The available coronavirus disease 2019 (COVID-19) vaccines have shown their effectiveness in clinical trials. We aimed to assess the real-world effects of SARS-CoV-2 vaccinations in Greece. We combined national data on vaccinations, SARS-CoV-2 cases, COVID-19-related ICU admissions and COVID-19-related deaths. We observed 3,367,673 vaccinations (30.68% of the Greek population), 278,821 SARS-CoV-2 infections and 7401 COVID-19-related deaths. The vaccination rate significantly increased from week 2 to week 6 by 85.70%, and from week 7 to 25 by 15.65%. The weekly mean of SARS-CoV-2 cases, COVID-19 ICU patients and COVID-19 deaths markedly declined as vaccination coverage accumulated. The rate of SARS-CoV-2 cases increased significantly from week 2 to week 13 by 16.15%, while from weeks 14–25 the rate decreased significantly by 13.50%. The rate of COVID-19-related ICU admissions decreased significantly by 7.41% from week 2 to week 4, increased significantly by 17.22% from weeks 5–11, then decreased significantly from weeks 17–20, by 11.99%, and from weeks 21–25, by 16.77%. The rate of COVID-19-related deaths increased significantly from week 2 to week 15 by 12.08% and decreased significantly by 16.58% from weeks 16–25. The data from this nationwide observational study underline the beneficial impact of the national vaccination campaign in Greece, which may offer control of the SARS-CoV-2 pandemic.

Background: The coronavirus disease in 2019 (COVID-19) heavily hit Italy, one of Europe’s most polluted countries. The extent to which PM pollution contributed to COVID-19 diffusion is needing further clarification. We aimed to investigate the particular matter (PM) pollution and its correlation with COVID-19 incidence across four Italian cities: Milan, Rome, Naples, and Salerno, during the pre-lockdown and lockdown periods. Methods: We performed a comparative analysis followed by correlation and regression analyses of the daily average PM10, PM2.5 concentrations, and COVID-19 incidence across four cities from 1 January 2020 to 8 April 2020, adjusting for several factors, taking a two-week time lag into account. Results: Milan had significantly higher average daily PM10 and PM2.5 levels than Rome, Naples, and Salerno. Rome, Naples, and Salerno maintained safe PM10 levels. The daily PM2.5 levels exceeded the legislative standards in all cities during the entire period. PM2.5 pollution was related to COVID-19 incidence. The PM2.5 levels and sampling rate were strong predictors of COVID-19 incidence during the pre-lockdown period. The PM2.5 levels, population’s age, and density strongly predicted COVID-19 incidence during lockdown. Conclusions: Italy serves as a noteworthy paradigm illustrating that PM2.5 pollution impacts COVID-19 spread. Even in lockdown, PM2.5 levels negatively impacted COVID-19 incidence.

One of the major mediators of neuroinflammation in PD is tumour necrosis factor alpha (TNF-α), which, similar to other cytokines, is produced by activated microglia and astrocytes. Although TNF-α can be neuroprotective in the brain, long-term neuroinflammation and TNF release can be harmful, having a neurotoxic role that leads to death of oligodendrocytes, astrocytes, and neurons and, therefore, is associated with neurodegeneration. Apart from cytokines, a wide family of molecules with homologous structures, namely chemokines, play a key role in neuro-inflammation by drawing cytotoxic T-lymphocytes and activating microglia. The objective of the current study was to examine the levels of the serum TNF-α and CCL2 (Chemokine (C-C motif) ligand 2), also known as MCP-1 (Monocyte Chemoattractant Protein-1), in PD patients compared with healthy controls. We also investigated the associations between the serum levels of these two inflammatory mediators and a number of clinical symptoms, in particular, disease severity and cognition. Such an assessment may point to their prognostic value and provide some treatment hints. PD patients with advanced stage on the Hoehn–Yahr scale showed an increase in TNF-α levels compared with PD patients with stages 1 and 2 (p = 0.01). Additionally, the UPDRS score was significantly associated with TNF-α levels. CCL2 levels, however, showed no significant associations.

Background Pulmonary embolism (PE) epidemiological data about the disease prevalence in the general population are unclear. The present study aims to investigate the prevalence of PE in Greece and the associated temporal trends for the years 2013–2017. Methods Data on medical prescriptions for PE in the years 2013–2017 were provided by the Greek National Health Service Organization (EOPYY). Data on age, gender, specialty of the prescribing physician and prescription unit were provided as well. Results The total number of medical prescriptions for PE for the study period was 101,426. Of the total prescriptions, 51% were issued by the Public Sector and 48% by the Private Sector. In 2013 the prevalence of PE was 5.43 cases per 100,000 citizens and increased constantly until 2017 with 23.79 cases per 100,000 population. Prevalence was higher in all years studied in the age group of 70–80 years. For the year 2017, we observed 69.35 cases per 100,000 population for subjects 70–80 years, followed by the ages 80–90 (60.58/100,000) and 60–70 years (56.47 /100,000). Females displayed higher PE prevalence than males and higher increasing trend. Conclusion PE prevalence has an increasing trend throughout the years 2013–2017 while prevalence in females is higher than males and displays a higher increasing trend. Our results may be used to appropriately organize nationwide health care campaigns aiming at the diagnosis, treatment and prevention of PE.

BackgroundMortality due to Parkinson's disease (PD) and its long-term trends worldwide in recent decades remain unknown. No previous studies have simultaneously studied age- and sex-specific mortality trends at a population level worldwide. Insights gained from this study can help identify high-risk populations and inform healthcare service requirements for managing Parkinson's disease globally.ObjectivesThe aim of the study was to examine trends in mortality from Parkinson's disease by age-group and sex across countries all over the world. In this study, we used worldwide registry data to examine the temporal trends in PD mortality across most counties of the world from 1994 to 2019 using joinpoint regression.ResultsIn data from vital registration systems, huge variations in the patterns of deaths due to Parkinson's disease were observed both over time and between countries. Between 1994 and 2019, there was a significant increase in mortality rates globally in both men and women. In more detail, the mortality rate (per 100,000) in 1994 was 1.76 and reached 5.67 in 2019. Greater increases in mortality were seen in men than in women; and in older than in younger people.ConclusionsThere has been a striking rising trend in Parkinson's disease mortality globally. Persistent age and sex disparities are found in Parkinson's disease mortality trends. Our findings may have important implications for future research, healthcare planning, and provision.

Background: The pandemic of coronavirus disease 2019 (COVID-19) is a global issue. The relationships between temperature and incidence, transmission, or survival of many enveloped coronaviruses such as severe acute respiratory syndrome (SARS), and Middle East respiratory syndrome (MERS) have been previously widely investigated. However, there has been a lively debate in the literature over whether higher temperatures modulate coronaviruses’ infectivity and spreading, which sets a fertile ground for research on a global scale. In this study, we aimed to investigate the relationship between day-to-day temperature variability and daily COVID-19 incidence rate, as well as the time is taken to reach the total number of 200 confirmed COVID-19 cases within the worst-hit countries by the pandemic. Methods: A within and among countries analysis of the relationship between daily fluctuations in the number of new confirmed COVID-19 cases and temperature for the period starting from 31st December 2019 to 29th March 2020, was conducted. The 46 worst-hit countries by the pandemic were included in the analysis.Results: What emerges from our results is that daily new COVID-19 cases were negatively correlated with daily temperature variation. Moreover, higher temperatures were positively correlated with a longer time to reach a standard number of confirmed COVID-19 cases within countries. Notably, countries with daily average temperatures below 20°C had a faster transmission rate than countries with higher daily average temperatures. Conclusions: Our study provides further insights into the hypothesis that there is an association between temperature and rate of COVID-19 spread within a country.

BackgroundPulmonary embolism (PE) is a potentially life-threatening disease with both physical and psychological impacts. The psychological distress in the early phase of the disease has not been previously studied in the literature. MethodsThe study sample included patients with PE with or without deep vein thrombosis. All subjects included in the study prospectively completed the Symptom Checklist-90-R (SCL-90-R) questionnaire, the Heartland Forgiveness Scale (HFS), and the Self-Compassion Scale (SCS) during their hospitalization for PE. ResultsForty-four PE patients were included in the study (59.1% males). The mean age was 62.27±15.03 years. The majority (77.3%) had at least one comorbidity with 9.1% previously diagnosed with depression. The Total Global Severity Index (GSI) score for SCL-90-R was 82.42±49.70 while 36.4% of subjects had a high "Obsessive-compulsive" score, 22.7% had a high "Depression" score, and 22.7% presented a high "Hostility" score. The total HFS score was 45.54±40.42 with 54.5% of patients classified as "usually forgiving." The mean SCS score was 2.05±0.65 with 59.1% of patients presenting moderate self-compassion while 18.2% had low self-compassion. The total SCS score was correlated with the total GSI score (p=0.005, r=-0.576) and total HFS score (p=0.005, r=0.675). The SCS Self-kindness score correlated with interpersonal sensitivity (p=0.024, r=-0.479), depression (p=0.008, r=-0.551), and GSI score (p=0.049, r=-0.425). Self-judgement correlated with paranoid ideation (p=0.044, r=-0.467), hostility (p=0.007, r=-0.597), and GSI (p=0.027, r=-0.505). Isolation correlated with interpersonal sensitivity (p=0.026, r=-0.509), anxiety (p=0.014, r=-0.553), hostility (p=0.032, r=-0.494), paranoid ideation (p=0.026, r=-0.509), and GSI (p=0.015, r=-0.548). The total SCS score correlated with anxiety (p=0.041, r=-0.438). SCS Self-kindness score correlated significantly with total HFS score (p=0.002, r=0.613), forgiveness of self (p=0.011, r=0.528), forgiveness of others (p=0.008, r=0.550), and forgiveness of situations (p=0.004. r=0.587). Common humanity was significantly correlated with total HFS score (p=0.023, r=0.481), forgiveness of others (p=0.033, r=0.456), and forgiveness of situations (p=0.016, r=0.507). Mindfulness was positively correlated with HFS total score (p=0.009, r=0.544), forgiveness of self (p=0.049, r=0.424), forgiveness of others (p=0.012, r=0.525), and forgiveness of situations (p=0.013, r=0.520). ConclusionsWe report for the first time that patients acutely hospitalized for PE present symptoms of obsessivecompulsive disorder, depression, and hostility and exhibit moderate self-compassion. The marginal majority of PE patients are "usually forgiving" during the acute phase of the disease. Self-compassion is positively associated with forgiveness and negatively associated with psychiatric symptoms. Further studies are warranted in order to assess longitudinal differences in psychometric scores and the possible result of targeted mental health interventions at PE-specific clin...

Since the emergence of the SARS-CoV-2 Omicron variant, many issues have arisen. We report SARS-CoV-2 vaccinations, SARS-CoV-2 cases and COVID-19 outcomes in Greece during weeks 2–26 of 2021 (Alpha variant period), weeks 27–51 of 2021 (Delta variant period) and week 51 of 2021 to week 27 of 2022 (Omicron variant period). The average weekly cases were higher during the Omicron period vs. the Delta (25,354.17 cases/week) and Alpha periods (11,238.48 cases/week). The average weekly vaccinations were lower in the Omicron period (26,283.69/week) than in the Alpha and Delta period. Joinpoint regression analysis identified that the trend of SARS-CoV-2 cases increased by 88.5% during the rise of the Omicron wave in Greece. The trend of the intensive care unit (ICU) admissions related to COVID-19 decreased by 5.0% immediately after the rise of Omicron while the trend of COVID-19-related deaths decreased by 8.1% from the 5th week of the Omicron wave until the end of the study. For vaccinations, an increasing trend of 8.3% was observed in the first half of 2021 (weeks 18–25/2021), followed by a decreasing trend in weeks 26–43/2021. For the weeks before and during the early rise of Omicron (44/2021–1/2022), we identified an increasing trend of 10.7% and for weeks 2–27/2022 we observed a decreasing trend of 18.1%. Unfortunately, we do not have available data about the vaccination status of the SARS-CoV-2 cases, ICU admissions or deaths. Our findings suggest that the Omicron variant is associated with increased transmissibility and reduced morbidity and mortality despite the previous increase in the trend of SARS-CoV-2 vaccinations.