Background: Inhaler therapy plays a crucial role in controlling respiratory symptoms in patients with chronic obstructive pulmonary disease (COPD). Incorrect or partially correct use of inhaler devices causes many chronic obstructive pulmonary disease (COPD) patients to continue to have respiratory symptoms due to poor drug deposition in the airways as a result of poor inhaler technique, leading to increased healthcare costs due to exacerbations and multiple emergency room presentations. Choosing the right inhaler device for each individual patient is a bigger challenge for doctors and chronic obstructive pulmonary disease (COPD) patients. The type of inhaler device and the correct inhaler technique depends on the control of symptoms in chronic obstructive pulmonary disease (COPD). Physicians treating patients with chronic obstructive pulmonary disease (COPD) play a central role in educating patients about the correct use of inhalation devices. The steps for the correct use of inhalation devices should be taught to patients by doctors in the presence of the family so that if the patient has difficulties handling the device correctly, the family can support them. Methods: Our analysis included 200 subjects divided into two groups—recommended group (RG) and chosen group (CG)—and aimed primarily to identify the behaviour of chronic obstructive pulmonary disease (COPD) patients when faced with deciding which type of inhaler device is most suitable for them. The two groups were monitored three times during the 12-month follow-up period. Monitoring required the physical presence of the patient at the investigating physician’s office. The study included patients who were smokers, ex-smokers, and/or with significant exposure to occupational pollutants, aged over 40 years diagnosed with chronic obstructive pulmonary disease (COPD), risk group B and C according to the GOLD guideline staging, and on inhaled ICS+LABA treatment, although they had an indication for LAMA+LABA dual bronchodilation treatment. Patients presented for consultation on their own initiative for residual respiratory symptoms under background treatment with ICS+LABA. The investigating pulmonologist who offered consultations to all scheduled patients, on the occasion of the consultation, also checked the inclusion and exclusion criteria. If the patient did not meet the study entry criteria, they were assessed and received the appropriate treatment, and if the study entry criteria were met, the patient signed the consent and followed the steps recommended by the investigating pulmonologist. As a result, patient entry into the study was randomised 1:1, meaning that the first patient was recommended the inhaler device by the doctor and the next patient entered into the study was left to decide for themselves which type of device was most suitable for them. In both groups, the percentage of patients who had a different choice of inhaler device from that of their doctor was statistically significant. Results: Compliance to treatment at T12 was found to be low, but compared to results previously published on compliance, in our analysis, compliance was higher and the only reasons identified as responsible for the better results were related to the selection of the target groups and the regular assessments, where, in addition to reviewing the inhaler technique, patients were encouraged to continue treatment, thus creating a strong bond between patient and doctor. Conclusions: Our analysis revealed that empowering patients by involving them in the inhaler selection process increases adherence to inhaler treatment, reduces the number of mistakes in inhaler use of the inhaler device, and implicitly the number of exacerbations.

The first cases of COVID-19 were reported in Wuhan Province, in China, in December 2019, spreading rapidly around the world. The World Health Organization (WHO) declared this pandemic at the beginning of March 2020 and, at the same time, the first patient in Galați County was confirmed. Both the global and the regional epidemiological evolutions have taken place with variations in incidence, which have been graphically recorded in several “waves”. We conducted a retrospective study on cases of COVID-19 infection, hospitalized between March and June 2020 in an infectious diseases clinic from Galati, in the south-east of Romania. The present paper describes the “first-wave” regional epidemiological and clinical-biological features and the evolution of the COVID-19 pandemic. A poor outcome was related to late presentation to hospital, old age, and over six comorbid conditions including Alzheimer’s disease. The high death rate among people from long-term care institutions is the consequence of the cumulative risk factors associated with immune senescence and inflammation, while COVID-19 is more likely a contributing factor to lower life expectancy.

The risk factors of hospitalized COVID-19 and obstructive sleep apnea (OSA) overlap. The aim of this study is to evaluate the prevalence and associated factors of post-COVID-19 OSA in hospitalized adult patients from southeastern Romania. A follow-up study was conducted on patients hospitalized for COVID-19 at the Pneumology Hospital in Galati, Romania, between 2021 and 2022. OSA was evaluated using the Epworth and STOP-BANG questionnaires and nocturnal polygraphy monitoring. Out of 331 patients, 257 were evaluated for sleep apnea in the 12th week. The prevalence of severe OSA was 57.97%. Significant associations were found with male gender, an age over 60, obesity, and cardiovascular co-morbidities. Non-invasive ventilatory therapy (NIV) and a hygienic–dietary regimen were recommended based on severity following a control visit after a month. Developing strategies for diagnosing and monitoring sleep disorders, including home sleep apnea tests and patient education, are the next directions for post-COVID-19 management.

Background and Objectives: Cardiac involvement in COVID-19 has been confirmed during the acute stage of the infection. However, the prevalence and spectrum of post-infectious cardiac dysfunction remain incompletely clarified. The objective of our study was to evaluate the frequency of echocardiographic changes 2 years after hospitalization for moderate and severe COVID-19 in patients with no previously known cardiac pathology. Material and Methods: We conducted a retrospective cohort study analyzing severity markers of COVID-19 infection and echocardiographic parameters assessed ≥2 years after the acute illness, based on recent guideline recommended algorithm for echocardiographic diagnostic of left ventricular (LV) dysfunction. Results: The study included 50 Caucasian patients, 60% male, 54% aged < 65 years, and 32% with severe forms of the disease. The primary comorbidities were hypertension, obesity, and diabetes. COVID-19 severity correlated with the computed tomography (CT) lung lesion score and a neutrophil-to-lymphocyte ratio >6 but was not associated with post-COVID-19 echocardiographic changes. Left ventricular ejection fraction (LVEF) was reduced in only 18% of cases, but global longitudinal strain (GLS) impairment was observed in 46% of patients, contributing to the LV systolic subclinical dysfunction in 61%. Impaired LV diastolic disfunction with normal pressure filling was present in 30.61% of cases and with elevated pressure 10.2%. Conclusions: COVID-19 is an independent predictive factor for GLS impairment, which can indicate myocardial contractile dysfunction, even in patients with asymptomatic heart disease. This underscores the importance of regular echocardiographic monitoring for patients recovering from moderate to severe COVID-19.

COVID-19 and influenza are highly contagious respiratory viral diseases and priority global public health concerns. We conducted a retrospective observational study of COVID-19 and/or influenza hospitalized cases, during 2023. We identified 170 influenza cases, 150 COVID-19 cases and 3 co-infections. Overall, 29.10% of patients had at least one COVID-19 vaccine dose and 4.6% received the seasonal Flu vaccine. The demographic data found older patients in the COVID-19 group and a higher index of the comorbidities, mainly due to chronic heart diseases, hypertension, and diabetes. Fever, chills, and rhinorrhea were more frequently related to influenza, while cough was prevalent in COVID-19. Antibiotics were more used in influenza than COVID-19, either pre-hospital or in-hospital. The mortality rate within the first 30 days from the onset of the respiratory infection was higher in influenza compared to COVID-19. We concluded that the COVID-19 clinical picture in hospitalized patients is changing to influenza-like symptoms. The evolution is variable, related to chronic comorbidities, but influenza had more frequent severe forms. All through 2023, due to poor vaccination rates, COVID-19 and influenza have continued to cause numerous hospitalizations, and a new strategy for efficient vaccinations is required.

Clinical manifestations and mortality caused by SARS-CoV-2 change, consistent with circulating viral variants and population immunity. Our retrospective study analyses the hospitalised COVID-19 cases from Romania in 2024 comparative with 2020. The circulation of SARS-CoV-2 in the fourth year of the pandemic led to changes in the characteristics of the hospitalised population, including clinical, biological, and radiological profiles, as well as an increase in 90-day mortality after hospitalisation. The hospitalised population became predominantly older with multiple comorbidities. Notable changes in symptomatology included an increase in the frequency of rhinorrhoea and syncope, while disturbances in taste and smell were less frequent. The mortality rate within the first 90 days increased in 2024 to 9%. Older age and a higher index of chronic comorbidities were associated with a higher frequency of severe forms and deaths within 90 days post-COVID-19. Hospitalisation for COVID-19 may be an unfavourable prognostic factor for the elderly population.