Parental COVID-19 Vaccine Hesitancy for Children in Romania: National Survey

Analysis regarding the impact of 'fake news' on the quality of life of the population in a region affected by earthquake activity. The case of Romania-Northern Oltenia

Purpose

The study aims to examine the impact of the wave of seismic activity in the northern region of Oltenia (Gorj County, Romania) in February 2023 and the belief in 'fake news' (circulated regarding causality, manifestations, and future developments of the seismic activity) on the quality of life of the affected population. It was considered opportune to conduct this study, given the novelty of such a situation, as the mentioned geographical area is not known to have a high seismic risk.

Methods

The study was built based on the questionnaire to which 975 respondents, present/residing in Gorj County during the earthquakes and at least 14 days after, and with a minimum age of 18 years, responded. The data was collected between February 27, 2023, and March 31, 2023, at a reasonable time interval from the recording of the first seismic event in the region, assuming that the respondents' opinions regarding the negative impact of seismic events on societal life are well crystallized. The aim was to obtain information and analyze it in order to establish the respondents' perception regarding the negative effects of seismic activity and the elements of "fake news" promoted in this context on the quality of life of individuals in the region.

Results

Our study indicates that individuals who are not concerned, due to their disbelief in "fake news" information, about the possibility of new strong earthquakes in the mentioned area feel the best physically, having an average satisfaction level of 82.80 (with a standard deviation of 19.70) on the WHOQOL-BREF scale. On the other hand, those who believed in the fake news experienced the lowest levels of psychological well-being, with an average satisfaction of 60.80 (and a standard deviation of 21.98). The WHOQOL-BREF is an instrument that assesses the quality of life across four distinct domains, and this study emphasizes the importance of accurate and trustworthy information for people's well-being.

Conclusion

The results of the study highlight that the quality of life indicators of people in the geographic area affected by the wave of seismic movements are negatively impacted due to the release of "fake news" in the public domain regarding the cause of seismic movements in Gorj county (and the previous earthquakes in Turkey) and their future manifestations and developments (the possibility of high magnitude seismic movements), as well as the lack of information provided by the public authorities on the issue at hand (causes, effects, future manifestations, management measures).

Quality of life three months post‑stroke among stroke patients and their caregivers in a single center study from Romania during the COVID‑19 pandemic: A prospective study

The aim of the present study was to determine the health-related quality of life of stroke patients and their caregivers during the fifth wave of the COVID-19 pandemic. A total of 70 patients who had been diagnosed with stroke between October 2021 and March 2022 and 70 caregivers were included in the present study. A prospective follow-up study assessing the quality of life at baseline was conducted after 3 months for both patients and their caregivers. A linear regression analysis was performed to evaluate potential associations between quality of life and assessed factors. The results revealed that age, sex, employment status, hospitalization period, type of stroke, Barthel index for activities of daily living (ADL) and discharge Modified Rankin Scale (mRS), were significant determinants of the 90-day Health-Related Quality of Life (HRQoL). An important clinical change in the QoL score was estimated for both post-stroke patients and their caregivers. The decrease of the HRQoL of patients was statistically influenced by a higher value of ADL (P=0.014), whereas, in the case of their caregivers, the decrease of HRQoL was primarily influenced by the QoL of patients after 3 months (P=0.043). The present study identified some important key factors with direct consequences on HRQoL regarding stroke survivors and their caregivers.

The Impact of the COVID-19 Pandemic on Outcomes in Acute Pancreatitis: A Propensity Score Matched Study Comparing before and during the Pandemic

We aimed to evaluate the outcomes and survival of patients with acute pancreatitis who shared the same clinical form, age, and sex before the pandemic, during the pandemic, and among those with confirmed COVID-19 infection upon hospital admission. This consideration used the sparse data in the existing literature on the influence of the pandemic and COVID-19 infection on patients with acute pancreatitis. To accomplish this, we conducted a multicentric, retrospective case-control study using propensity score matching with a 2:1 match of 28 patients with SARS-CoV-2 infection and acute pancreatitis, with 56 patients with acute pancreatitis pre-pandemic, and 56 patients with acute pancreatitis during the pandemic. The study outcome demonstrated a six-fold relative risk of death in patients with acute pancreatitis and SARS-CoV-2 infection compared to those with acute pancreatitis before the pandemic. Furthermore, restrictive measures implemented during the pandemic period led to a partial delay in the care of patients with acute pancreatitis, which likely resulted in an impairment of their immune state. This, in certain circumstances, resulted in a restriction of surgical treatment indications, leading to a three-fold relative risk of death in patients with acute pancreatitis during the pandemic compared to those with acute pancreatitis before the pandemic.

Has COVID-19 Modified the Weight of Known Systemic Inflammation Indexes and the New Ones (MCVL and IIC) in the Assessment as Predictive Factors of Complications and Mortality in Acute Pancreatitis?

We aimed at evaluating the prognostic capacity of the inflammatory indices derived from routine complete blood cell counts in two groups of patients with acute pancreatitis from two different time periods, before and during the COVID-19 pandemic, when a high incidence of complications with surgical risk and mortality was found. Two new markers were introduced: the mean corpuscular volume to lymphocyte ratio (MCVL) and the cumulative inflammatory index (IIC), which were calculated at a baseline in the two groups of patients. Of the already established markers, none of them managed to effectively predict the complications with surgical risk and mortality, with a decrease of less than 50% in specificity in the peri-COVID group. The MCVL had the best prediction of complications with surgical risk in both the pre-COVID and peri-COVID groups, validated it as an independent factor by multivariate analysis. The IIC had the best prediction of mortality in both periods and was proven to be an independent factor by multivariate analysis. As the IIC predicted death best, we tested the occurrence of death and found that patients with PA who had an IIC > 12.12 presented a risk of death 4.08 times higher in the pre-COVID group and 3.33 times higher in the peri-COVID group. The new MCVL and IIC independent markers had a superior sensitivity and specificity in predicting surgical risk complications and, respectively, mortality in the group of patients with acute pancreatitis during the COVID-19 pandemic, which makes them widely applicable in populations with modified immune and inflammatory status. Conclusions: In patients with acute pancreatitis, MCVL has a significant predictive value regarding complications with surgical risk (abscess, necrosis, and pseudocyst), and the IIC has a significant predictive value for mortality.

Study on the Vaccination of the Population of Romania against Monkeypox in Terms of Medical Security

Although it has been shown in numerous studies that immunization of the population by vaccination is the most effective way to protect against smallpox or other polioviruses, the anti-vaccination public rhetoric recorded during the COVID-19 pandemic is likely to influence the populations acceptance of vaccination against newly emerging viruses. This fact influenced our decision to study the vaccination of the Romanian population against the virus that causes monkeypox, aiming to identify the degree of compliance regarding the decision related to vaccination acceptance/non-acceptance/hesitation, based on the survey of a representative sample of respondents. The study is based on an online questionnaire completed between 1 July and 31 July 2022 by 820 individuals, aged 18 years or above, with a permanent residency in Romania. The study was undertaken in order to observe the attitudes of the respondents regarding the acceptance, refusal, or hesitation of vaccination against monkeypox. The sociological data resulting from the application of the questionnaire on 820 people highlighted that 97.16% were vaccinated with the vaccines of the national mandatory scheme and 53.32% were vaccinated with the optional vaccines (rotavirus vaccine, anti-hepatitis A, meningococcal vaccine, etc.). Although 47.13% of respondents considered monkeypox to be a real problem facing humanity today, only 26.37% of those surveyed expressed their fear of becoming infected, and 29.30% were willing to immunize themselves against the virus by vaccination. Only 19.59% of respondents believed that the monkeypox disease will generate a new global pandemic, while 31.86% considered pandemics to be a human security issue, and 30.28% expressed their desire to accept a reduction in some rights and freedoms, in the short term, for the adoption of institutional measures to combat a possible pandemic caused by monkeypox. The study clearly highlights the fact that monkeypox is perceived as a threat to the health of the population, with relatively low acceptance of conspiracy theories regarding its origins/manifestation/consequences among respondents (between 21.7% and 28.9%). The vaccination of the population against monkeypox is strongly influenced by the validity of the results obtained over time, in the vaccination campaigns against the smallpox virus (vaccine found in the mandatory vaccination scheme in Romania until 1979). We believe that the negative public rhetoric regarding the COVID-19 vaccination is likely to negatively influence monkeypox vaccination. Although specialized studies and practical results showed that the immunization of the population through vaccination represents an important vector in the prevention/management of pandemic-type issues, we believe that a national pro-vaccination campaign, based on scientific evidence, can lead the population to accept vaccination when the epidemiological context requires it. We also believe that a culture of health security needs to be developed among citizens to raise awareness of the role of vaccines as an important vector in the field of population health.

Survey upon the Reasons of COVID-19 Vaccination Acceptance in Romania

Aim: The present study aims to observe the reasons for which the participants have chosen to uptake one of the COVID-19 vaccines approved in Romania. Thus, it will help us to determine whether the reasons are medical in nature, with the respondents’ scope to stay healthy, or if there are other motivations. High rates of vaccine acceptance are essential in the struggle against the COVID-19 pandemic, and trust indicators in other inoculations may be vital for the good management of the vaccination campaign. Methods: The research consisted in applying an online questionnaire in the period January–March 2022 during the fifth wave of COVID-19. The individuals in the target group had to comply with three conditions: they should be inoculated, at least 18 years of age and Romanian residents. The questionnaire was administered to 2297 people and structured to obtain socio-demographic data, determine confidence in mandatory and optional vaccines (rotavirus, hepatitis A, meningococcal vaccine, etc.) and extract the reasons why respondents chose to be vaccinated. Results: The data extracted from the questionnaire reveal a high rate of confidence of participants in the vaccines included in the national vaccination scheme (98.6%) and in the optional vaccines other than anti-COVID-19 (97.2%). Of the respondents, 23.4% had at least one positive test for COVID-19. Although the entire sample is vaccinated against the SARS-CoV-2 virus, the reasons behind the decision to vaccinate are not only medical in nature, thus, 18.3% were motivated by “protecting their own health/protection against the virus”, 17% due to “fear of the disease”, 8.8% for getting back to normal life and ending the pandemic and 8.5% due to government restrictions/vaccination certificate. Conclusions: In our study, we were able to validate the research hypothesis that the reasons for vaccine acceptance are multiple and not only medical (health protection, existing co-morbidities, etc.) and to show that although vaccination has been accepted, some participants believe in conspiracy theories, including those that try to convince people of the harmfulness of the vaccine. In addition, by applying Pearson, Kendall and Spearman correlation tests, we observed that indicators showing high confidence in optional vaccines relate strongly with the decision to vaccinate against COVID-19.