Background and Objectives: Hematological disorders, especially chronic anemia and coagulation disorders, are common in patients with chronic kidney disease (CKD). Severe anemia is associated with increased cardiovascular morbidity and mortality in this special group of patients and is also responsible for decreased hope and quality of life. Despite the use of appropriate iron therapy and erythropoietin-stimulating agents, red blood cell transfusion is occasionally required, usually in the setting of acute bleeding or for correction of perioperative anemia. The COVID-19 pandemic has accelerated the progression of chronic diseases and worsened the outcomes for patients with nephrological conditions. As a precautionary measure against infections, patients’ access to hospitalization for their procedures has been reduced and their chronic complications, including hematological abnormalities, have gotten out of control. Materials and Methods: Our retrospective observational study was designed to evaluate the impact of the COVID-19 pandemic on blood transfusion for the patients with chronic kidney disease hospitalized in our emergency county medical unit, over a period of four years (2019–2022) who were admitted or at least referred for evaluation to the Nephrology department. We also followed the measures adopted to ensure the necessary blood products during this time. Results: Between 2190–2022, a total of 24,096 hospitalized patients were transfused at the Emergency County Clinical Hospital in Constanta, Romania. Meanwhile, in the nephrology and other medical or surgical wards of our medical unit, 1590 CKD patients were transfused with different blood derivatives. During the pandemic years, as expected, the number of transfused patients and transfused blood units decreased by 4% and 7%, respectively, in comparison with the pre-pandemic year, 2019. Unlike the general trend of transfusion activity, more patients with CKD transfused in 2022 (580) than before the pandemic (414 in 2019), and the number of blood units was higher in 2022 than in 2019 for red blood products and plasma. Between 2020–2022, from the total number of transfused patients in our study, 254 with CKD patients (16%) and 798 non-CKD (4%) died in-hospital. Conclusions: The adaptive strategies implemented to ensure the necessary blood products in the hospital during the COVID-19 pandemic mainly included restrictive transfusion and limitation of elective surgical procedures. The subject matter of the article is important as blood shortages are a problem that healthcare workers may encounter in future pandemics.

Background: Myocardial ischemia remains a major cause of morbidity and mortality worldwide. Although traditional risk factors are well-established, genetic predisposition—particularly involving MTHFR polymorphisms—has garnered increasing attention. This study investigates the association between MTHFR C677T and A1298C polymorphisms and first-episode myocardial ischemia in a Romanian population. Methods: This study included 69 adult patients with first-episode myocardial ischemia and 55 healthy controls, matched by age and sex. Participants were recruited from southeastern Romania between 2023 and 2025. Clinical data—such as blood pressure, body mass index, smoking, and alcohol consumption—were recorded. Genotyping for MTHFR C677T and A1298C polymorphisms was performed using a real-time PCR-based assay (Bosphore^® MTHFR 677-1298 Detection Kit v2), following the manufacturer’s protocol. Results: A significantly higher frequency of homozygous mutant genotypes was observed in patients with myocardial ischemia. The TT genotype of MTHFR C677T was present in 71% of patients, compared to only 7.3% of controls. Similarly, the CC genotype of A1298C was detected in 59.4% of patients, versus 7.3% in controls. These genotypic patterns suggest a strong genetic predisposition among affected individuals. The association between MTHFR polymorphisms and myocardial ischemia was particularly evident in participants over 50 years of age, indicating a possible interaction between genetic vulnerability and age-related cardiovascular risk. Conclusions: Our findings indicate a strong association between MTHFR C677T and A1298C homozygous mutant genotypes and the risk of first-episode myocardial ischemia, particularly in older adults. These results underscore the potential role of genetic screening in early cardiovascular risk stratification.

Background: Anemia is common in hospitalized cardiac patients and affects prognosis and cardiovascular mortality in patients with acute decompensated heart failure. Aim: to investigate the impact of anemia severity, blood transfusion practices, and the evolution and outcome in patients with acute cardiovascular events. Methods: We performed a retrospective analysis of the patients hospitalized in the Cardiology Department of Constanta County Hospital who required blood derivatives transfusions, between 1 January 2021 and 31 December 2021. Results: Out of the total 270 patients, 170 received a single unit of resuspended erythrocyte concentrate within the same month, while 100 required multiple transfusions, receiving between 2 and 5 units during a single hospitalization, to correct anemia. Before transfusions, the mean hemoglobin (Hb) level was 7.60 g/dL, with values ranging from 6.50 g/dL to 9.10 g/dL. Men show a higher prevalence (64%) than women (36%), likely due to gender differences in susceptibility to heart conditions. Patients with associated acute or chronic renal failure consistently experience higher in-hospital mortality in all left ventricular ejection fraction (LVEF) subgroups. Conclusions: Anemia in heart failure patients is linked to worsening symptoms, decreased kidney function, and higher hospitalization and mortality rates. The findings aim to inform and optimize clinical decision making, particularly regarding transfusion strategies and risk management in this high-risk population.

Anemia is common in hospitalized cardiac patients and affects prognosis. Even moderate levels of anemia can be associated with high cardiovascular mortality when compared to normal hemoglobin levels in cases of patients with acute decompensated heart failure. Background: Anemia is a comorbidity potentially treatable, with significant prognostic implications. A restrictive transfusion is triggered by hemoglobin is ≤8g/dl (severe anemia) and a liberal transfusion is considered when hemoglobin ≤10 g/dL. Methods: We perform a retrospective analysis of the patients hospitalized in the Cardiology Department of Constanta County Hospital who required blood derivatives transfusions, between 1st of January 2021 - 31st of December 2021. Results: Out of the total 270 patients, 170 received a single unit of resuspended erythrocyte concentrate within the same month, while 100 required multiple transfusions, receiving between 2 and 5 units during a single hospitalization to correct anemia. Before transfusions, the mean hemoglobin (Hb) level was 7.60 g/dl, with values ranging from 6.50 g/dl to 9.10 g/dl. Men show a higher prevalence (64%) than women (36%), likely due to gender differences in susceptibility to heart conditions. After transfusions, the mean Hb reached 10.05 g/dl (minimum/maximum values of 7.40 and 12.70 g/dl). CKD patients consistently experience higher in-hospital mortality across LVEF sub-groups, while CRS patients have relatively lower mortality rates, with significant associations observed between reduced LVEF and increased mortality across all patient groups. Conclusions: Anemia in heart failure patients is linked to worsening symptoms, including decreased exercise tolerance, increased cardiovascular events, decreased kidney function and higher hospitalization and mortality rates, especially in those with associated acute or chronic kidney failure. The findings aim to inform and optimize clinical decision making, particularly regarding transfusion strategies and risk management in this high-risk population.