Persistent pulmonary impairment post-COVID-19 has been reported, albeit variably. This single-center observational study aims to longitudinally evaluate pulmonary function in 140 COVID-19 survivors one year after recovery, assessing associations with disease severity and pre-existing lung conditions. Participants aged 18 and older, with confirmed SARS-CoV-2 infection, were evaluated using spirometry and Diffusion Capacity of Lungs for Carbon Monoxide (DLCO) tests. Pulmonary function parameters like Forced Expiratory Volume at 1 s (FEV1), Forced Vital Capacity (FVC), and Total Lung Capacity (TLC) were measured. Participants were stratified by age, gender, body mass index, smoking status, and lung damage severity via computed tomography (CT). The cohort consisted of mostly males (58.6%), with a mean age of 53.8 years and body mass index of 24.9 kg/m². Post-COVID fibrosis was seen in 22.7%, 27.3%, and 51.9% of mild, moderate, and severe disease patients, respectively (p = 0.003). FVC significantly reduced with disease severity (p < 0.001), while FEV1, FEF25-75, and DLCO showed a non-significant downward trend. FEV1/FVC ratio increased with disease severity (p = 0.033), and TLC and RV significantly declined (p = 0.023 and p = 0.003, respectively). A one-year follow-up indicated a non-significant change in FVC, FEV1, FEV1/FVC ratio, FEF25-75, and RV compared with the 40-day measurement, but it revealed significant improvements in DLCO and TLC (p = 0.010). There were significant mean increases in FVC, FEV1, DLCO, TLC, and RV across all disease severities over one year. They were most pronounced in the patients with a history of severe COVID-19, who had a better recovery over one year, compared with the mild and moderate COVID-19 patients whose lung function almost normalized. One year after the SARS-CoV-2 infection, we observed a significant association between disease severity and post-COVID fibrotic changes. Though some lung function parameters remained stable over the year, significant improvements were noted in DLCO and TLC. Particularly, individuals with severe disease showed substantial recovery in lung function, indicating the potential reversibility of COVID-19-related pulmonary damage.

This review addresses the ongoing challenges in asthma management, particularly focusing on patient adherence to inhaler therapy. Asthma, a chronic condition characterized by variable respiratory symptoms and airflow obstruction, can lead to significant morbidity and mortality if not properly managed. Despite advances in inhaler technology and therapeutic options, non-adherence remains a significant barrier to optimal asthma control. This review explores both intentional and unintentional non-adherence, influenced by factors such as age, socioeconomic status, and the complexity of inhaler devices. The Global Initiative for Asthma (GINA) provides guidelines aimed at improving adherence through targeted interventions, and this review examines their application. Common inhaler technique errors, including incorrect inhalation speed, not exhaling before inhaling, and failure to hold breath post-inhalation, are identified as major contributors to inadequate asthma control. Furthermore, the review explores the emerging role of electronic monitoring devices (EMDs), such as CapMedic and DigiHaler, which offer real-time feedback to enhance inhaler technique and adherence. The role of biomarkers in assessing adherence and the potential of personalized treatment strategies, including biologic therapies, are also discussed. Overall, addressing adherence requires a comprehensive approach that integrates patient education, tailored interventions, and technological innovations to achieve better clinical outcomes in asthma management.

Background and Objectives: Ward-level risk in pulmonary tuberculosis (TB) is often estimated from static admission data. This study evaluated a pragmatic composite—TRIAD-TB—integrating physiology (SpO₂, respiratory rate), inflammation (systemic immune-inflammation index [SII], C-reactive protein [CRP]), and nutrition (BMI, albumin), augmented by 72 h changes in CRP and albumin, to predict 30-day mortality and hospital length of stay (LOS). Methods: A pooled prospective cohort of 126 HIV-negative adults without chronic systemic immunosuppression hospitalized with culture-confirmed pulmonary TB at two Romanian tertiary centers was analyzed. TRIAD-TB combined z-scored admission markers and 72 h deltas. The primary outcome was 30-day all-cause mortality; secondary outcomes included LOS. Associations were estimated using Firth logistic regression (mortality) and quasi-Poisson regression (LOS). Discrimination and overall performance were summarized by AUC and Brier score; internal performance used bootstrap optimism-correction. Results: Across TRIAD-TB tertiles, 30-day mortality increased from 2.4% to 16.7%, and mean LOS rose from 24.7 ± 5.8 to 32.1 ± 7.3 days. Each SD increase in TRIAD-TB was associated with higher odds of death (adjusted OR 2.4, 95% CI 1.3–4.8; p = 0.006) and longer hospitalization (adjusted IRR 1.19, 95% CI 1.09–1.30; p < 0.001). The full model discriminated mortality well (AUC 0.84; Brier 0.067) and explained 21.8% of LOS deviance. Early dynamics were informative: higher CRP ratio (72 h/0 h) and albumin decline tracked with adverse outcomes. An admission-only “mini-TRIAD” retained strong discrimination (AUC 0.79). Conclusions: A dynamic composite leveraging routine vitals and laboratory tests—plus 72 h trajectories—accurately stratified short-term risk in hospitalized pulmonary TB, while an admission-only “mini-TRIAD” retained strong discrimination. Together, these tools may support early escalation, targeted monitoring, and capacity planning. TRIAD-TB may support early escalation, targeted monitoring, and capacity planning; however, because it was derived in HIV-negative, non-immunosuppressed adults in an Eastern European setting, TRIAD-TB and the admission-only “mini-TRIAD” require external validation, including in cohorts with substantial HIV co-infection and different comorbidity profiles, before any broader implementation.

Stress, anxiety, and post-surgical chest pain are common problems among patients with thoracic surgical pathology. The way in which psychological distress is managed—the coping style—can influence the postsurgical evolution and quality of life of patients. In our study, we monitored the influence of coping style on patients’ anxiety and the intensity of post-operative chest pain. We conducted a cross-sectional study on 90 subjects with thoracic surgical pathology. One month after their surgeries, patients completed the following scales and questionnaires, translated, adapted, and validated for the Romanian population: COPE scale inventory, Generalized Anxiety Disorder-7 Questionnaire, McGill Pain Questionnaire, and Numeric Pain Rating Scale. Anxiety (evaluated using the Generalized Anxiety Disorder-7 Questionnaire) and postoperative thoracic pain intensity (evaluated by means of the Numeric Pain Rating Scale, Number of Words Chosen, and McGill Pain Questionnaire) were significantly higher in patients exhibiting social-focused coping than in patients presenting emotion-focused or problem-focused coping as their main coping style (Kruskal–Wallis, p = 0.028, p = 0.022, p = 0.042, p = 0.007). In our study, there were no differences observed in pain intensity relative to level of anxiety. Coping style is an important concept in the management of anxiety and pain experienced by patients undergoing chest surgery. Therefore, a multidisciplinary approach should be considered in clinical practice.

Background and Objectives: Blood-borne inflammatory ratios have been proposed as inexpensive prognostic tools across a range of diseases, but their role in pulmonary tuberculosis (TB) remains uncertain. In this retrospective case–control analysis, we explored whether composite indices derived from routine haematology—namely the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), the systemic immune–inflammation index (SII) and a novel CRP–Fibrinogen Index (CFI)—could enhance risk stratification beyond established cytokine measurements among Romanian adults with culture-confirmed pulmonary T. Materials and Methods: Data were drawn from 80 consecutive TB in-patients and 50 community controls. Full blood counts, C-reactive protein, fibrinogen, and four multiplex cytokines were extracted from electronic records, and composite indices were calculated according to standard formulas. The primary outcomes were in-hospital mortality within 90 days and length of stay (LOS). Results: Among TB patients, the median NLR was 3.70 (IQR 2.54–6.14), PLR was 200 (140–277) and SII was 1.36 × 10⁶ µL⁻¹ (0.74–2.34 × 10⁶), compared with 1.8 (1.4–2.3), 117 (95–140) and 0.46 × 10⁶ µL⁻¹ (0.30–0.60 × 10⁶) in controls. Those with SII above the cohort median exhibited more pronounced acute-phase responses (median CRP 96 vs. 12 mg L⁻¹; fibrinogen 578 vs. 458 mg dL⁻¹), yet median LOS remained virtually identical (29 vs. 28 days) and early mortality was low in both groups (8% vs. 2%). The CFI showed no clear gradient in hospital stay across its quartiles, and composite ratios—while tightly inter-correlated—demonstrated only minimal association with cytokine levels and LOS. Conclusions: Composite cell-count indices were markedly elevated but did not predict early death or prolonged admission. In low-event European cohorts, their chief value may lie in serving as cost-free gatekeepers, flagging those who should proceed to more advanced cytokine or genomic testing. Although routine reporting of NLR and SII may support low-cost surveillance, validation in larger, multicentre cohorts with serial sampling is needed before these indices can be integrated into clinical decision-making.

Background: Idiopathic pulmonary fibrosis (IPF) is a progressive disease with a major impact on respiratory function, but also with possible underestimated effects on cognitive function. Although interest in cognitive impairment in chronic respiratory diseases, such as COPD, has increased, data on IPF remain limited and heterogeneous. Objective: This systematic review aimed to synthesize current evidence on cognitive impairment in IPF, identify the most affected domains, and evaluate the certainty of evidence using standardized methodological tools. Methods: A systematic review was conducted according to PRISMA 2020, with a registered PROSPERO protocol (CRD420251041866). Four databases (PubMed, Scopus, Web of Science, Cochrane Library) were searched for studies from 2014 to 2025. Methodological quality and certainty of evidence were appraised with the Joanna Briggs Institute (JBI) and GRADE frameworks. Results: Four studies met the inclusion criteria (two cross-sectional, one descriptive, one case–control). Across investigations, working and verbal memory emerged as the most consistently impaired domains, followed by processing speed and executive function, whereas visuospatial and language abilities were less frequently affected. Cognitive impairment was present even in mild IPF and became more pronounced with lower DLCO, shorter 6 min walk distance, greater desaturation, and obstructive sleep apnea. Certainty of evidence ranged from low to moderate due to small samples and heterogeneous testing. Conclusions: Cognitive dysfunction, particularly in memory, attention, and executive domains, is a frequent but under-recognized feature of IPF. Routine screening with brief, validated tools such as the MoCA may facilitate early detection and guide individualized rehabilitation.