ABSTRACT
Background: COVID-19 is a deadly viral infection that kills many people throughout the globe. The goal of this study was to find out how people in Pakistan felt about the COVID-19 vaccine.Method: Convenience and respondent-driven sampling method was used to conduct an online survey with 15 closed-and open-ended questions to a sample of 330 participants. The proportion of people who had a positive attitude towards vaccination vs. those who had a negative attitude towards vaccination was revealed by the closed-ended questions. The open-ended questions elicited qualitative data on why peo-ple accepted or rejected the vaccination.Results: 62.9% of the total number of respondents, male 1.97 times more likely (OR: 1.97, CI: 1.08-3.58) than female, 80% younger than 50 years, higher age groups, 71.3% married, 69.3% of the working population intended to get vaccinated with COVID-19 vaccine. People who held pro-vaccine health beliefs, had knowledge of, access to the COVID-19 vaccine, were employed, or under government pressure to get vaccinated, or visited public vaccination location, reported a positive attitude towards vaccination. People with safety concerns, social pressure of not getting vaccinated, low levels of awareness, trust and belonging to communities with anti-vaccination beliefs were likely to have negative attitudes towards COVID-19 vaccine.Conclusion: This study helps to identify the attitudes of people and has implications for COVID-19 immunization efforts in Pakistan for various population segments.
ABSTRACT
Objective: To determine the spectrum of clinical presentation, multisystem involvement and treatment outcome in children with MIS-C. Study Design: A descriptive cohort study Place and Duration of Study: Conducted at The Children's Hospital and Institute of Child Health, Lahore from May 15, 2020 to November 22, 2020. Material and Methods: Children (aged 0-16 years) with features of this new inflammatory syndrome who fulfilled the WHO criteria for MIS-C and required admission to hospital were prospectively identified. Demographic and clinical data were collected from patient records and entered on a predesigned proforma and results were analyzed on SPSS 20. Results: A total of 24 patients were enrolled in the study. Majority were males (17/24, 70%). Mean age of presentation was 7.3 years. Six patients (25%) had a positive PCR for SARS CoV-2 but none of the patients had been symptomatic with classic COVID-19 respiratory symptoms in the 6 weeks prior to admission. Comorbid conditions were present in only 2 patients (8%). SARS-CoV-2 antibodies were positive for 23/24 patients (96%). Despite being clinically unwell, with laboratory evidence of elevated C-reactive protein, ferritin, and D-dimers, no pathological organism was isolated in any of the 24 children. There were two major presentations: one as atypical or typical Kawasaki disease (18 of 24, 75%) and a more severe second one with shock or low cardiac output (6 of 24, 25%). Common presenting features were fever, body aches, and abdominal pain. Four out of 24 (16%) patients had sufficient criteria for typical Kawasaki disease, whereas 18 children (75%) presented more sub acutely with presentation resembling Kawasaki disease;all had at least two features of classic Kawasaki. Myocardial dysfunction seen in 3 patients (12%) and pericardial effusion was observed in 5 patients (20%). Coronary artery dilatation was seen in 12 (50%) patients. All 6 children with shock-like presentation had coronary artery involvement. Twenty children (83%) received intravenous immunoglobulin within the first 2 days of their stay. Thirteen (54%) patients received therapeutic anticoagulation (enoxaparin) on the basis of the high risk of thromboembolism and number of D-dimers. There was one death (4%). Conclusion: The SARS-COV 19 pandemic led to the identification of a new and potentially life-threating childhood disease, referred to as MIS-C. Prompt diagnosis and early treatment with IVIGs has shown a good early outcome. .