The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused a global pandemic and one group of patients has developed a severe form of COVID-19 pneumonia with an urgent need for hospitalization and intensive care unit (ICU) admission. The aim of our study was to evaluate the prognostic role of MDW, CRP, procalcitonin (PCT), and lactate in critically ill COVID-19 patients. The primary outcome of interest is the 28 day mortality of ICU patients with confirmed SARS-CoV-2 infection and sepsis (according to Sepsis 3 criteria with acute change in SOFA score ≥ 2 points). Patients were divided into two groups according to survival on the 28th day after admission to the ICU. Every group was divided into two subgroups (women and men). Nonparametric tests (Mann–Whitney) for variables age, PCT, lactate, and MDW were lower than alpha p < 0.05, so there was a significant difference between survived and deceased patients. The Chi-square test confirmed statistically significant higher values of MDW and lactate in the non-survivor group. We found a significant association between MDW, lactate, procalcitonin, and fatal outcome, higher values were reported in the deceased group.

Various biomarkers like certain complete blood cell count parameters and the derived ratios including neutrophil–lymphocyte ratio are commonly used to evaluate disease severity. Our study aimed to establish if baseline levels of complete blood cell count-derived biomarkers and CRP, measured before any treatment which can interfere with their values, could serve as a predictor of development of pneumonia and the need for hospitalization requiring oxygen therapy. We retrospectively analyzed the laboratory data of 200 consecutive patients without comorbidities, who denied usage of medications prior to blood analysis and visited a COVID-19 ambulance between October and December 2021. Multivariate regression analysis extracted older age, elevated CRP and lower eosinophil count as significant independent predictors of pneumonia (p = 0.003, p = 0.000, p = 0.046, respectively). Independent predictors of hospitalization were higher CRP (p = 0.000) and lower platelet count (p = 0.005). There was no significant difference in the neutrophil–lymphocyte and platelet–lymphocyte ratios between examined groups. Individual biomarkers such as platelet and eosinophil count might be better in predicting the severity of COVID-19 than the neutrophil–lymphocyte and platelet–lymphocyte ratios.

The gut microbiome plays a crucial role in shaping immune responses, and its connection to immunity has never been more relevant than in the COVID-19 era. The interaction between gut microbes and the immune system, known as microbiome-immunity crosstalk, influences both how the body responds to infections and how well it recovers. COVID-19, whether in its acute phase or lingering as long COVID, has been linked to disturbances in the gut microbiome. During infection, many patients experience dysbiosis—an imbalance in gut bacteria—that can contribute to immune dysfunction and excessive inflammation. This imbalance may not only worsen the severity of the disease but also prolong recovery, leading to persistent symptoms like fatigue, brain fog, and digestive issues. Long COVID, in particular, has been associated with ongoing immune dysregulation, where the body's defense system remains in a state of heightened activation, causing chronic inflammation. Given the strong link between gut health and immunity, there is growing interest in strategies to restore microbial balance. Synbiotics—combinations of probiotics (beneficial bacteria) and prebiotics (nutrients that support them)—are being explored as a potential therapeutic approach. By replenishing beneficial gut microbes, synbiotics may help regulate immune responses, reduce inflammation, and support overall recovery from COVID-19. Emerging research suggests that improving gut health could enhance the body's ability to fight infections and recover more efficiently. As we continue to understand the long-term impact of COVID-19, focusing on the gut microbiome offers a promising path forward. Supporting a balanced and diverse microbiome through diet, lifestyle, and targeted interventions like synbiotics may provide a natural way to strengthen immunity and improve health outcomes in both acute and long COVID cases.

Background: Population aging is accompanied by progressive immune remodeling, chronic low-grade inflammation, and increased susceptibility to neurodegenerative diseases. Although the microbiota–gut–brain axis is increasingly recognized as a regulator of neuroimmune homeostasis, mechanisms linking age-associated dysbiosis with immunosenescence, barrier dysfunction, and brain aging remain incompletely understood. This review integrates current evidence into the proposed Gut–Immune–Brain Resilience Axis (GIBRA), a systems-level model describing how microbial signaling shapes neuroimmune resilience during aging. Methods: A structured narrative review was conducted using PubMed and the Web of Science Core Collection from database inception up to July 2026. Evidence from systematic reviews, meta-analyses, consensus statements, mechanistic and translational studies, longitudinal cohorts, randomized clinical trials, and observational studies was synthesized. Results: Current evidence supports an important role for the disruption of microbial functional signaling in neuroimmune aging, while microbial taxonomy and functional profiles provide complementary levels of biological information. Reduced short-chain fatty acid production, dysregulated tryptophan metabolism, microbial translocation, endotoxin-mediated innate immune activation, and gut-conditioned adaptive immune responses promote immunosenescence, inflammaging, barrier dysfunction, and microglial priming. The proposed Double-Barrier Hypothesis links intestinal and blood–brain barrier dysfunction as complementary mechanisms underlying chronic neuroinflammation. GIBRA highlights functional microbiome endotypes, biomarkers, multi-omics, and artificial intelligence as emerging tools for precision medicine. Conclusions: GIBRA provides an integrated systems biology perspective connecting microbial signaling, immune resilience, barrier integrity, and brain resilience during aging. Prioritizing functional resilience over microbial taxonomy may improve biomarker discovery, patient stratification, and microbiome-targeted interventions for neurodegenerative disease prevention. Prospective longitudinal studies integrating multi-omics are needed to support clinical translation.

Introduction/Objective. Early identification of high-risk patients with COVID-19-associated sepsis is essential for timely intervention and optimal ICU resource allocation. This study aimed to evaluate and compare the prognostic performance of risk-stratification of emergency department sepsis (REDS) and sequential organ failure assessment (SOFA) scores, alongside D-dimer levels, in predicting 28-day mortality among critically ill patients. Methods. A retrospective analysis was conducted on 163 critically ill adult patients with confirmed COVID- 19 and sepsis (Sepsis-3 criteria) admitted to the intensive care unit of a tertiary center between November 2020 and May 2022. REDS, SOFA, and D-dimer values were assessed within 24 hours of ICU admission. Predictive value was evaluated using ROC analysis, logistic regression, and ?2 automatic interaction detector (CHAID) decision tree modeling. Results. The overall 28-day mortality rate was 65.6%. REDS (AUC = 0.690) and SOFA (AUC = 0.680) demonstrated moderate predictive ability, while D-dimer showed lower accuracy (AUC = 0.632). REDS > 2 had the highest sensitivity (80.2%), and SOFA > 4 had the highest specificity (56.1%). Both REDS and SOFA were identified as independent mortality predictors. CHAID analysis recognized REDS as the strongest discriminator, stratifying mortality risk into three distinct groups (42.9%, 66.1%, and 84.5%). Conclusion. REDS and SOFA scores provide meaningful prognostic value in patients with COVID-19-related sepsis. REDS demonstrated a slight advantage and may serve as a simple and effective bedside tool for early risk stratification in clinical practice and future viral pandemics.

Introduction. Congenital tongue base cysts are uncommon in everyday clinical practice and they could be asymptomatic or cause stridor, respiratory distress and asphyxia. We are presenting a case of two-month-old infant with the symptoms of stridor and the acute respiratory insufficiency caused by congenital tongue base cyst. Case outline. A two-month-old apyretic male infant was admitted to hospital with the symptoms of severe dyspnea, nonproductive cough and stridor. Due to severe respiratory insufficiency the infant was on mechanical ventilation. Computed tomography scans of thorax and neck was performed along with the application of the intravenous contrast where a cystic formation was shown. The depicted formation narrowed the lumen of oropharynx which is the same as the size of valleculas (3 mm). The formations pressed both valleculas, more significantly the left one. The same day the marsupialization of the cyst was done and the material was sent to the pathohistological analysis (the report of the pathologist indicates the cyst of the thyroid channel). Conclusion. Clinical manifestations of cyst depend on the level of obstruction and can be presented as inspiratory stridor, apnea, cyanosis, chronic coughing and feeding difficulty. The flexible nasopharyngeal laryngoscopy or bronchoscopy, CT and MR imaging help consider the differential diagnosis. The symptoms of stridor were removed completely after applied marsupialization of the cyst.