Laboratory Findings and Clinical Outcomes of ICU-admitted COVID-19 Patients: A Retrospective Assessment of Particularities Identified among Romanian Minorities

Abstract

The Roma population accounts for over 3% (approximately 10 to 15 million) of Romania’s permanent population, and it represents one of Europe’s most impoverished populations. Due to poverty and unemployment, Romania’s Roma minority may have diminished access to healthcare and preventive medicine. The limited existing evidence suggests that the European Roma group has been at a higher risk of becoming ill and dying during the pandemic owing to their lifestyle choices, socioeconomic circumstances, and genetic pathophysiological traits. As a result, the purpose of the present research was to investigate the link between the inflammatory markers implicated and the clinical progression of COVID-19 in Roma patients who were brought to the intensive care unit. We considered 71 Roma patients admitted to the ICU with SARS-CoV-2 infection and 213 controls from the general population with the same inclusion criteria. The body mass index of patients was statistically significantly higher among Roma patients, with more than 57% being overweight, compared with 40.7% in the control group. Frequent smoking was more prevalent in patients of Roma ethnicity admitted to the ICU and the number of comorbidities. We observed a significantly higher proportion of severe imaging features at admission in the group of cases, although this difference may have been associated with the higher prevalence of smoking in this group. The mean duration of hospitalization was longer by 1.8 days than the control group. Elevated ESR levels were observed in 54.0% of Roma patients at admission, compared with 38.9% in the control group. Similarly, 47.6% of them had elevated CRP levels. IL-6 increased significantly at the time of ICU admission, similarly to the significant rise in the CRP levels, compared with the general population. However, the proportion of intubated patients and mortality did not differ significantly. On multivariate analysis, the Roma ethnicity significantly influenced the CRP (β = 1.93, p-value = 0.020) and IL-6 (β = 1.85, p-value = 0.044). It is necessary to plan different healthcare strategies aimed at special populations, such as the Roma ethnicity, to prevent the reduced disparities presented in in this study.

Understanding the Impact of COVID-19 on Roma Vulnerable Communities in Western Romania: Insights and Predictive Factors from a Retrospective Study

“…Roma patients tended to be more overweight (53.47% vs. 40.78% in the general population), come from a rural place (60.42% vs. 41.71% in the general population) and could not state the origin of transmission more frequently (50% vs. 44.01%). Similar findings were also observed in the studies of Mocanu et al, while also taking into consideration that Roma patients were more likely to be unemployed [ 38 , 39 ]. The unemployment situation of Roma patients remains a hot topic, even at an international level [ 40 ].…”

“…There were only 5 (3.47%) minors in our Roma group and 21 (4.84%) in our general population group. These patients were excluded in the research by Mocanu et al [ 38 , 39 ]; however, there are two studies by Miconi et al discussing the demographics, risks, and perspectives of Roma adolescents [ 41 , 42 ].…”

“…On the subject of vaccination, a difference was not established between the two groups, which was also observed in the work of Mocanu et al, although they did notice a higher use of the Jcovden (Ad26.COV2.S) vaccine in the Roma group and a preference for the Pfizer (BNT162b2) vaccine in the Romanian group. While the Moderna (mRNA-1273) vaccine use was similar, this was not statistically significant ( p = 0.757) [ 39 ]. Although a general vision of vaccine hesitancy was observed [ 43 ], usually due to the mobility of the group (emigrant/traveler status), their relative hard to reach locations, poor access to healthcare services, stereotypes, etc.…”

Prevalence and association of oral manifestations with disease severity in patients diagnosed with COVID‑19: A cross‑sectional study

“…According to experts, it is likely that these cases of tongue-COVID are not reported, as in some situations, doctors do not ask patients to open their mouths to examine their oral cavity, as such an examination increases the risk of infection. In addition, patients usually keep the mask on their face, as this protective measure is crucial to reduce the spread of the virus ( 52 ). In the present study, a reduction in olfactory and gustatory capacities individuals diagnosed with COVID-19, as compared to those who did not report such alterations.…”

COVID-19 and Laboratory Markers from Romanian Patients—A Narrative Review

“…The major laboratory markers that were studied by Romanian authors are displayed in Table 1. Yes, even more so in Roma [53,54,[58][59][60][61][62]70] Diabetes [48,94] Antiphospholipid syndrome [47] Hypertension [27] Cardiac dysfunction [46,73,93] Overweight/metabolic syndrome [27,54,93] Lung involvement [50,57] PIMS [83] Chronic Spontaneous Urticaria Exacerbation [42] Pneumothorax/ pneumomediastinum [31,72] Liver failure [44] Multiple organ dysfunction [ [57,58,102,103] No [55] More comorbidities [29,101] Lung involvement [57] In addition, this article aimed to identify gaps in this research and provide encouragement for Romanian research to focus on novel and detailed aspects of the pandemic. For instance, as Romania grapples with the aftermath of the COVID-19 pandemic, understanding the long-term effects of the disease is of paramount importance.…”