Understanding the Impact of COVID-19 on Roma Vulnerable Communities in Western Romania: Insights and Predictive Factors from a Retrospective Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Inclusion Criteria and Selected Data
2.3. Statistical Analysis
3. Results
4. Discussion
Strengths and Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variable | Roma (n = 144) | Romanian (n = 434) | p Value |
---|---|---|---|
Sex | 0.9286 | ||
Male | 83 (57.64%) | 252 (58.06%) | |
Female | 61 (42.36%) | 182 (41.94%) | |
Spearman rho (male) | −0.0037 | 0.9287 | |
Age | 0.5753 | ||
<18 | 5 (3.47%) | 21 (4.84%) | |
18–40 | 30 (20.83%) | 70 (16.13%) | |
40–65 | 61 (42.36%) | 192 (44.24%) | |
>65 | 48 (33.33%) | 151 (34.79%) | |
Spearman rho | −0.0150 | 0.7190 | |
BMI | 0.0292 * | ||
Underweight | 8 (5.56%) | 30 (6.91%) | |
Normal | 59 (40.97%) | 227 (52.30%) | |
Overweight | 77 (53.47%) | 177 (40.78%) | |
Spearman rho | 0.1060 | 0.0107 * | |
Location | 0.0001 * | ||
Urban | 57 (39.58%) | 253 (58.29%) | |
Rural | 87 (60.42%) | 181 (41.71%) | |
Spearman rho (rural) | 0.1620 | 0.0001 * | |
Tobacco intake | 0.1546 | ||
No/occasional smoking | 42 (29.17%) | 140 (32.26%) | |
Regular smoker | 50 (34.72%) | 174 (40.09%) | |
Heavy smoker | 52 (36.11%) | 120 (27.65%) | |
Spearman rho | 0.0635 | 0.1274 | |
Alcohol intake | 0.5215 | ||
No/occasional drinking | 69 (47.92%) | 201 (46.31%) | |
Regular drinker | 65 (45.14%) | 189 (43.55%) | |
Heavy drinker | 10 (6.94%) | 44 (10.14%) | |
Spearman rho | −0.0627 | 0.2730 | |
Transmission source | 0.0215 * | ||
Community | 13 (9.03%) | 82 (18.89%) | |
Family | 59 (40.97%) | 161 (37.10%) | |
Unknown | 72 (50.00%) | 191 (44.01%) | |
Spearman rho (unknown) | 0.0520 | 0.2116 | |
Vaccination | 0.5549 | ||
Yes | 19 (13.19%) | 66 (15.21%) | |
No | 125 (86.81%) | 368 (84.79%) | |
Spearman rho | −0.0246 | 0.5553 |
Variable | Roma (n = 144) | Romanian (n = 434) | p Value |
---|---|---|---|
Severity | 0.0490 * | ||
Asymptomatic | 23 (15.97%) | 72 (16.59%) | |
Mild | 31 (21.53%) | 114 (26.27%) | |
Moderate | 30 (20.83%) | 118 (27.19%) | |
Severe | 54 (37.50%) | 124 (28.57%) | |
Critical | 6 (4.17%) | 6 (1.38%) | |
Spearman rho | 0.0814 | 0.0506 | |
ICU admission | 0.0399 * | ||
Yes | 60 (41.67%) | 140 (32.26%) | |
No | 84 (58.33%) | 294 (67.74%) | |
Spearman rho | 0.0855 | 0.0398 * | |
Deceased | 0.1764 | ||
Yes | 34 (23.61%) | 80 (18.43%) | |
No | 110 (76.39%) | 354 (81.57%) | |
Spearman rho | 0.0563 | 0.1766 |
Variable | Roma (n = 144) | Romanian (n = 434) | p Value | |
---|---|---|---|---|
CRP | Median | 25.245 | 20.945 | 0.0245 * |
IQR | 24.760 | 18.080 | ||
Spearman rho | 0.0936 | 0.0244 * | ||
FER | Median | 184.225 | 173.770 | 0.9548 |
IQR | 219.315 | 163.820 | ||
Spearman rho | 0.0024 | 0.9548 | ||
IL-6 | Median | 8.495 | 7.105 | <0.0001 * |
IQR | 5.040 | 3.360 | ||
Spearman rho | 0.2400 | <0.0001 * | ||
D-dimers | Median | 274.895 | 261.000 | 0.3228 |
IQR | 154.185 | 195.910 | ||
Spearman rho | 0.0412 | 0.3232 | ||
LDH | Median | 211.180 | 202.800 | 0.8921 |
IQR | 98.835 | 127.920 | ||
Spearman rho | 0.0057 | 0.8923 | ||
HDL | Median | 36.160 | 39.695 | 0.0008 * |
IQR | 14.060 | 12.310 | ||
Spearman rho | −0.1400 | 0.0008 * | ||
25-OHD | Median | 20.265 | 20.995 | 0.0299 * |
IQR | 8.700 | 10.410 | ||
Spearman rho | −0.0904 | 0.0298 * |
Roma | Romanian | |||
---|---|---|---|---|
rho | p | rho | p | |
CRP | 0.791 | <0.0001 * | 0.433 | <0.0001 * |
FER | 0.661 | <0.0001 * | 0.633 | <0.0001 * |
IL-6 | 0.802 | <0.0001 * | 0.897 | <0.0001 * |
D-dimers | 0.647 | <0.0001 * | 0.610 | <0.0001 * |
LDH | 0.811 | <0.0001 * | 0.861 | <0.0001 * |
HDL | −0.850 | <0.0001 * | −0.734 | <0.0001 * |
25-OHD | −0.862 | <0.0001 * | −0.868 | <0.0001 * |
ICU EXP (β) | 95% CI Low | 95% CI High | p | Death EXP (β) | 95% CI Low | 95% CI High | p | |
---|---|---|---|---|---|---|---|---|
Female | 1 | - | - | - | 1 | - | - | - |
Male | 2.379 | 1.598 | 3.541 | <0.0001 * | 1.975 | 1.220 | 3.199 | 0.0057 * |
Adults (18–64) | 1 | - | - | - | 1 | - | - | - |
Children (<18) | 0.686 | 0.215 | 2.191 | 0.5242 | 1.002 | - | - | 0.9980 |
Elders (≥65) | 1.370 | 0.938 | 2.000 | 0.1035 | 2.696 | 1.745 | 4.166 | <0.0001 * |
Normal BMI | 1 | - | - | - | 1 | - | - | - |
Underweight | 0.885 | 0.600 | 1.305 | 0.5380 | 1.081 | 0.681 | 1.718 | 0.7404 |
Overweight | 1.419 | 0.674 | 2.986 | 0.3566 | 2.138 | 0.900 | 5.083 | 0.0853 |
Urban | 1 | - | - | - | 1 | - | - | - |
Rural | 1.258 | 0.873 | 1.813 | 0.2173 | 1.096 | 0.709 | 1.695 | 0.6788 |
No/occasional smoking | 1 | - | - | - | 1 | - | - | - |
Regular smoker | 1.332 | 0.847 | 2.096 | 0.2148 | 1.049 | 0.613 | 1.798 | 0.8607 |
Heavy smoker | 1.768 | 1.099 | 2.845 | 0.0188 * | 1.253 | 0.718 | 2.186 | 0.4277 |
No/occasional drinking | 1 | - | - | - | 1 | - | - | - |
Regular drinker | 1.452 | 0.992 | 2.127 | 0.0552 | 1.404 | 0.893 | 2.207 | 0.1421 |
Heavy drinker | 0.803 | 0.413 | 1.560 | 0.5242 | 0.966 | 0.445 | 2.095 | 0.9306 |
General population | 1 | - | - | - | 1 | - | - | - |
Roma | 1.454 | 0.963 | 2.195 | 0.0751 | 1.366 | 0.839 | 2.224 | 0.2093 |
Roma BMI | General Population BMI | |||||
---|---|---|---|---|---|---|
Severity | Underweight | Normal | Overweight | Underweight | Normal | Overweight |
Asymptomatic | 3 (2.08%) | 11 (7.64%) | 9 (6.25%) | 3 (0.69%) | 41 (9.45%) | 28 (6.45%) |
Mild | 3 (2.08%) | 17 (11.81%) | 11 (7.64%) | 7 (1.61%) | 59 (13.59%) | 48 (11.06%) |
Moderate | 1 (0.69%) | 9 (6.25%) | 20 (13.89%) | 9 (2.07%) | 59 (13.59%) | 50 (11.52%) |
Severe | 1 (0.69%) | 22 (15.28%) | 31 (21.53%) | 10 (2.30%) | 65 (14.98%) | 49 (11.29%) |
Critical | 0 (0.00%) | 0 (0.00%) | 6 (4.17%) | 1 (0.23%) | 3 (0.69%) | 2 (0.46%) |
Chi2 p | 0.0347 * | 0.9474 | ||||
Spearman rho | 0.2491 | −0.0231 | ||||
Spearman p | 0.0027 * | 0.6306 |
rho | 95% CI | p | ||
---|---|---|---|---|
Whole lot n = 578 | Severity—ICU | 0.636 | 0.584–0.682 | <0.0001 * |
Severity—Death | 0.435 | 0.366–0.499 | <0.0001 * | |
General population n = 434 | Severity—ICU | 0.606 | 0.543–0.663 | <0.0001 * |
Severity—Death | 0.412 | 0.331–0.487 | <0.0001 * | |
Roma n= 144 | Severity—ICU | 0.700 | 0.606–0.775 | <0.0001 * |
Severity—Death | 0.489 | 0.353–0.604 | <0.0001 * |
Roma | General Population | |||
---|---|---|---|---|
ICU-No | ICU-Yes | ICU-No | ICU-Yes | |
Death-No | 84 (58.33%) | 26 (18.06%) | 284 (65.44%) | 70 (16.13%) |
Death-Yes | 0 (0.00%) | 34 (23.61%) | 10 (2.30%) | 70 (16.13%) |
Chi2 p | <0.0001 * | <0.0001 * | ||
Spearman rho | 0.658 | 0.562 | ||
Spearman p | <0.0001 * | <0.0001 * |
Constants (Dependent) | General Population | Roma | ||||||
---|---|---|---|---|---|---|---|---|
EXP (β) | 95% CI Low | 95% CI High | p | EXP (β) | 95% CI Low | 95% CI High | p | |
Elevated CRP | 1.110 | 1.080 | 1.141 | <0.0001 * | 1.381 | 1.194 | 1.596 | 0.0003 * |
Elevated FER | 1.000 | 0.997 | 1.003 | 0.9244 | 0.999 | 0.992 | 1.006 | 0.7871 |
Elevated IL-6 | 1.332 | 0.997 | 1.781 | 0.0523 | 0.931 | 0.560 | 1.550 | 0.7846 |
Elevated D-dimers | 0.998 | 0.996 | 1.001 | 0.2166 | 0.998 | 0.991 | 1.005 | 0.5883 |
Elevated LDH | 1.001 | 0.995 | 1.007 | 0.6895 | 0.992 | 0.975 | 1.008 | 0.3245 |
Normal HDL | 0.947 | 0.913 | 0.983 | 0.0039 * | 0.910 | 0.822 | 1.008 | 0.0699 |
Normal 25-OHD | 0.853 | 0.800 | 0.910 | <0.0001 * | 0.864 | 0.692 | 1.078 | 0.1948 |
Constants (Dependent) | General Population | Roma | ||||||
---|---|---|---|---|---|---|---|---|
EXP (β) | 95% CI Low | 95% CI High | p | EXP (β) | 95% CI Low | 95% CI High | p | |
Elevated CRP | 1.104 | 1.076 | 1.132 | <0.0001 * | 1.154 | 1.084 | 1.229 | <0.0001 * |
Elevated FER | 1.000 | 0.997 | 1.003 | 0.9874 | 1.004 | 1.000 | 1.009 | 0.0699 |
Elevated IL-6 | 1.328 | 0.946 | 1.863 | 0.1007 | 0.755 | 0.488 | 1.167 | 0.2060 |
Elevated D-dimers | 0.999 | 0.996 | 1.001 | 0.2889 | 1.005 | 0.998 | 1.011 | 0.1531 |
Elevated LDH | 0.994 | 0.987 | 1.001 | 0.1019 | 0.991 | 0.976 | 1.005 | 0.2097 |
Normal HDL | 0.920 | 0.883 | 0.960 | 0.0001 * | 0.982 | 0.904 | 1.066 | 0.6574 |
Normal 25-OHD | 0.921 | 0.864 | 0.983 | 0.0127 * | 0.832 | 0.703 | 0.984 | 0.0318 * |
Variable | Roma (n = 144) | Romanian (n = 434) | ICU Related p Value | Roma (n = 144) | Romanian (n = 434) | Death Related p Value | |
---|---|---|---|---|---|---|---|
CRP | AUC | 0.985 | 0.867 | <0.0001 * | 0.925 | 0.893 | 0.2565 |
(95% CI) | (0.950–0.998) | (0.832–0.898) | (0.869–0.962) | (0.860–0.920) | |||
Cutoff | 28.98 | 29.03 | 29.4 | 29.73 | |||
Sensitivity; Specificity | 93.33; 96.43 | 65.7; 95.9 | 97.06; 77.27 | 76.23; 89.55 | |||
FER | AUC | 0.796 | 0.740 | 0.2196 | 0.785 | 0.735 | 0.3261 |
(95% CI) | (0.721–0.858) | (0.696–0.781) | (0.709–0.849) | (0.691–0.776) | |||
Cutoff | 180.46 | 201.95 | 180.46 | 172.52 | |||
Sensitivity; Specificity | 80.00; 70.24 | 67.86; 73.13 | 85.29; 60.00 | 86.25; 57.63 | |||
IL-6 | AUC | 0.865 | 0.860 | 0.8780 | 0.764 | 0.797 | 0.4738 |
(95% CI) | (0.798–0.916) | (0.823–0.891) | (0.687–0.831) | (0.756–0.833) | |||
Cutoff | 6.46 | 6.56 | 6.46 | 6.66 | |||
Sensitivity; Specificity | 100.00; 64.29 | 97.86; 62.93 | 100; 49.11 | 100.00; 54.00 | |||
D-dimers | AUC | 0.781 | 0.715 | 0.1534 | 0.744 | 0.665 | 0.1488 |
(95% CI) | (0.705–0.846) | (0.670–0.757) | (0.664–0.813) | (0.619–0.710) | |||
Cutoff | 257.77 | 286.67 | 290.55 | 289.95 | |||
Sensitivity; Specificity | 88.33; 66.67 | 71.43; 70.41 | 79.44; 65.53 | 70.00; 63.28 | |||
LDH | AUC | 0.837 | 0.832 | 0.8990 | 0.781 | 0.763 | 0.6901 |
(95% CI) | (0.766–0.893) | (0.793–0.866) | (0.705–0.846) | (0.720–0.802) | |||
Cutoff | 196.53 | 213.69 | 221.99 | 225.56 | |||
Sensitivity; Specificity | 85.00; 69.05 | 87.14; 73.47 | 85.33; 66.41 | 78.69; 68.12 | |||
HDL | AUC | 0.859 | 0.797 | 0.0989 | 0.772 | 0.771 | 0.9893 |
(95% CI) | (0.792–0.912) | (0.756–0.834) | (0.695–0.838) | (0.729–0.810) | |||
Cutoff | 37.83 | 38.65 | 34.63 | 37.83 | |||
Sensitivity; Specificity | 93.33; 70.24 | 75.71; 72.79 | 82.35; 68.18 | 78.67; 68.94 | |||
25-OHD | AUC | 0.840 | 0.845 | 0.9013 | 0.788 | 0.774 | 0.7684 |
(95% CI) | (0.769–0.896) | (0.807–0.877) | (0.712–0.851) | (0.731–0.812) | |||
Cutoff | 19.93 | 18.17 | 19.16 | 18.82 | |||
Sensitivity; Specificity | 83.33; 78.57 | 75.00; 80.61 | 79.41; 68.18 | 80.00; 58.64 |
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Capraru, I.D.; Marian, C.; Vulcanescu, D.D.; Tanasescu, S.; Dragomir, T.L.; Marti, T.D.; Boru, C.; Avram, C.R.; Susan, M.; Vlad, C.S. Understanding the Impact of COVID-19 on Roma Vulnerable Communities in Western Romania: Insights and Predictive Factors from a Retrospective Study. Viruses 2024, 16, 435. https://doi.org/10.3390/v16030435
Capraru ID, Marian C, Vulcanescu DD, Tanasescu S, Dragomir TL, Marti TD, Boru C, Avram CR, Susan M, Vlad CS. Understanding the Impact of COVID-19 on Roma Vulnerable Communities in Western Romania: Insights and Predictive Factors from a Retrospective Study. Viruses. 2024; 16(3):435. https://doi.org/10.3390/v16030435
Chicago/Turabian StyleCapraru, Ionut Dragos, Catalin Marian, Dan Dumitru Vulcanescu, Sonia Tanasescu, Tiberiu Liviu Dragomir, Teodora Daniela Marti, Casiana Boru, Cecilia Roberta Avram, Monica Susan, and Cristian Sebastian Vlad. 2024. "Understanding the Impact of COVID-19 on Roma Vulnerable Communities in Western Romania: Insights and Predictive Factors from a Retrospective Study" Viruses 16, no. 3: 435. https://doi.org/10.3390/v16030435
APA StyleCapraru, I. D., Marian, C., Vulcanescu, D. D., Tanasescu, S., Dragomir, T. L., Marti, T. D., Boru, C., Avram, C. R., Susan, M., & Vlad, C. S. (2024). Understanding the Impact of COVID-19 on Roma Vulnerable Communities in Western Romania: Insights and Predictive Factors from a Retrospective Study. Viruses, 16(3), 435. https://doi.org/10.3390/v16030435