Introduction: This is a structured scoping review to assess whether there is a relationship between stress-induced hyperglycemia (SIH), cytokine interactions, and mortality in trauma patients in comparison to non-diabetic normoglycemia [NDN], diabetic normoglycemia [DN], and diabetic hyperglycemia [DH]. Methods: We conducted a literature search of MEDLINE (PubMed) databases from 2000 to 2022 using a search strategy to identify observational studies. Initially, 2879 articles were retrieved. Of these, 2869 were excluded due to insufficient variables, and non-trauma focuses. Results: Nine studies on the interaction between SIH and proinflammatory cytokines were analyzed. SIH was associated with the highest mortality rate (21.3%), followed by DH (5.4%), DN (2.8%), and NDN (2.3%) (p < 0.001). Furthermore, SIH patients exhibited an 11.28-fold higher likelihood of mortality compared to NDN patients (95% CI [9.13–13.93]; p < 0.001) and a 4.72-fold higher likelihood compared to DH patients (OR 4.72; 95% CI [3.55–6.27]; p < 0.001). Conclusions: SIH patients had elevated IL-6 concentrations relative to NDN, DN, and DH patients. SIH is linked to higher mortality in trauma, with greater odds than NDN. However, the robustness of this association is still being determined due to statistical and clinical variability. Uncertainties about injury severity and IL-6 level similarities between SIH and DH patients require further investigation.

The SARS-CoV-2 pandemic has posed global medical challenges due to its ability to affect multiple organ systems. Among the post-COVID-19 complications, multisystem inflammatory syndrome has emerged as a severe condition affecting both children (MIS-C) and adults (MIS-A). This review aims to compile and analyze published data to investigate clinical characteristics, laboratory findings, and outcomes of MIS post-COVID-19. A comprehensive search of various databases was conducted to identify studies reporting MIS-related complications in pediatric and adult populations post-COVID-19 infection. Screening, data extraction, and cross-checking were performed by two independent reviewers. Only 64 studies met our inclusion criteria, and compiled results revealed that cardiac complications were the predominant manifestation followed by gastrointestinal, hematologic, neurological, and mucocutaneous involvement. Laboratory findings consistently demonstrated elevated inflammatory markers including CRP, ferritin, D-dimer, and IL-6. Most patients required hospitalization, and many needed intensive care; treatment typically involved IVIG, corticosteroids, and biologic therapies. While most patients recovered, a subset experienced persistent complications. These findings highlight the importance of early recognition, multidisciplinary management, and structured follow-up for MIS. Future research is warranted to clarify the underlying mechanisms, risk factors, and long-term outcomes associated with MIS in post-COVID-19 patients.

Background: Sepsis is a time-sensitive, serious condition; therefore, early recognition and prompt initiation of therapy are critical to improving outcomes in patients with infection. We sought to evaluate whether prehospital antibiotic administration (PHAA) is associated with improved outcomes in patients with suspected severe sepsis. Methods: We conducted a systematic review and meta-analysis. This review was conducted in accordance with the PRISMA guidelines, and the protocol was developed a priori and registered with the International Prospective Register of Systematic Reviews (PROSPERO). PubMed, Embase, Cochrane, and Scopus were searched from inception through January 2026. Randomized controlled trials (RCTs) and observational studies evaluating empirical PHAA compared with the standard of care were included. The risk of bias and certainty of evidence were assessed. Outcomes included short- and long-term mortality, hospital length of stay (HLOS), and intensive care unit (ICU) admission. Sensitivity analyses were performed. Results: Eleven studies recruiting 23,146 patients were included (three RCTs and eight observational studies). Restricting the short-term mortality analysis to RCTs alone showed no mortality benefit with PHAA (RR 0.96, 95% CI 0.74–1.23), whereas the broader, observational-dominated pooled analysis suggested a possible reduction in short-term mortality (RR 0.84, 95% CI 0.68–1.02, I² = 51.0%), reaching statistical significance when restricted to the adult sepsis/septic shock population (RR 0.82, 95% CI 0.69–0.99, I² = 18.5%). No significant difference in short-term mortality was observed in the exploratory subgroup analysis of two high-severity studies (RR 0.89, 95% CI 0.67–1.18). There were no significant long-term mortality differences in the observational and RCT studies (RR 0.86, 95% CI 0.71–1.04 and RR 1.09, 95% CI 0.76–1.54, respectively). Patients who received PHAA had no significantly different ICU admissions (RR 1.12, 95% CI 0.95–1.33) or HLOS (MD −1.79 days, 95% CI −6.05 to 2.47). Even though individual studies showed no significant difference, pooled HLOS was significantly higher with PHAA for the RCT subgroup (MD 0.66, 95% CI 0.42–0.90, I² = 0.00%) after conversion of median to mean values (for better statistical compatibility). Conclusions: PHAA was not associated with a significant reduction in short-term mortality, though a significant reduction was observed when restricted to adult sepsis/septic shock population. No mortality benefit was found in pooled RCTs, mixed-age population studies, or long-term mortality. Observational studies suggest a possible mortality benefit, whereas randomized evidence does not confirm it. This discrepancy may reflect confounding by indication, patient selection, severity, and differences in EMS systems rather than a true treatment effect. The certainty of evidence remains very low, and data on prehospital antibiotic type, blood culture, and infection severity are lacking. Therefore, high-quality prospective RCTs are warranted.