Mocanu Alexandra, Lazureanu Voichita Elena, Laza Ruxandra, Marinescu Adelina Raluca, Cut Talida Georgiana, Sincaru Suzana-Vasilica, Marza Adina Maria, Popescu Irina-Maria, Herlo Lucian-Flavius, Nelson-Twakor Andreea, Rivis Mircea, Bratosinand Felix, Porosnicu Tamara Mirela, Mederle Alexandru Ovidiu
Department XIII, Discipline of Infectious Diseases, "Victor Babes" University of Medicine and Pharmacy, 300041 Timișoara, Romania.
Emergency Institute for Cardiovascular Diseases and Transplantation, Strada Gheorghe Maricescu, 540327 Targu Mures, Romania.
J Pers Med. 2023 Jan 21;13(2):195. doi: 10.3390/jpm13020195.
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, -value = 0.020) and IL-6 (β = 1.85, -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.
罗姆人口占罗马尼亚常住人口的3%以上（约1000万至1500万），是欧洲最贫困的人群之一。由于贫困和失业，罗马尼亚的罗姆少数群体获得医疗保健和预防医学的机会可能减少。现有有限证据表明，欧洲罗姆人群体在疫情期间由于其生活方式选择、社会经济状况和基因病理生理特征，患病和死亡风险更高。因此，本研究的目的是调查入住重症监护病房的罗姆患者中相关炎症标志物与COVID-19临床进展之间的联系。我们纳入了71名因SARS-CoV-2感染入住重症监护病房的罗姆患者和213名来自普通人群且符合相同纳入标准的对照组。罗姆患者的体重指数在统计学上显著更高，超过57%超重，而对照组为40.7%。入住重症监护病房的罗姆族患者中经常吸烟更为普遍，合并症数量也更多。我们观察到病例组入院时严重影像学特征的比例显著更高，尽管这种差异可能与该组吸烟率较高有关。平均住院时间比对照组长1.8天。入院时，54.0%的罗姆患者血沉水平升高，而对照组为38.9%。同样，其中47.6%的患者C反应蛋白水平升高。与普通人群相比，入住重症监护病房时白细胞介素-6显著升高，C反应蛋白水平也显著升高。然而，插管患者比例和死亡率没有显著差异。多因素分析显示，罗姆族显著影响C反应蛋白（β = 1.93，P值 = 0.020）和白细胞介素-6（β = 1.85，P值 = 0.044）。有必要针对特殊人群，如罗姆族，制定不同的医疗保健策略，以防止本研究中出现的差距缩小。
