The Impact of Different Types of Diet on the Prevention of Diseases among Polish Inhabitants, Including COVID-19 Disease

Proper nutrition may help in preventing deaths or at least alleviating the symptoms of many chronic diseases. While the COVID-19 disease was still taking its toll, the world had to adjust to new life conditions, which could change nutritional habits. In this observational, cross-sectional study, we aimed to identify the potential correlations between sociodemographic factors and diet and the presence of common chronic diseases among Polish inhabitants. Furthermore, we tried to determine whether the COVID-19 pandemic led to changes in nutritional habits. Therefore, based on the online study (the National Test for Poles' Health (NTPH), we collected data from 376,102 and 200,000 respondents in two different time frames (before the COVID-19 pandemic: 2019-2020 and during the COVID-19 pandemic: 2021-2022, respectively). Despite the rapid global rise of the COVID-19 pandemic, among our study group, hypertension was still the most commonly occurring disease in both time frames (32.33% in 2019-2020 and 34.95% in 2021-2022, p < 0.001). Furthermore, more chronic diseases were reported during the COVID-19 pandemic than in 2019-2020. Regarding sociodemographic factors, male respondents were more likely to develop hypertension and diabetes (OR = 1.35 CI 95% (1.28-1.43), p < 0.001; and OR = 1.20 CI 95% (1.11-1.30), p < 0.001). Vegetarian diet decreases the likelihood of hypertension, neurological disease, and diabetes (OR = 0.69, CI 95% (0.60-0.81), p < 0.001; OR = 0.72, CI 95% (0.59-0.88), p = 0.001; and OR = 0.73, CI 95% (0.55-0.96), p = 0.026). In line with this, consuming meat meals increases the risk of hypertension (OR = 1.09, CI 95% (1.02-1.17), p = 0.009). Interestingly, a reduced-sodium diet has an association with decreased morbidity of COVID-19 disease (OR = 0.72, CI 95% (0.63-0.82), p < 0.001). This result brings new light to more research to be done to allow efficient prevention of this disease. In conclusion, our study shows the beneficial role of a balanced diet in reducing the incidence rate of common chronic diseases. Our findings may be educational for those who would like to change their nutritional habits and/or for public health professionals to suggest the implementation of proper diets to their patients.

Evaluation of the Approach towards Vaccination against COVID-19 among the Polish Population-In Relation to Sociodemographic Factors and Physical and Mental Health

Due to the rapid development of COVID-19 vaccines, the world has faced a huge challenge with their general acceptance, including Poland. For this reason, we attempted to determine the sociodemographic factors influencing the decision of positive or negative attitudes toward COVID-19 vaccination. The analysis included 200,000 Polish participants-80,831 women (40.4%) and 119,169 men (59.6%). The results revealed that the most common reasons for vaccine refusal and hesitancy were the fear of post-vaccination complications and their safety (11,913/31,338, 38.0%; 9966/31,338, 31.8%). Negative attitudes were observed more often among male respondents with primary or secondary education (OR = 2.01, CI95% [1.86-2.17] and OR = 1.52, CI95% [1.41-1.63], respectively). On the other hand, older age ≥ 65 (OR = 3.69; 95%CI [3.44-3.96]), higher education level (OR = 2.14; 95%CI [2.07-2.22]), living in big cities with a range of 200,000-499,999 inhabitants and more than 500,000 inhabitants (OR = 1.57, CI95% [1.50-1.64] and OR = 1.90, CI95% [1.83-1.98], respectively), good physical conditions (OR = 2.05; CI95% [1.82-2.31]), and at last normal mental health conditions (OR = 1.67, CI95% [1.51-1.85]) were significantly associated with COVID-19 vaccine acceptance. Our study indicates which population group should be further supplied with data and information by health education, the government, and healthcare professionals to alleviate the negative attitude toward COVID-19 vaccines.

Identification of Factors Affecting the Increased Percentage of CGA Recommendations among Patients on Geriatric Ward

In Poland, the elderly population is noticeably increasing every year. Therefore, the current healthcare system has to rise to the challenge of treatment and prevention strategies targeting elderly persons. Based on the Vulnerable Elders Survey (VES-13 scale), consisting of international and validated scales, we put effort into identifying the factors affecting the increased percentage of CGA (Comprehensive Geriatric Assessment) recommendations by healthcare system physicians. The study group involved 78 patients from the Department of Geriatrics, Wroclaw Medical University, Poland, aged 60-91 (median Me = 81 years old). Of the studied patients, 51 were recommended for CGA (51/78; 64.6%). A statistically significant association was observed between CGA recommendation and age (p < 0.001); the likelihood of a CGA recommendation increased with age. Furthermore, the increased CGA recommendation was observed among geriatric patients with: (a) frailty syndrome (OR = 11.2, CI95% 2.88-43.5, p < 0.001), (b) high risk of malnutrition or malnutrition (OR = 3.87; CI95%, 1.00-14.9, p = 0.04), (c) low mental status (OR = 3.32, CI95% 1.22-9.09, p = 0.029), (d) low ability to perform basic daily duties (according to ADL scale-OR = 12.6, CI95% 1.57-101, p = 0.004 and IADL scale-OR = 4.71, CI95% 1.72-12.9, p = 0.003), and (e) fall risk (OR = 15.0, CI95% 4.67-48.3, p < 0.001). Moreover, homocysteine levels increased with age (p = 0.003) and decreased with sleep duration (p = 0.043). Taken together, all these factors seem to be important when implementing treatment programs adjusted to the individual geriatric patient.

Prevalence of Use of Preventive Services in Poland: Result from a Population-Based Nationwide Study

Systematic reviews of scientific evidence have identified clinical services that prevent or ameliorate illness and reduce mortality. This study aimed to assess the prevalence of all recommended evidence-based preventive services in a publicly funded healthcare setting. We conducted a population-based nationwide cross-sectional computer-assisted telephone survey of 1000 Polish adults (response rate 42%). The self-reported use of all recommended clinical preventive services was assessed, including mammography, colonoscopy, blood glucose screening, vaccination, blood pressure screening, and preventive counselling. The results showed that only 6.4% of adults had received all recommended preventive screening, whereas only 4.3% had received appropriate counselling. General practitioner (GP) visits, blood pressure screening, blood glucose screening, and cervical smear were among the most commonly provisioned interventions, while flu vaccination, PSA assessment, and preventive counselling were among the least prevalent services. Despite the low uptake of preventive interventions, over 75% is interested in remote access to preventive services using telemedicine platforms and e-consultations. Our findings suggest that there are significant gaps in the receipt of preventive interventions. Further improvements require not only changes in the incentive system for healthcare providers, but also system-level innovation such as telemedicine solutions to deliver preventive services remotely and engage individuals in the monitoring process.

Clinical preventive services to reduce pandemic deaths

•

High utilization of clinical preventive services reduces mortality during outbreaks.

•

The prevention of comorbidities can reduce the COVID-19 death toll.

•

Prevention of hypertension bears the highest potential to decrease COVID-19 deaths.

The recent COVID-19 pandemic has highlighted inadequacies in both national and international preparedness. The outbreak has resulted in an overburdening and incapacitation of health systems worldwide, as well as numerous deaths of individuals with comorbidities.

We have performed a simulation study to examine the effect of comorbidities and their prevention on the clinical outcome and mortality of patients during the COVID-19 pandemic. The data from past and present outbreaks indicate that individuals with comorbidities are significantly more susceptible to infections and yield poorer clinical outcomes. Our simulation study revealed that the prevention of morbidities like hypertension, diabetes, and cardiovascular disease bears an enormous potential to decrease the COVID-19 death toll. The accumulating evidence emphasizes our ability to reduce both the susceptibility of uninfected individuals to pathogenic factors, as well as the mortality of infected individuals during pandemics, by adopting a more comprehensive approach to disease prevention. Higher utilization of clinical preventive services is critical to reduce pandemic deaths and increase our preparedness for future outbreaks.

Update on serologic testing in COVID-19

Serologic tests are one of the available diagnostic tools in COVID-19. Growing literature highlights their role in the clinical management of the disease. Unfortunately, due to the limited availability of commercial tests and the lack of reliable trials establishing the sensitivity and specificity of the diagnostic method, the clinical application of the test needs to be precisely determined. In this paper, we discuss the utility of anti-SARS-CoV-2 serology testing in a clinical setting and propose diagnostic algorithms that include serological tests in patients with confirmed or suspected COVID-19.