Background and Objectives: Romania has experienced the highest measles incidence rate in the European Union since late 2023, driven by suboptimal measles–mumps–rubella (MMR) uptake. Contemporary data on bedside predictors of clinical deterioration are scarce. The objective was to characterise demographic, clinical and laboratory differences between severe and non-severe measles and derive a multivariable model for intensive-care-unit (ICU) admission. Methods: We undertook a retrospective cohort study at the “Victor Babeș” University Hospital for Infectious Diseases, Timișoara. All admissions from 1 November 2023 to 15 May 2025 with serological or RT-PCR confirmation and a complete baseline laboratory panel were included. Descriptive statistics compared ward-managed versus ICU-managed patients; independent predictors of ICU transfer were identified through logistic regression that incorporated age, vaccination status, leukocyte count, C-reactive protein (CRP) and interleukin-6 (IL-6). Results: Among 455 patients (median age 3.0 y, interquartile range [IQR] 1.0–7.0), 17 (3.7%) required ICU care. Vaccine coverage was 18.0% overall and 0% among ICU cases. Compared with ward peers, ICU patients exhibited higher leukocyte counts (8.1 × 10⁹ L vs. 6.0 × 10⁹ L; p = 0.003) and a near-five-fold elevation in IL-6 (18 pg mL vs. 4 pg mL; p < 0.001), while CRP, procalcitonin and fibrinogen were similar. ICU admission prolonged median length of stay from 5 days (IQR 4–7) to 8 days (5–12; p = 0.004). In multivariable modelling, IL-6 remained the sole independent predictor (odds ratio [OR] 1.07 per pg mL; 95% confidence interval [CI] 1.03–1.12; p = 0.001); the model’s AUC was 0.83, indicating good discrimination. Complete separation precluded reliable estimation of the protective effect of vaccination, but no vaccinated child required ICU care. Conclusions: A simple admission panel centred on IL-6 accurately identified Romanian measles patients at risk of critical deterioration, whereas traditional markers such as CRP and leukocyte count added little incremental value. Even a single documented MMR dose was associated with the complete absence of ICU transfers, underscoring the urgent need for catch-up immunisation campaigns. Integrating IL-6-guided triage with intensified vaccination outreach could substantially reduce measles-related morbidity and health-system strain in low-coverage EU settings.

Background and Objectives: Pulmonary embolism (PE) complicating COVID-19 combines viral pneumonia with immunothrombosis, but the relative prognostic value of comorbidities, embolic burden, lung involvement, and inflammatory markers is uncertain. We aimed to characterize clinical profiles and identify independent predictors of respiratory failure and in-hospital mortality in COVID-19–associated PE. Materials and Methods: We performed an observational single-center study including 161 adults with RT-PCR–confirmed COVID-19 and CTPA-confirmed acute PE. Demographic data, comorbidities, CT lung involvement, biomarkers, and treatments were compared across outcomes, and multivariable logistic regression and principal component analysis (PCA) were used to model risk. Results: In-hospital mortality was 24.8% (40/161), and invasive mechanical ventilation was 18.6% (30/161). Classical PE variables (Wells score, PESI, thrombus location, D-dimer) and comorbidities showed limited discrimination, whereas severe CT lung involvement independently predicted death (OR 4.46; 95% CI 1.55–12.86) and intubation (OR 8.88; 95% CI 2.92–27.04). Each 50 mg/L increase in CRP increased mortality odds by 41% (OR 1.41; 95% CI 1.02–1.96), and a 10-fold rise in IL-6 (log10 IL-6) was associated with six-fold higher mortality (OR 6.10; 95% CI 1.84–20.18). PCA identified a hyperinflammatory–thrombotic component (PC1); per 1-SD increase in standardized PC1, the odds of intubation or death rose 3.5-fold (OR 3.50; 95% CI 2.05–5.99), and event rates across PC1 tertiles were 7.4%, 20.8%, and 57.4%. Conclusions: In COVID-19–related PE, integrated immunothrombotic activation and extent of lung involvement, rather than embolic burden alone, drive early critical outcomes and may support refined risk stratification.

Background/Objectives: Metabolic comorbidities and systemic inflammation are implicated in colon carcinogenesis, yet their relationship with acute obstructive presentation and early in-hospital course remains unclear. This study evaluated whether age, metabolic multimorbidity, and inflammatory–metabolic biomarkers are associated with obstruction severity and length of stay in a surgical colon cancer cohort. Methods: We analyzed 677 consecutive adults undergoing surgery for histologically confirmed colon cancer. Acute presentation was categorized as no obstruction, subocclusive syndrome, or frank obstruction. Predictors included age, comorbidity count (multimorbidity defined as ≥2), diabetes, hypertension, and preoperative biomarkers (C-reactive protein (CRP), lipids, glucose; neutrophil-to-lymphocyte ratio (NLR)/platelet-to-lymphocyte ratio (PLR)/C-reactive protein-to-albumin ratio (CAR)where available). Multivariable logistic and ordinal regression assessed obstructive presentation; linear regression assessed length of stay. Results: Subocclusion or obstruction occurred in 34.8% of patients. In multivariable logistic regression, age was independently associated with obstructive presentation (odds ratio (OR) 1.016 per year; 95% confidence interval (CI) 1.001–1.032), while comorbidity count and CRP were not. In an ordinal model, age increased the odds of more severe presentation (OR 1.018 per year), whereas diabetes was inversely associated (OR 0.573). Length of stay was independently associated only with presentation severity (β = −0.959 days per category). Correlations between inflammatory indices and length of stay were negligible. Conclusions: In this hospital-based surgical cohort, age showed a modest association with obstructive presentation, while metabolic multimorbidity and routine inflammatory markers provided limited discrimination for obstruction or early in-hospital resource use.

The recent European measles resurgence has driven record-high hospitalization, yet objective tools for early risk stratification remain scarce. This study evaluated the diagnostic accuracy of routine admission inflammatory biomarkers for predicting severe disease and prolonged hospitalization. We retrospectively analyzed 509 patients with laboratory-confirmed measles hospitalized during a Romanian outbreak (November 2023–August 2025). Severe disease was defined via a clinical composite endpoint (intensive-care admission, mechanical ventilation, supplemental oxygen, acute respiratory failure, or sepsis). Biomarker discriminative performance was assessed using receiver-operating-characteristic (ROC) curves, Youden-optimal cut-offs, and DeLong tests. Multivariable logistic and Cox proportional-hazards regression evaluated independent predictors of severity and time to discharge. The cohort exhibited a pediatric predominance (median age: 3.0 years; 20% infants) with an 82% unvaccinated rate; 33% developed severe disease. Interleukin-6 (IL-6) demonstrated superior diagnostic accuracy (AUC 0.863, 95% CI 0.820–0.898; cut-off ≥ 7 pg/mL, sensitivity 73%, specificity 93%), significantly outperforming ferritin (AUC 0.800) and conventional markers (all p < 0.001). Multivariable modeling established IL-6 and ferritin as the sole independent predictors of severity. All intensive-care admissions occurred exclusively for unvaccinated patients (5.0% vs. 0%). Severe disease, pneumonia, male sex, unvaccinated status and elevated C-reactive protein (CRP) independently predicted prolonged hospitalization. Admission IL-6 and ferritin serve as robust, independent prognostic biomarkers that accurately identify high-risk measles patients, providing objective criteria with which to optimize clinical triage and inpatient management during outbreaks.