{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T22:23:58Z","timestamp":1772749438632,"version":"3.50.1"},"reference-count":60,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2022,3,12]],"date-time":"2022-03-12T00:00:00Z","timestamp":1647043200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007771","name":"Medical University of Silesia","doi-asserted-by":"publisher","award":["PCN-1-122\/N\/0\/K"],"award-info":[{"award-number":["PCN-1-122\/N\/0\/K"]}],"id":[{"id":"10.13039\/100007771","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Multiple Sclerosis (MS) is the most common chronic autoimmune disease of the central nervous system, affecting around 2.8 million people worldwide. Patients\u2019 knowledge about COVID-19 infection, and their proper protective actions, may reduce the risk of infection. The aim of this study was to assess the knowledge of patients with MS about SARS-CoV-2, COVID-19 illness, the relationship between MS and COVID-19, willingness to be vaccinated, and the impact of the pandemic on MS care. An original, anonymous, 35-items, self-reported questionnaire was used in both web-based and on-site survey formats. Two-hundred and forty-eight questionnaires were analyzed (mean age 40.8 \u00b1 10.6 years, 77.8% women). Participants reported the use of multiple sources of information, and the most common were websites (77.8%) and television (59.3%). The majority of participants knew the correct symptoms of COVID-19 or transmission routes (94.4%), and accepted the pandemic\u2019s restrictions (96.8%). A total of 93.2% considered SARS-CoV-2 as highly infectious, and 69% thought they were at higher risk of being infected with SARS-CoV-2, mainly because of immunodeficiency (82.7%). Although most of them were afraid of COVID-19 (69.0%), only two-thirds wanted to be vaccinated. Patients who were afraid of COVID-19 had a 3.5-times higher chance to declare willingness for vaccination. A total of 29.8% patients claimed that the COVID-19 pandemic limited access to the healthcare system. This study shows that Polish patients with MS represent a good level of knowledge about COVID-19 disease, and acceptance for public rules, but their willingness for vaccinations is not sufficient. Country-wide educational campaigns should be conducted, particularly on the internet and TV. Restrictions in healthcare facilities should be balanced to secure access for patients with MS.<\/jats:p>","DOI":"10.3390\/ijerph19063366","type":"journal-article","created":{"date-parts":[[2022,3,13]],"date-time":"2022-03-13T22:29:43Z","timestamp":1647210583000},"page":"3366","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Awareness of COVID-19 Symptoms, Risk Factors, and Vaccinations in Patients with Multiple Sclerosis"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4441-3088","authenticated-orcid":false,"given":"Ewa","family":"Krzystanek","sequence":"first","affiliation":[{"name":"Department of Neurology, Faculty of Health Sciences in Katowice, Medical University of Silesia, 40-635 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agata","family":"Jurczak","sequence":"additional","affiliation":[{"name":"Students\u2019 Scientific Association, Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kinga","family":"Kocur","sequence":"additional","affiliation":[{"name":"Students\u2019 Scientific Association, Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jakub","family":"Jurkiewicz","sequence":"additional","affiliation":[{"name":"Students\u2019 Scientific Association, Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aleksandra","family":"Kaczmarczyk","sequence":"additional","affiliation":[{"name":"Department of Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1056\/NEJMra1401483","article-title":"Multiple Sclerosis","volume":"378","author":"Reich","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1816","DOI":"10.1177\/1352458520970841","article-title":"Rising prevalence of multiple sclerosis worldwide: Insights from the Atlas of MS, third edition","volume":"26","author":"Walton","year":"2020","journal-title":"Mult. Scler. J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.msard.2018.02.016","article-title":"Prevalence of multiple sclerosis in Poland","volume":"21","author":"Brola","year":"2018","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1159\/000310301","article-title":"Socioeconomic trends in hospitalization for multiple sclerosis","volume":"35","author":"Lad","year":"2010","journal-title":"Neuroepidemiology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"103162","DOI":"10.1016\/j.msard.2021.103162","article-title":"Multiple sclerosis incidence and prevalence in Poland: Data from administrative health claims","volume":"55","author":"Wnuk","year":"2021","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_6","unstructured":"(2022, March 07). Atlas of MS. Available online: https:\/\/www.atlasofms.org\/fact-sheet\/poland."},{"key":"ref_7","first-page":"161","article-title":"Clinical and epidemiological characteristics of multiple sclerosis patients receiving disease-modifying treatment in Poland","volume":"54","author":"Collin","year":"2020","journal-title":"Neurol. I Neurochir Pol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1647","DOI":"10.2147\/PPA.S109520","article-title":"Self-reported quality of life in multiple sclerosis patients: Preliminary results based on the Polish MS Registry","volume":"10","author":"Brola","year":"2016","journal-title":"Patient Prefer. Adherence"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1111\/ene.14040","article-title":"Comorbidity in multiple sclerosis: Its temporal relationships with disease onset and dose effect on mortality","volume":"27","author":"Chou","year":"2020","journal-title":"Eur. J. Neurol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1038\/nrneurol.2017.33","article-title":"Comorbidity in multiple sclerosis: Implications for patient care","volume":"13","author":"Marrie","year":"2017","journal-title":"Nat. Rev. Neurol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"101982","DOI":"10.1016\/j.msard.2020.101982","article-title":"Infections in patients diagnosed with multiple sclerosis: A multi-database study","volume":"41","author":"Persson","year":"2020","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1212\/WNL.0000000000000753","article-title":"Dramatically changing rates and reasons for hospitalization in multiple sclerosis","volume":"83","author":"Marrie","year":"2014","journal-title":"Neurology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1111\/ene.12130","article-title":"Hospital admission due to infections in multiple sclerosis patients","volume":"20","author":"Montgomery","year":"2013","journal-title":"Eur. J. Neurol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1506","DOI":"10.1177\/1352458516681198","article-title":"Tremlett, H. Infection-related health care utilization among people with and without multiple sclerosis","volume":"23","author":"Wijnands","year":"2017","journal-title":"Mult. Scler."},{"key":"ref_15","first-page":"1315","article-title":"Therapeutic decisions in multiple sclerosis: Moving beyond efficacy","volume":"70","author":"Gold","year":"2013","journal-title":"JAMA Neurol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1001\/jamaneurol.2019.3365","article-title":"Infection risks among patients with multiple sclerosis treated with fingolimod, natalizumab, rituximab, and injectable therapies","volume":"77","author":"Luna","year":"2020","journal-title":"JAMA Neurol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1007\/BF00867354","article-title":"Viral infections trigger multiple sclerosis relapses: A prospective seroepidemiological study","volume":"240","author":"Andersen","year":"1993","journal-title":"J. Neurol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1263","DOI":"10.1177\/1352458509107010","article-title":"Excess mortality and cause of death in a cohort of Norwegian multiple sclerosis patients","volume":"15","author":"Smestad","year":"2009","journal-title":"Mult. Scler."},{"key":"ref_19","unstructured":"World Health Organization (2021, August 24). WHO Coronavirus (COVID-19) Dashboard. Available online: https:\/\/covid19.who.int\/."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e3303","DOI":"10.1002\/jgm.3303","article-title":"COVID-19: Virology, biology and novel laboratory diagnosis","volume":"23","author":"Mohamadian","year":"2021","journal-title":"J. Gene Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1021\/acs.molpharmaceut.0c00608","article-title":"COVID-19 Transmission, Current Treatment, and Future Therapeutic Strategies","volume":"18","author":"Salian","year":"2021","journal-title":"Mol. Pharm."},{"key":"ref_22","unstructured":"Centers for Disease Control and Prevention (2022, February 02). Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic, Available online: https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/infection-control-recommendations.html."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"704558","DOI":"10.3389\/fpsyt.2021.704558","article-title":"Unknown Enemy and Psychopathological Responses: A Cross-Sectional Nationwide Study Assessing the Knowledge about COVID-19","volume":"12","author":"Maciaszek","year":"2021","journal-title":"Front. Psychiatry"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Walkowiak, M.P., Walkowiak, J.B., and Walkowiak, D. (2021). COVID-19 Passport as a Factor Determining the Success of National Vaccination Campaigns: Does It Work? The Case of Lithuania vs. Poland. Vaccines, 9.","DOI":"10.3390\/vaccines9121498"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Szmyd, B., Karuga, F.F., Bartoszek, A., Staniecka, K., Siwecka, N., Bartoszek, A., B\u0142aszczyk, M., and Radek, M. (2021). Attitude and Behaviors towards SARS-CoV-2 Vaccination among Healthcare Workers: A Cross-Sectional Study from Poland. Vaccines, 9.","DOI":"10.3390\/vaccines9030218"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Szmyd, B., Bartoszek, A., Karuga, F.F., Staniecka, K., B\u0142aszczyk, M., and Radek, M. (2021). Medical Students and SARS-CoV-2 Vaccination: Attitude and Behaviors. Vaccines, 9.","DOI":"10.3390\/vaccines9020128"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Walkowiak, M.P., and Walkowiak, D. (2021). Predictors of COVID-19 Vaccination Campaign Success: Lessons Learnt from the Pandemic So Far. A Case Study from Poland. Vaccines, 9.","DOI":"10.3390\/vaccines9101153"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Raciborski, F., Samel-Kowalik, P., Gujski, M., Pinkas, J., Arcimowicz, M., and Jankowski, M. (2021). Factors Associated with a Lack of Willingness to Vaccinate against COVID-19 in Poland: A 2021 Nationwide Cross-Sectional Survey. Vaccines, 9.","DOI":"10.3390\/vaccines9091000"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"3550","DOI":"10.1007\/s12325-021-01761-3","article-title":"Vaccine Considerations for Multiple Sclerosis in the COVID-19 Era","volume":"38","author":"Coyle","year":"2021","journal-title":"Adv. Ther."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"4161","DOI":"10.1016\/j.vaccine.2015.04.036","article-title":"SAGE Working Group on Vaccine Hesitancy. Vaccine hesitancy: Definition, scope and determinants","volume":"33","author":"MacDonald","year":"2015","journal-title":"Vaccine"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.4161\/hv.24657","article-title":"Vaccine hesitancy: An overview","volume":"9","author":"Laberge","year":"2013","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1080\/21645515.2018.1564437","article-title":"Knowledge, attitudes and beliefs towards compulsory vaccination: A systematic review","volume":"15","author":"Gualano","year":"2019","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1444","DOI":"10.1212\/WNL.33.11.1444","article-title":"Rating neurologic impairment in multiple sclerosis: An expanded disability status scale (EDSS)","volume":"33","author":"Kurtzke","year":"1983","journal-title":"Neurology"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Boguszewski, R., Makowska, M., and Podkowinska, M. (2021). A Typology of Poles\u2019 Attitudes toward COVID-19 during the First Wave of the Pandemic. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18042002"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1661","DOI":"10.1038\/s41598-021-81308-2","article-title":"Effects of social distancing on the spreading of COVID-19 inferred from mobile phone data","volume":"11","author":"Khataee","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_36","unstructured":"Brennen, J.S., Simon, F.M., Howard, P.N., and Nielsen, R.K. (2020). Types, Sources, and Claims of COVID-19 Misinformation. [Ph.D. Thesis, University of Oxford]."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"102193","DOI":"10.1016\/j.msard.2020.102193","article-title":"Knowledge regarding COVID-19 pandemic in patients with Multiple sclerosis (MS): A report from Iran","volume":"42","author":"Sahraian","year":"2020","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"163","DOI":"10.2147\/RMHP.S288579","article-title":"Knowledge, Attitudes, Practices and Information Needs During the COVID-19 Pandemic in Indonesia","volume":"14","author":"Sulistyawati","year":"2021","journal-title":"Risk Manag. Healthc Policy"},{"key":"ref_39","unstructured":"National Multiple Sclerosis Society (2021, August 24). COVID-19 Vaccine Guidance for People Living with MS. Available online: https:\/\/www.nationalmssociety.org\/coronavirus-covid-19-information\/multiple-sclerosis-and-coronavirus\/covid-19-vaccine-guidance."},{"key":"ref_40","unstructured":"World Health Organization (2021, September 23). COVID-19 Vaccines. Available online: https:\/\/www.who.int\/emergencies\/diseases\/novel-coronavirus-2019\/covid-19-vaccines."},{"key":"ref_41","unstructured":"Centers for Disease Control and Prevention (2021, September 23). Science Brief: COVID-19 Vaccines and Vaccination, Available online: https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/science\/science-briefs\/fully-vaccinated-people.html."},{"key":"ref_42","unstructured":"NAWA Polish National Agency for Academic Exchange (2021, September 23). Vaccination in Poland: How to Apply and Other Things You Need to Know, Available online: https:\/\/study.gov.pl\/news\/vaccination-poland."},{"key":"ref_43","unstructured":"(2021, October 03). Szczepienia Przeciw COVID-19 u Chorych Na Stwardnienie Rozsiane. Stanowisko Polskiego Towarzystwa Neurologicznego, Available online: https:\/\/szczepienia.pzh.gov.pl\/szczepienia-przeciw-covid-19-chorych-na-stwardnienie-rozsiane-stanowisko-polskiego-towarzystwa-neurologicznego\/."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"8","DOI":"10.5603\/PJNNS.a2021.0016","article-title":"COVID-19 mRNA vaccines (Pfizer-BioNTech and Moderna) in patients with multiple sclerosis: A statement by a working group convened by the Section of Multiple Sclerosis and Neuroimmunology of the Polish Neurological Society","volume":"55","author":"Nojszewska","year":"2021","journal-title":"Neurol. Neurochir. Pol."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Raciborski, F., Jankowski, M., Gujski, M., Pinkas, J., and Samel-Kowalik, P. (2021). Changes in Attitudes towards the COVID-19 Vaccine and the Willingness to Get Vaccinated among Adults in Poland: Analysis of Serial, Cross-Sectional, Representative Surveys, January-April 2021. Vaccines, 9.","DOI":"10.3390\/vaccines9080832"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"102880","DOI":"10.1016\/j.msard.2021.102880","article-title":"Willingness to be vaccinated against COVID-19: An exploratory online survey in a Portuguese cohort of multiple sclerosis patients","volume":"51","author":"Serrazina","year":"2021","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"102788","DOI":"10.1016\/j.msard.2021.102788","article-title":"Willingness to obtain COVID-19 vaccination in adults with multiple sclerosis in the United States","volume":"49","author":"Ehde","year":"2021","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Rzymski, P., Zeyland, J., Poniedzia\u0142ek, B., Ma\u0142ecka, I., and Wysocki, J. (2021). The Perception and Attitudes toward COVID-19 Vaccines: A Cross-Sectional Study in Poland. Vaccines, 9.","DOI":"10.3390\/vaccines9040382"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"103163","DOI":"10.1016\/j.msard.2021.103163","article-title":"COVID-19 vaccine hesitancy in adults with multiple sclerosis in the United States: A follow up survey during the initial vaccine rollout in 2021","volume":"54","author":"Ehde","year":"2021","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"102856","DOI":"10.1016\/j.msard.2021.102856","article-title":"Perceptions of risk and adherence to care in MS patients during the COVID-19 pandemic: A cross-sectional study","volume":"50","author":"Zhang","year":"2021","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1001\/jamaneurol.2020.2581","article-title":"Clinical Characteristics and Outcomes in Patients With Coronavirus Disease 2019 and Multiple Sclerosis","volume":"77","author":"Louapre","year":"2020","journal-title":"JAMA Neurol."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Capasso, N., Palladino, R., Montella, E., Pennino, F., Lanzillo, R., Carotenuto, A., Petracca, M., Iodice, R., Iovino, A., and Aruta, F. (2020). Prevalence of SARS-CoV-2 Antibodies in Multiple Sclerosis: The Hidden Part of the Iceberg. J. Clin. Med., 9.","DOI":"10.3390\/jcm9124066"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"e954","DOI":"10.1212\/NXI.0000000000000954","article-title":"Incidence and Impact of COVID-19 in MS: A Survey From a Barcelona MS Unit","volume":"8","author":"Llufriu","year":"2021","journal-title":"Neurol. Neuroimmunol. Neuroinflammation"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"212","DOI":"10.5603\/PJNNS.a2021.0031","article-title":"Clinical course and outcome of SARS-CoV-2 infection in multiple sclerosis patients treated with disease-modifying therapies\u2014the Polish experience","volume":"55","author":"Czarnowska","year":"2021","journal-title":"Neurol. Neurochir. Pol."},{"key":"ref_55","unstructured":"(2021, February 05). Raport Zaka\u017ce\u0144 Koronawirusem (SARS-CoV-2)\u2014Koronawirus: Informacje I Zalecen, Available online: https:\/\/www.gov.pl\/web\/koronawirus\/wykaz-zarazen--koronawirusem-sars-cov-2."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1177\/1352458520948231","article-title":"Multiple sclerosis management during the COVID-19 pandemic","volume":"26","author":"Moss","year":"2020","journal-title":"Mult. Scler. J."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1007\/s40520-020-01601-4","article-title":"The potential long-term impact of the COVID-19 outbreak on patients with non- communicable diseases in Europe: Consequences for healthy ageing","volume":"32","author":"Palmer","year":"2020","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1212\/WNL.0000000000009507","article-title":"Treating multiple sclerosis and neuromyelitis optica spectrum disorder during the COVID-19 pandemic","volume":"94","author":"Brownlee","year":"2020","journal-title":"Neurology"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"102073","DOI":"10.1016\/j.msard.2020.102073","article-title":"The COVID-19 pandemic and the use of MS disease modifying therapies","volume":"39","author":"Giovannoni","year":"2020","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"102512","DOI":"10.1016\/j.msard.2020.102512","article-title":"Impact of the COVID-19 pandemic on the health care of >1,000 People living with multiple sclerosis: A cross-sectional study","volume":"46","author":"Vogel","year":"2020","journal-title":"Mult. Scler. Relat. Disord."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/6\/3366\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:35:39Z","timestamp":1760135739000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/6\/3366"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,12]]},"references-count":60,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,3]]}},"alternative-id":["ijerph19063366"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19063366","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,12]]}}}