**1. Introduction**

Coronavirus-disease-19 (COVID-19), the disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has evolved into a pandemic with tremendous effects on public health, world economy, and quality of life of every individual [1]. The disease spreads from human to human primarily through droplet and direct contact and has an incubation period of 2 to 14 days [2]. Health care workers (HCWs) are in the front line of COVID-19 patients' management, thus, they are facing constantly higher risk of infection than the wider community [3]. On the other hand, COVID-19 has affected quality of life, psychological condition, and training of HCWs, as shown in recent studies [4–7]. Several recommendations have been published from national and international societies, such as

**Citation:** Ioannou, P.; Karakonstantis, S.; Mathioudaki, A.; Sourris, A.; Papakosta, V.; Panagopoulos, P.; Petrakis, V.; Papazoglou, D.; Arvaniti, K.; Trakatelli, C.M.; et al. Knowledge and Perceptions about COVID-19 among Health Care Workers: Evidence from COVID-19 Hospitals during the Second Pandemic Wave. *Trop. Med. Infect. Dis.* **2021**, *6*, 136. https://doi.org/10.3390/ tropicalmed6030136

Academic Editors: Peter A. Leggat, John Frean and Lucille Blumberg

Received: 31 May 2021 Accepted: 16 July 2021 Published: 19 July 2021

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the World Health Organization (WHO) regarding the prevention and control of COVID-19 for HCWs [8]. However, misunderstandings among HCWs may negatively impact the delivery of appropriate care to COVID-19 patients and increase the risk of transmission of the virus. Additionally, knowledge gaps may affect the perceptions of HCWs, certainly depending on their beliefs and past experiences [9,10]. Except of few studies performed during the first wave of the pandemic, the level and quality of knowledge and the global perceptions of HCWs regarding COVID-19 have not been extensively studied [11].

The aim of the study was to explore the knowledge and perceptions of HCWs in COVID-19 tertiary hospitals of distal geographical regions in Greece regarding COVID-19 issues during the second wave of the pandemic. In addition, we aimed to explore the beliefs and practices of HCWs concerning personal protection equipment matters.

#### **2. Materials and Methods**

### *2.1. Study Design*

This is a cross-sectional survey conducted from 21 October 2020 to 31 January 2021 in four tertiary care COVID-19 hospitals in four metropolitan areas in Greece. All HCWs were eligible to participate.

A printed questionnaire was developed by a team of infectious disease specialists, fellows, and internists. It consisted of 36 items, including close-ended, multiple choice, and Likert-scale questions, divided as follows: 6 on demographics and practice-related information, 4 regarding knowledge on COVID-19, 7 regarding personal beliefs on COVID-19, 7 regarding infection control measures, 3 regarding daily practice for COVID-19 patients and issues, 2 regarding COVID-19 vaccination, and 7 regarding medical evidence on COVID-19. The questionnaire is available as Supplementary Material.

#### *2.2. Participation and Ethical Approval*

Participation was voluntary, anonymous, and without compensation. Invitation to participate was through direct contact with a study investigator. Informed consent was distributed concomitantly with the questionnaire. The study was approved by the Ethical Committee of the University Hospital of Heraklion.
