COVID-19-associated vascular disease complications are primarily associated with endothelial dysfunction; however, the consequences of disease on vascular structure and function, particularly in the long term (>7 weeks post-infection), remain unexplored. Individual pre- and post-infection changes in arterial stiffness as well as central and systemic hemodynamic parameters were measured in patients diagnosed with mild COVID-19. As part of in-laboratory observational studies, baseline measurements were taken up to two years before, whereas the post-infection measurements were made 2–3 months after the onset of COVID-19. We used the same measurement protocol throughout the study as well as linear and mixed-effects regression models to analyze the data. Patients (N = 32) were predominantly healthy and young (mean age ± SD: 36.6 ± 12.6). We found that various parameters of arterial stiffness and central hemodynamics—cfPWV, AIx@HR75, and cDBP as well as DBP and MAP—responded to a mild COVID-19 disease. The magnitude of these responses was dependent on the time since the onset of COVID-19 as well as age (p_{regression_models} ≤ 0.013). In fact, mixed-effects models predicted a clinically significant progression of vascular impairment within the period of 2–3 months following infection (change in cfPWV by +1.4 m/s, +15% in AIx@HR75, approximately +8 mmHg in DBP, cDBP, and MAP). The results point toward the existence of a widespread and long-lasting pathological process in the vasculature following mild COVID-19 disease, with heterogeneous individual responses, some of which may be triggered by an autoimmune response to COVID-19.

Pulse wave velocity (PWV), a direct measure of arterial stiffness, is a promising biomarker of cardiovascular risk and a cardiovascular surrogate outcome. The resolution for detecting its smallest clinically significant change is dependent on the expected reproducibility, but there is currently no consensus on this. We estimated the PWV reproducibility in a range of intra-subject values that were observed over a 2 week period in a broad range of participants and under clinically relevant experimental conditions (two observers, morning/afternoon sessions, and number of visits) using SphygmoCor and Arteriograph devices. Each participant was recorded 12 times with each device over three visits, one week apart, and two morning and two afternoon recordings were taken per visit. The factors affecting reproducibility and the discrepancies between the consecutive PWV measurements for each device were also examined using multilevel mixed-effect models. We show that current PWV estimation guidance recommending 2 + 1 measurements is suboptimal because the PWV range was outside of the 1 m/s threshold for most of the participants, which is proposed as a minimal clinically important difference. The best reproducibility was yielded with median of four measurements and a 1.1 m/s threshold. Although PWV reproducibility and repeatability are frequently used interchangeably in studies, we demonstrated that despite their relative measures of variability (e.g., coefficient of variation) being comparable, their ranges revealed a clinically significant difference between them. We also found that different physiological variables were predictors of the discrepancy between the consecutive measurements made by the two devices, which is likely due to their distinct modes of operation. The evidence base for PWV reproducibility is limited, and more research is needed to deepen our understanding of the variation in arterial stiffness over time, as well as fluctuations within a population group and in an intervention setting.

Students, as a relatively health-informed population group, may still have limitations in health literacy, which is a concern as students take increasing responsibility for their health and make independent health decisions. The aim of this study was to evaluate the overall attitudes towards COVID vaccination among university students and to investigate various factors contributing to vaccination willingness among health and non-health studies students. A total of 752 students from the University of Split were included in this cross-sectional study and completed a questionnaire that consisted of three sections: socio-demographic data, health status information, and information on vaccination against COVID-19. Results show that the majority of students of health and natural sciences were willing to be vaccinated, but the majority of students of social sciences were not (p < 0.001). Students who used credible sources of information had a more significant proportion of those willing to be vaccinated and the majority of students who used less credible sources (79%) or did not think about it (68.8%) were unwilling to be vaccinated (p < 0.001). Multiple binary logistic regression modeling shows that female gender, younger age, studying social sciences, negative opinion about the need to reintroduce lockdown and the effectiveness of epidemiological measures, and usage of less credible sources of information were the most important factors contributing to increased vaccination hesitancy. Therefore, improving health literacy and restoring trust in relevant institutions can be critical in health promotion and COVID-19 prevention.

Medicinski otpad je otpad koji nastaje u zdravstvenim ustanovama i može biti različitih vrsta, a prema svojstvima može biti opasni medicinski otpad i neopasni medicinski otpad. Zbog potencijalno opasnih svojstava nužno je gospodarenje medicinskim otpadom provoditi sukladno odredbama Zakona o gospodarenju otpadom (1) i prema Pravilniku o gospodarenje medicinskim otpadom (2). U razdoblju od 2015. do 2019. godine količina medicinskog otpada rasla je godišnje u prosjeku za 8 %. U 2020. godini, nastalo je 7.014 tona medicinskog otpada od čega je 74 % opasnog i 26 % neopasnog medicinskog otpada. U odnosu na 2019. godinu, riječ je o porastu, za 28 % što se može pripisati povećanoj potrošnji medicinskih proizvoda uslijed COVID-19 pandemije. Količina opasnog medicinskog otpada povećala se za 18 %, a količina neopasnog medicinskog otpada za 67 %. Cilj ovoga rada bio je istražiti razlike u količini, sastavu i postupanju medicinskim otpadom u predpandemijskom i pandemijskom razdoblju za vrijeme COVID-19 u zdravstvenim ustanovama Splitsko-dalmatinske županije. Povećana upotreba dodatne zaštitne opreme za vrijeme rada zdravstvenih djelatnika u pandemiji COVID-19 uzrokovala je stvaranja trostruko više infektivnog otpada. U radu je istaknuta važnost pravilnog rukovanja, sakupljanja, obrade i odlaganja infektivnog medicinskog otpada kako bi se spriječilo izravno ili neizravno prenošenje zaraze te štetan utjecaj na zdravlje ljudi i/ili životinja.