Perception And Attitude Towards COVID-19 Vaccine: A Cross-Sectional Study From Pakistan

ABSTRACT Objective: The aim of this study was to investigate the awareness regarding COVID-19 vaccines and identify the factors underlying refusal. Methodology: A cross-sectional study was carried out amongst the general population from different walk of life regarding awareness and myths about COVID-19 vaccine selected by convenient sampling method. To collect data, we developed an online survey using questionnaires regarding beliefs and myths about vaccination. The study was started in March 2021 after approval from the ethical committee. Survey consisting of several questions was created using google form. The link was shared on different social media applications and participants were requested to fill the questionnaires. Some patients and their attendants who were visiting HIT hospital Taxila for any reason were also included in the study and they were requested to fill the form at the spot. Participants were given a brief summary of the survey and its purpose, as well as the study protocol and a declaration of confidentiality and privacy, before beginning the questionnaire. Data was collected on online server form. Demographic information was noted. They were asked about their registration, vaccination status and their fear regarding vaccine and its complications. They were questioned about myths and misbeliefs about covid 19 vaccine. Post vaccination symptoms, their preference for different types of available vaccine, and need of booster dose were also inquired. Their beliefs regarding effectiveness of vaccine in prevention of covid-19 symptoms and severity and following the SOPs released by health authorities were noted. Results: Total 287 individuals were included in this study. 62% were females and 31% were males. 50% were doctors and 30% were not registered for vaccination. 70% of individuals were vaccinated and 83% were not afraid to get vaccination while 50% of people thought that they will get COVID-19 after vaccination. 35% participants were afraid that they will get allergic reaction post vaccination and 9% thought that COVID-19 is fake i.e., there is no such disease as COVID-19. 82% were aware that they will need vaccine even if they had COVID-19. Only 7% of population thought that COVID-19 will change their DNA. Chi square test was applied to find out statistically significant difference in opinion between three groups i.e., age, gender and academic qualification. Majority of the statistical correlation was found in these questions on the basis of qualification. There was statistically significant difference in opinion depending on academic qualification, health care and  non-health care workers shown by p value less than 0.05. Health care professionals think there is need for new vaccinations for every new variant, there were mild covid symptoms post vaccination and there was need of booster dose every year while others have contrary opinion. Medical students didn’t believe in DNA alteration. Their was also statistically significant difference in opinion between male and female gender. Most female participants believe that there was requirement of new vaccine for every new variant, there were more chances of covid after vaccination and they need booster dose every year to prevent covid while males have opposite opinion. Majority of the post vaccination symptoms were observed in femaleswhile male observed pain on the injection site only Conclusion: Awareness and education of general population regarding safety, efficacy and benefits of covid-19 vaccination is the cornerstone of the path to eradicate this pandemic. Different platform of social, print and electronic media plays a pivotal role in this regard. However, the importance of health authorities, religious scholars, social activists and politicians in creating awareness cannot be denied either. Collectively all these factors attribute towards the COVID free Pakistan. Key Words: COVID-19, vaccine hesitancy, Pakistan, public awareness, myth

Effectiveness of Tocilizumab in reducing inflammatory response associated with COVID-19 pneumonia at Islamabad Medical Complex, Islamabad

Objective: To determine the effectiveness of Tocilizumab in covid-19 related severe pneumonia. Introduction: COVID-19 is a global health problem causing respiratory infection. This is triggered by IL-6 characterized by raised inflammatory markers that is called cytokine release storm. Severe disease leads to hospitalization, oxygen requirement and poor outcome. Methods: This interventional study (descriptive analytic) was conducted from July-December 2021 at Intensive Care Unit, after ethical approval. Seventy cases of COVID-19 pneumonia with cytokine storm were included. Twenty cases were dropped either refusal to tocilizumab, pregnancy or having contraindication to tocilizumab, leaving 50 study participants. The patient’s demography, clinical, laboratory and radiological findings, timing and response variables of tocilizumab were recorded. The temporal readings of inflammatory markers, oxygen requirement and clinical status were compared at admission and after tocilizumab. SPSS version 25 was used for data analysis. Chi-square test was applied with significant p-value < 0.05. Results: There was male predominance of 66% with mean age of 58.6±14.8 years. Mean day of illness and hospital stay was 8th day and 17.56 days respectively. C-reactive protein levels improved in all cases 50(100%) (p <0.0001), ferritin in 31(62%) (0.019), D dimers in 28 (56%) (p0.014), LDH in 30(60%) (p 0.02) and interleukin-6 in 32(64%) (0.017. Survival benefit with tocilizumab was significant in patients that received within 10th day of illness (p 0.021). At discharge, 66.6% were off oxygen and 33.3% required domiciliary oxygen. Conclusion: COVID-19 Pneumonia with cytokine release storm bears high mortality. Significant improvement in inflammatory markers like CRP, ferritin, D-dimers and LDH shows effectiveness of tocilizumab. Early administration within 10 days of illness has survival benefits. 

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake