
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Koureas M, Speletas M, Bogogiannidou Z, Babalis D, Pinakas V, Pinaka O, Komnos A, Tsoutsa S, Papadamou G, Kyritsi MA, Vontas A, Nakoulas V, Sapounas S, Kanellopoulos N, Kalompatsios D, Papadouli V, Dadouli K, Soteriades S, Mina P, Mouchtouri VA, Anagnostopoulos L, Stamoulis KE, Agorastos K, Petinaki EA, Prezerakos P, Tsiodras S, Hadjichristodoulou C. Transmission Dynamics of SARS-CoV-2 during an Outbreak in a Roma Community in Thessaly, Greece-Control Measures and Lessons Learned. Int J Environ Res Public Health 2021; 18:2878. [PMID: 33799791 PMCID: PMC8002111 DOI: 10.3390/ijerph18062878] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/26/2021] [Accepted: 03/07/2021] [Indexed: 11/17/2022]
Abstract
A COVID-19 outbreak occurred among residents of a Roma settlement in Greece (8 April-4 June 2020). The aim of this study was to identify factors associated with an increased risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and to evaluate the effectiveness of control measures implemented. Data were analyzed from individuals that were tested for SARS-CoV-2 during contact tracing, population screening or hospital visits. RT-PCR was used for the detection of SARS-CoV-2 in oropharyngeal samples. Risk factors for household secondary attack rates (SAR) and hospitalization with COVID-19 were examined using chi-square tests, Fisher's exact tests and logistic regression analyses. During the outbreak, 142 cases, 20 hospitalizations and 1 death were recorded, with a total of 2273 individuals tested. The risk of hospitalization was associated with age (OR: 1.04, 95% CI: 1.02-1.07) and Cycle threshold (Ct) values (OR for a decrease in Ct values by 1: 1.18, 95% CI: 1.07-1.31). Household SAR was estimated at 38.62% (95% CI: 32.50-45.01%). After the designation of an isolation facility for cases, household SAR declined from 74.42% to 31.03%. Household size was associated with the risk of infection (OR: 2.65, 95% CI: 1.00-7.07). The presence of COVID-19 symptoms among index cases was correlated with higher transmission (OR: 23.68, 95% CI 2.21-253.74) in multivariate analysis, while age was found to be associated with SAR only in univariate analysis. Roma communities can be particularly vulnerable to the spread of SARS-CoV-2. In similar settings, symptomatic cases are more important transmitters of SARS-CoV-2. Within these communities, immediate measures should be implemented to mitigate disease spread.
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Affiliation(s)
- Michalis Koureas
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (O.P.); (M.A.K.); (A.V.); (V.N.); (D.K.); (K.D.); (S.S.); (P.M.); (V.A.M.); (L.A.)
| | - Matthaios Speletas
- Department of Immunology and Histocompatibility, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece;
| | - Zacharoula Bogogiannidou
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (O.P.); (M.A.K.); (A.V.); (V.N.); (D.K.); (K.D.); (S.S.); (P.M.); (V.A.M.); (L.A.)
| | - Dimitris Babalis
- General Hospital of Larissa, 41221 Larissa, Greece; (D.B.); (A.K.); (S.T.)
| | - Vassilios Pinakas
- Region of Thessaly, Koumoundourou & Papanastasiou str, 41222 Larissa, Greece; (V.P.); (N.K.); (K.A.)
| | - Ourania Pinaka
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (O.P.); (M.A.K.); (A.V.); (V.N.); (D.K.); (K.D.); (S.S.); (P.M.); (V.A.M.); (L.A.)
| | - Apostolos Komnos
- General Hospital of Larissa, 41221 Larissa, Greece; (D.B.); (A.K.); (S.T.)
| | - Stella Tsoutsa
- General Hospital of Larissa, 41221 Larissa, Greece; (D.B.); (A.K.); (S.T.)
| | - Georgia Papadamou
- Emergency Department, University Hospital of Larissa, Mezourlo, 41110 Larissa, Greece;
| | - Maria A. Kyritsi
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (O.P.); (M.A.K.); (A.V.); (V.N.); (D.K.); (K.D.); (S.S.); (P.M.); (V.A.M.); (L.A.)
| | - Alexandros Vontas
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (O.P.); (M.A.K.); (A.V.); (V.N.); (D.K.); (K.D.); (S.S.); (P.M.); (V.A.M.); (L.A.)
| | - Vasileios Nakoulas
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (O.P.); (M.A.K.); (A.V.); (V.N.); (D.K.); (K.D.); (S.S.); (P.M.); (V.A.M.); (L.A.)
| | - Spyros Sapounas
- Hellenic National Public Health Organization, 15123 Athens, Greece;
| | - Nikolaos Kanellopoulos
- Region of Thessaly, Koumoundourou & Papanastasiou str, 41222 Larissa, Greece; (V.P.); (N.K.); (K.A.)
| | - Dimitrios Kalompatsios
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (O.P.); (M.A.K.); (A.V.); (V.N.); (D.K.); (K.D.); (S.S.); (P.M.); (V.A.M.); (L.A.)
| | - Vassiliki Papadouli
- Local Health Unit of Ampelokipi, 5th Regional Health Authority of Thessaly & Sterea, Ministry of Health, 41447 Larissa, Greece;
| | - Katerina Dadouli
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (O.P.); (M.A.K.); (A.V.); (V.N.); (D.K.); (K.D.); (S.S.); (P.M.); (V.A.M.); (L.A.)
| | - Soteris Soteriades
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (O.P.); (M.A.K.); (A.V.); (V.N.); (D.K.); (K.D.); (S.S.); (P.M.); (V.A.M.); (L.A.)
| | - Paraskevi Mina
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (O.P.); (M.A.K.); (A.V.); (V.N.); (D.K.); (K.D.); (S.S.); (P.M.); (V.A.M.); (L.A.)
| | - Varvara A. Mouchtouri
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (O.P.); (M.A.K.); (A.V.); (V.N.); (D.K.); (K.D.); (S.S.); (P.M.); (V.A.M.); (L.A.)
| | - Lemonia Anagnostopoulos
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (O.P.); (M.A.K.); (A.V.); (V.N.); (D.K.); (K.D.); (S.S.); (P.M.); (V.A.M.); (L.A.)
| | | | - Kostantinos Agorastos
- Region of Thessaly, Koumoundourou & Papanastasiou str, 41222 Larissa, Greece; (V.P.); (N.K.); (K.A.)
| | - Efthimia A. Petinaki
- Department of Microbiology, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece;
| | | | - Sotirios Tsiodras
- Medical School, National and Kapodistrian University of Athens, 15772 Athens, Greece;
| | - Christos Hadjichristodoulou
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (O.P.); (M.A.K.); (A.V.); (V.N.); (D.K.); (K.D.); (S.S.); (P.M.); (V.A.M.); (L.A.)
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Bogogiannidou Z, Vontas A, Dadouli K, Kyritsi MA, Soteriades S, Nikoulis DJ, Mouchtouri VΑ, Koureas M, Kazakos EI, Spanos EG, Gioula G, Ntzani EE, Eleftheriou AA, Vatopoulos A, Petinaki E, Papaevangelou V, Speletas M, Tsiodras S, Hadjichristodoulou C. Repeated leftover serosurvey of SARS-CoV-2 IgG antibodies, Greece, March and April 2020. ACTA ACUST UNITED AC 2020; 25. [PMID: 32762796 PMCID: PMC7459271 DOI: 10.2807/1560-7917.es.2020.25.31.2001369] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
A serosurvey of IgG antibodies against severe acute respiratory coronavirus 2 (SARS-CoV-2) was performed during March and April 2020. Among 6,586 leftover sera, 24 (0.36%) were positive, with higher prevalence in females, older individuals and residents of large urban areas. Seroprevalence was estimated at 0.02% and 0.25%, respectively, in March and April, infection fatality rate at 2.66% and 0.54%. Our findings confirm low COVID-19 incidence in Greece and possibly the effectiveness of early measures.
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Affiliation(s)
- Zacharoula Bogogiannidou
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Alexandros Vontas
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Katerina Dadouli
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Maria A Kyritsi
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Soteris Soteriades
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Dimitrios J Nikoulis
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Varvara Α Mouchtouri
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Michalis Koureas
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Evangelos I Kazakos
- Faculty of Midwifery, School of Health Sciences, University of Western Macedonia, Kozani, Greece
| | - Emmanouil G Spanos
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Georgia Gioula
- National Influenza Reference Laboratory for Northern Greece, Microbiology Department, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evangelia E Ntzani
- Institute of Biosciences, University Research Center of loannina, Ioannina, Greece.,Center for Evidence Synthesis in Health, Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, United States.,Department of Hygiene and Epidemiology, University of Ioannina Faculty of Medicine, Ioannina, Greece
| | - Alexandros A Eleftheriou
- Department of Hygiene and Epidemiology, University of Ioannina Faculty of Medicine, Ioannina, Greece
| | - Alkiviadis Vatopoulos
- Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece
| | - Efthimia Petinaki
- Department of Microbiology, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Vassiliki Papaevangelou
- Third Department of Paediatrics, National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, Athens, Greece
| | - Matthaios Speletas
- Department of Immunology and Histocompatibility, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Sotirios Tsiodras
- Fourth Department of Internal Medicine, National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, Athens, Greece
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Mouchtouri VA, Koureas M, Kyritsi M, Vontas A, Kourentis L, Sapounas S, Rigakos G, Petinaki E, Tsiodras S, Hadjichristodoulou C. Environmental contamination of SARS-CoV-2 on surfaces, air-conditioner and ventilation systems. Int J Hyg Environ Health 2020; 230:113599. [PMID: 32823069 PMCID: PMC7425762 DOI: 10.1016/j.ijheh.2020.113599] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/17/2020] [Accepted: 07/19/2020] [Indexed: 12/23/2022]
Abstract
Background COVID-19 can be transmitted directly through respiratory droplets or indirectly through fomites. SARS-CoV-2 has been detected on various environmental surfaces, air samples and sewage in hospital and community settings. Methods Environmental samples were collected from a ferryboat during a COVID-19 ongoing outbreak investigation and a nursing home and from three COVID-19 isolation hospital wards and a long-term care facility where asymptomatic COVID-19 cases were isolated. Samples were tested by real-time reverse transcriptase–polymerase chain reaction. Results SARS-CoV-2 was detected on swab samples taken from surfaces of food preparation and service areas, hospital isolation wards, an air exhaust duct screen, air-conditioning filter, sewage treatment unit and air sample during investigations conducted in response to COVID-19 outbreaks on a ferryboat, nursing home, isolation facility and COVID-19 hospital wards. Discussion Food preparation areas and utensils can be contaminated during COVID-19 outbreaks. Respiratory droplets/nuclei from infected persons can be displaced by the air flow and deposited on surfaces. It can be assumed that in the same manner, air flow could transfer and deposit infected respiratory droplets/nuclei from infected persons to the mucous membranes of persons standing against the air flow direction.
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Affiliation(s)
| | - Michalis Koureas
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, Larisa, Greece
| | - Maria Kyritsi
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, Larisa, Greece
| | - Alexandros Vontas
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, Larisa, Greece
| | - Leonidas Kourentis
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, Larisa, Greece
| | - Spyros Sapounas
- Hellenic National Public Health Organization, Athens, Greece
| | - George Rigakos
- Hellenic National Public Health Organization, Athens, Greece
| | - Efthimia Petinaki
- Department of Microbiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Sotirios Tsiodras
- National and Kapodistrian University of Athens, Medical School, Athens, Greece
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16
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Koureas M, Kirgou P, Amoutzias G, Hadjichristodoulou C, Gourgoulianis K, Tsakalof A. Target Analysis of Volatile Organic Compounds in Exhaled Breath for Lung Cancer Discrimination from Other Pulmonary Diseases and Healthy Persons. Metabolites 2020; 10:metabo10080317. [PMID: 32756521 PMCID: PMC7464039 DOI: 10.3390/metabo10080317] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/29/2020] [Accepted: 07/31/2020] [Indexed: 02/07/2023] Open
Abstract
The aim of the present study was to investigate the ability of breath analysis to distinguish lung cancer (LC) patients from patients with other respiratory diseases and healthy people. The population sample consisted of 51 patients with confirmed LC, 38 patients with pathological computed tomography (CT) findings not diagnosed with LC, and 53 healthy controls. The concentrations of 19 volatile organic compounds (VOCs) were quantified in the exhaled breath of study participants by solid phase microextraction (SPME) of the VOCs and subsequent gas chromatography-mass spectrometry (GC-MS) analysis. Kruskal-Wallis and Mann-Whitney tests were used to identify significant differences between subgroups. Machine learning methods were used to determine the discriminant power of the method. Several compounds were found to differ significantly between LC patients and healthy controls. Strong associations were identified for 2-propanol, 1-propanol, toluene, ethylbenzene, and styrene (p-values < 0.001-0.006). These associations remained significant when ambient air concentrations were subtracted from breath concentrations. VOC levels were found to be affected by ambient air concentrations and a few by smoking status. The random forest machine learning algorithm achieved a correct classification of patients of 88.5% (area under the curve-AUC 0.94). However, none of the methods used achieved adequate discrimination between LC patients and patients with abnormal computed tomography (CT) findings. Biomarker sets, consisting mainly of the exogenous monoaromatic compounds and 1- and 2- propanol, adequately discriminated LC patients from healthy controls. The breath concentrations of these compounds may reflect the alterations in patient's physiological and biochemical status and perhaps can be used as probes for the investigation of these statuses or normalization of patient-related factors in breath analysis.
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Affiliation(s)
- Michalis Koureas
- Department of Hygiene and Epidemiology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, 41222 Larissa, Greece; (M.K.); (C.H.)
| | - Paraskevi Kirgou
- Respiratory Medicine Department, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece; (P.K.); (K.G.)
| | - Grigoris Amoutzias
- Bioinformatics Laboratory, Department of Biochemistry and Biotechnology, University of Thessaly, 41500 Larissa, Greece;
| | - Christos Hadjichristodoulou
- Department of Hygiene and Epidemiology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, 41222 Larissa, Greece; (M.K.); (C.H.)
| | - Konstantinos Gourgoulianis
- Respiratory Medicine Department, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece; (P.K.); (K.G.)
| | - Andreas Tsakalof
- Department of Hygiene and Epidemiology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, 41222 Larissa, Greece; (M.K.); (C.H.)
- Department of Biochemistry, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece
- Correspondence: ; Tel.: +30-2410685580
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17
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Dardiotis E, Aloizou AM, Sakalakis E, Siokas V, Koureas M, Xiromerisiou G, Petinaki E, Wilks M, Tsatsakis A, Hadjichristodoulou C, Stefanis L, Hadjigeorgiou GM. Organochlorine pesticide levels in Greek patients with Parkinson's disease. Toxicol Rep 2020; 7:596-601. [PMID: 32426240 PMCID: PMC7225589 DOI: 10.1016/j.toxrep.2020.03.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 03/23/2020] [Accepted: 03/25/2020] [Indexed: 12/21/2022] Open
Abstract
Background Parkinson’s disease (PD) is a neurodegenerative disease, mostly presenting with characteristic motor symptoms. Organochlorines (OC) are a class of widely-used pesticides that have been included among the list of environmental factors incriminated in PD pathogenesis. However, most studies reporting this association are based on questionnaires, and few have reported exposure data. Aim To examine the relationship between OC blood concentrations and PD risk. Methods In the present study, we studied the concentrations of 8 OC compounds (hexachlorobenzene, heptachlor, hepachlor epoxide, c-chlordane, a-chlordane, p,p’-DDE, DDD, DDT) in 104 Greek PD patients and 110 healthy controls. Results All substances studied were present in at least one sample. The most frequently detected (above the level of quantification) pesticides were p,p’-DDE (n = 214, 100 % of both groups) and hexachlorobenzene, HCB (n = 189, cases 46.5 %, controls 53.5 %). Higher levels of DDE were detected among PD patients in comparison to controls by using logistic regression analysis to control for confounders [Odds Ratio, OR (95 % confidence interval, C.I.)]: 2.592,(1.29–5.21)], whilst lower levels of HCB were detect among PD patients [OR,95 %CI:0.176(0.09−0.35)]. Conclusions Our data suggest that exposure to specific OCs is related to the risk of PD. Further studies, using real exposure data, are needed in order to confirm and extend these findings.
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Affiliation(s)
- Efthimios Dardiotis
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Athina-Maria Aloizou
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Evagelos Sakalakis
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Vasileios Siokas
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Michalis Koureas
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, 41222, Larissa, Greece
| | - Georgia Xiromerisiou
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Efthymia Petinaki
- Department of Microbiology, Medical School, University of Thessaly, Larissa, Greece
| | - Martin Wilks
- Swiss Centre for Applied Human Toxicology, University of Basel, CH‑4055, Basel, Switzerland
| | - Aristidis Tsatsakis
- Center of Toxicology Science & Research, Medical School, University of Crete, 71003, Heraklion, Crete, Greece
| | - Christos Hadjichristodoulou
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, 41222, Larissa, Greece
| | - Leonidas Stefanis
- 1stDepartment of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, 72-74 Vas.Sophias Ave, 11528, Athens, Greece
| | - Georgios M Hadjigeorgiou
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece.,Department of Neurology, Medical School, University of Cyprus, Nicosia, Cyprus
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18
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Koureas M, Rousou X, Haftiki H, Mouchtouri VA, Rachiotis G, Rakitski V, Tsakalof A, Hadjichristodoulou C. Spatial and temporal distribution of p,p'-DDE (1‑dichloro‑2,2‑bis (p‑chlorophenyl) ethylene) blood levels across the globe. A systematic review and meta-analysis. Sci Total Environ 2019; 686:440-451. [PMID: 31181528 DOI: 10.1016/j.scitotenv.2019.05.261] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 04/26/2019] [Accepted: 05/17/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Although p,p'‑DDT (1,1,1‑trichloro-2,2‑bis (p‑chlorophenyl)‑ethane) has been banned for decades in most countries, its major metabolite p,p'-DDE (1‑dichloro‑2,2‑bis (p‑chlorophenyl) ethylene) is still detected in the vast majority of human blood samples. OBJECTIVES The purpose of this study was to quantitatively estimate the geographical distribution of DDE blood levels and record time-trends for specific countries and continents, exploiting available data from the scientific literature. METHODS A literature search was performed in SCOPUS and PUBMED databases. Studies were screened at 2 levels applying different sets of inclusion/exclusion criteria. Blood levels of DDE along with other variables of interest were extracted, and a meta-analysis of random effects was conducted, by using the package metafor within the statistical programming language R. Results were expressed as pooled geometric means (GM [95% confidence intervals, CIs]). RESULTS A total of 418 papers were included in the quantitative synthesis that contained data for 854 population subgroups, and analyzed a total of 195,595 samples. Overall global DDE concentrations dropped from 5207 (95% CI: 3616-7499) ng/g lipids during 1951-1969 to 207 (95% CI: 159-269) ng/g lipids for studies reporting sampling after 2000. Analyses for studies published from 2001 and onward revealed geographical differences regarding DDE burden. DISCUSSION The significant decline in DDE blood levels after its restriction is demonstrated in our results. Differences in decrease trends were observed in different parts of the globe, which can be explained by deferred implementation of environmental policies. In some countries DDE concentrations remain high, and systematic biomonitoring is proposed.
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Affiliation(s)
- M Koureas
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, Larissa 41222, Greece
| | - X Rousou
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, Larissa 41222, Greece
| | - H Haftiki
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, Larissa 41222, Greece
| | - V A Mouchtouri
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, Larissa 41222, Greece
| | - G Rachiotis
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, Larissa 41222, Greece
| | - V Rakitski
- Russian Institute for Pesticides Hygiene, Toxicology and Chemical Safety, Russia
| | - A Tsakalof
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, Larissa 41222, Greece; Department of Biochemistry, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - C Hadjichristodoulou
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, Larissa 41222, Greece.
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19
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Koureas M, Rachiotis G, Tsakalof A, Hadjichristodoulou C. Increased Frequency of Rheumatoid Arthritis and Allergic Rhinitis among Pesticide Sprayers and Associations with Pesticide Use. Int J Environ Res Public Health 2017; 14:ijerph14080865. [PMID: 28763046 PMCID: PMC5580569 DOI: 10.3390/ijerph14080865] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 07/28/2017] [Accepted: 07/29/2017] [Indexed: 12/26/2022]
Abstract
Objective: The aim of this study was to identify diseases linked with the pesticide sprayer occupation and explore possible associations with exposure history data. Methods: A cross sectional study was conducted among pesticide sprayers (n = 80) and the general population (n = 90) in Thessaly (Greece). Medical history, demographic characteristics and detailed exposure history were recorded by conducting personal interviews. Lifetime exposure indicators were calculated for several pesticide chemical subclasses. Moreover, organophosphate metabolite levels were quantified in urine samples of all participants by using gas chromatography-mass spectrometry (GC-MS). Multinomial analysis was used to determine associations between occupational pesticide exposure and diseases or disorders. Results: In the pesticide sprayers group, significantly higher frequencies for rheumatoid arthritis (RA) and allergic rhinitis were observed compared with the control group (p = 0.002 and p = 0.024 respectively). Within the pesticide sprayers group, high lifetime pesticide exposure was associated with increased risk for reporting RA (OR: 43.07 95% CI: 3.09–600.67) and allergic rhinitis (OR: 9.72 95% CI: 2.31–40.89), compared with low pesticide exposure. Exposure to organophsphate, guanidine and quinone pesticides were associated with RA while organophosphates, pyrethroids and paraquat were associated with allergic rhinitis. Despite the higher levels of certain pesticide metabolites observed among participants with rheumatoid arthritis, the differences were not statistically significant. One metabolite (diethylthiophosphate) was found to be significantly increased in allergic rhinitis cases (p = 0.037). Conclusions: The results from the current study suggest a possible association of occupational pesticide exposure with RA and allergic rhinitis that should be further investigated.
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Affiliation(s)
- Michalis Koureas
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, 41222 Larissa, Greece.
| | - George Rachiotis
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, 41222 Larissa, Greece.
| | - Andreas Tsakalof
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, 41222 Larissa, Greece.
| | - Christos Hadjichristodoulou
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, 41222 Larissa, Greece.
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20
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Tsakalof A, Koureas M, Karagkouni F, Rakitskii V, Hadjichristodoulou C, Tsatsakis A. Population biomonitoring for the exposure to organochlorine pesticides in Thessaly, Greece. Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.06.1796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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21
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Koureas M, Karagkouni F, Rakitskii V, Hadjichristodoulou C, Tsatsakis A, Tsakalof A. Serum levels of organochlorine pesticides in the general population of Thessaly, Greece, determined by HS-SPME GC-MS method. Environ Res 2016; 148:318-321. [PMID: 27107243 DOI: 10.1016/j.envres.2016.04.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 04/09/2016] [Accepted: 04/12/2016] [Indexed: 06/05/2023]
Abstract
In this study, exposure levels of organochlorine pesticides (OCs) were determined in general population residing in Larissa, central Greece. Serum samples from 103 volunteers were analyzed by optimized headspace solid-phase microextraction gas chromatography-mass spectrometry, to detect and quantify OC levels. The most frequently detected analytes were p,p'-DDE (frequency 99%, median:1.25ng/ml) and Hexachlorobenzene (HCB) (frequency 69%, median: 0.13ng/ml). Statistical analysis revealed a significant relationship of p,p'-DDE and HCB levels with age.
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Affiliation(s)
- Michalis Koureas
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, Larissa 41222, Greece
| | - Foteini Karagkouni
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, Larissa 41222, Greece
| | - Valerii Rakitskii
- Federal Scientific Center of Hygiene named after F.F. Erisman, Mitischy, Russia
| | - Christos Hadjichristodoulou
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, Larissa 41222, Greece
| | - Aristidis Tsatsakis
- Laboratory of Toxicology, University of Crete, Medical School, Crete 71409, Greece
| | - Andreas Tsakalof
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, Larissa 41222, Greece.
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22
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Koureas M, Tsezou A, Tsakalof A, Orfanidou T, Hadjichristodoulou C. Increased levels of oxidative DNA damage in pesticide sprayers in Thessaly Region (Greece). Implications of pesticide exposure. Sci Total Environ 2014; 496:358-364. [PMID: 25089694 DOI: 10.1016/j.scitotenv.2014.07.062] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 07/17/2014] [Accepted: 07/17/2014] [Indexed: 06/03/2023]
Abstract
The widespread use of pesticides substances nowadays largely guarantees the protection of crops and people from undesired pests. However, exposure to pesticides was related to a variety of human health effects. The present study was conducted in the region of Thessaly which is characterized by intensive agricultural activities and wide use of pesticides. The study aimed at estimating the oxidative damage to DNA in different subpopulations in Thessaly region (Greece) and investigating its correlation with exposure to pesticides and other potential risk factors. In total, the study involved 80 pesticide sprayers, 85 rural residents and 121 individuals, inhabitants of the city of Larissa. Demographic characteristics, habits, medical history and exposure history of the participants to pesticides were recorded by personal interviews. Blood and urine samples were collected from all participants. For the measurement of exposure to organophosphorus insecticides, dialkylphosphate (DAP) metabolites were quantified in urine, by gas chromatography-mass spectrometry. Genomic DNA was extracted from peripheral blood samples and the oxidation by-product 8-hydroxydeoxyguanosine (8-OHdG) was determined by Enzyme Immuno-Assay. Urinary metabolite concentrations were not associated with 8-OHdG levels but it was found that pesticide sprayers had significantly higher levels of 8-OHdG (p=0.007) in comparison to the control group. Last season's exposure to insecticides and fungicides, expressed as total area treated multiplied by the number of applications, showed a statistically significant association with the risk of having high 8-OHdG levels [RR: 2.19 (95%CI:1.09-4.38) and RR: 2.32 (95% CI:1.16-4.64) respectively]. Additionally, from the subgroups of pesticides examined, seasonal exposure to neonicotinoid insecticides [RR: 2.22 (95% CI:1.07-4.63)] and glufosinate ammonium [RR: 3.26 (95% CI:1.38-7.69)] was found to have the greater impact on 8-OHdG levels. This study produced findings that support the hypothesis that pesticide exposure is involved in the induction of oxidative damage to DNA and identified chemical groups of pesticides which should be given greater attention in future investigations.
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Affiliation(s)
- Michalis Koureas
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, Larissa 41222, Greece
| | - Aspasia Tsezou
- Laboratory of Cytogenetics and Molecular Genetics, University of Thessaly, School of Medicine, Larissa, Greece
| | - Andreas Tsakalof
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, Larissa 41222, Greece; Department of Chemistry, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Timoklia Orfanidou
- Department of Biomedical Research and Technology, Institute for Research and Technology-Thessaly (I.RE.TE.TH), 51 Papanastasiou Street, Larissa 41222, Greece
| | - Christos Hadjichristodoulou
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakyriazi Street, Larissa 41222, Greece.
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Malissiova E, Tsakalof A, Arvanitoyannis I, Katsafliaka A, Katsioulis A, Tserkezou P, Koureas M, Govaris A, Hadjichristodoulou C. Monitoring Aflatoxin M1 levels in ewe's and goat's milk in Thessaly, Greece; potential risk factors under organic and conventional production schemes. Food Control 2013. [DOI: 10.1016/j.foodcont.2013.04.035] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Koureas M, Tsakalof A, Tzatzarakis M, Vakonaki E, Tsatsakis A, Hadjichristodoulou C. Biomonitoring of organophosphate exposure of pesticide sprayers and comparison of exposure levels with other population groups in Thessaly (Greece). Occup Environ Med 2013; 71:126-33. [DOI: 10.1136/oemed-2013-101490] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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25
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Kokouva M, Koureas M, Dardiotis E, Almpanidou P, Kalogeraki A, Kyriakou D, Hadjigeorgiou GM, Hadjichristodoulou C. Relationship between the paraoxonase 1 (PON1) M55L and Q192R polymorphisms and lymphohaematopoietic cancers in a Greek agricultural population. Toxicology 2013; 307:12-6. [DOI: 10.1016/j.tox.2012.07.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Revised: 07/04/2012] [Accepted: 07/06/2012] [Indexed: 11/26/2022]
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