Background and Objectives: We conducted a retrospective observational study to evaluate the impact of elevated blood glucose levels in patients with SARS-CoV-2 infection and a prior diagnosis of diabetes mellitus (DM) or newly diagnosed hyperglycemia. Materials and Methods: This study analyzed 6065 patients admitted to the COVID-19 departments of the “Marius Nasta” National Institute of Pulmonology in Bucharest, Romania, between 26 October 2020 and 5 January 2023. Of these, 813 patients (13.40%) were selected for analysis due to either a pre-existing diagnosis of DM or hyperglycemia at the time of hospital admission. Results: The erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were elevated in patients with blood glucose levels exceeding 300 mg/dL. These elevations correlated with the presence of respiratory failure and increased mortality rates. Additionally, oxygen requirements were significantly higher at elevated blood glucose levels (p < 0.001), with a direct relationship between glycemia and oxygen demand. This was accompanied by lower oxygen saturation levels (p < 0.001). Maximum blood glucose levels were associated with the severity of respiratory failure (AUC 0.6, 95% CI: 0.56–0.63, p < 0.001). We identified cut-off values for blood glucose at admission (217.5 mg/dL) and maximum blood glucose during hospitalization (257.5 mg/dL), both of which were associated with disease severity and identified as risk factors for increased mortality. Conclusions: High blood glucose levels, both at admission and during hospitalization, were identified as risk factors for poor prognosis and increased mortality in patients with SARS-CoV-2 infection, regardless of whether the hyperglycemia was due to a prior diagnosis of DM or was newly developed during the hospital stay. These findings underscore the importance of glycemic control in the management of hospitalized COVID-19 patients.

The coronavirus disease (COVID-19) was declared a pandemic by the World Health Organization (WHO) on March 11, 2020. Facing a new and unknown virus, the entire medical community made considerable efforts to find a specific treatment, develop guidelines, and even create a vaccine. Besides all the measures taken, a wide range of complications associated with the disease increased the mortality and morbidity rates, adding more difficulty to the management of the patients. We performed a retrospective study, including the patients with SARS-CoV-2 pneumonia who were admitted to our hospital between March 2020 and August 2021. We analyzed complications that developed during the hospitalization, such as respiratory failure or acute injury to other organs (the heart, pancreas, kidneys, and liver), and whether they were treatment- and hospitalization-related. One thousand eight hundred and forty-four cases were evaluated, and we analyzed the complications that developed during the hospitalization. Out of this, 1392 (75.48%) cases developed at least one complication during hospitalization, most frequently respiratory failure (71.14%), hyperglycemia (43.54%), renal injury (42.67%), or cardiovascular events (7.10%). SARS-CoV-2 infection in hospitalized patients with pneumonia can cause injuries to any organ, making the management of those patients even more difficult.

Insulin resistance (IR), a core component in the development of type 2 diabetes mellitus (T2DM), is increasingly recognized for its role in cardiovascular and pulmonary complications. This review explores the relationship between IR, right ventricular dysfunction (RVD), and decreased lung volume in patients with T2DM. Emerging evidence suggests that IR contributes to early structural and functional alterations in the right ventricle, independent of overt cardiovascular disease. The mechanisms involved include oxidative stress, inflammation, dyslipidemia, and obesity—factors commonly found in metabolic syndrome and T2DM. These pathophysiological changes compromise right ventricular contractility, leading to reduced pulmonary perfusion and respiratory capacity. RVD has been associated with chronic lung disease, pulmonary hypertension, and obstructive sleep apnea, all of which are prevalent in the diabetic population. As RVD progresses, it can result in impaired gas exchange, interstitial pulmonary edema, and exercise intolerance—highlighting the importance of early recognition and management. Therapeutic strategies should aim to improve insulin sensitivity and cardiac function through lifestyle interventions, pharmacological agents such as SGLT2 inhibitors and GLP-1/GIP analogs, and routine cardiac monitoring. These approaches may help slow the progression of RVD and its respiratory consequences. Considering the global burden of diabetes and obesity, and the growing incidence of related complications, further research is warranted to clarify the mechanisms linking IR, RVD, and respiratory dysfunction. Understanding this triad will be crucial for developing targeted interventions that improve outcomes and quality of life in affected patients.

Background: Pulmonary tuberculosis is one of the major public health issues globally. According to the World Health Organization, it is among the top 10 causes of death caused by a single pathogen. In Romania, its reported incidence rate in 2024 was approximately 60 per 100,000 people, making it the country with the highest incidence in Europe. Rheumatoid arthritis (RA) is a systemic chronic autoimmune inflammatory disease characterized by the destruction of the small joints along with symmetrical distribution and multiorgan involvement. Pulmonary manifestations are more common in males with positive serology and can involve the lungs, airways, or pleura. Short-term corticotherapy may be initiated in patients with severe symptoms, and biological therapy (anti-TNF alpha drugs) may be used in those with inefficiency of disease-modifying antirheumatic drugs, with an increased risk for disseminated forms of tuberculosis in those with latent infection. Case description: We present the case of a 38-year-old male patient with a 5-year history of seropositive RA who was treated with methotrexate and methylprednisolone, without any prior investigations for latent tuberculosis infection or any chest radiography performed, and was admitted with severe respiratory failure. The results of thoracic computed tomography showed bilateral pneumothorax and pneumomediastinum, with pulmonary lesions suggestive of a diagnosis of tuberculosis, which was confirmed by bacteriological testing of samples. Conclusion: The coexistence of two severe diseases—one requiring immunosuppressive treatment and the other one favored by immunosuppression—in a country with a high prevalence of tuberculosis infection and in the absence of latent tuberculosis infection screening or periodic pulmonological assessment can lead to severe, life-threatening complications that require complex, multidisciplinary, long-term, and expensive management.

Starting December 2019, in China, the SARS-CoV-2 infection became a local health issue, but its high infectiveness quickly turned it into a pandemic, to be declared an epidemiological emergency of international concern less than two months from identifying the first cases. Despite tremendous efforts aimed at discovering new drug classes that would slow down or stop the evolution of the COVID-19 disease and curb the number of severe cases and related complications, there is no specific antiviral treatment to date. The only efficient measure proved to be the prophylaxis, through vaccination.

Background: Immunotherapy and targeted therapy have gained ground over conven-tional chemotherapy in treating various cancers. While pulmonary toxicity associated with these agents is rare, it represents a significant factor in both mortality and morbidity and may influence the overall success of cancer treatment. This case series report adds to the emerging evidence of cancer therapy-induced pneumonitis features and cortico-therapy outcomes. Patients and methods: This case series report consists of a retrospective analysis of 12 cases of patients undergoing immunotherapy (4 Nivolumab, 4 Pembrolizumab) or targeted therapy (3 Obinutuzumab, 1 Abemaciclib) for cancer (7 lung, 3 non-Hodgkin lymphoma, 1 breast, 1 renal) that developed pneumonitis during their follow-up. Results: The onset of pneumonitis ranged from 6 to 48 months (median = 18.5), and in 4 cases it occurred after discontinuation of oncologic treatment. The diagnosis was estab-lished with a high probability based only on clinical picture, radiologic features, and concomitant oncologic therapy. The cases with onset after discontinuation of oncologic treatment required a more thorough investigation (including bronchoscopy with BAL analysis). The main symptom was dyspnea (10/12 cases), and 3 of 12 patients had res-piratory failure (SpO2≤88%). The CTCAE severity grades were: 1 mild, 7 moderate, 3 severe, and 1 life-threatening. The CT scan showed different patterns (7 OP, 4 NSIP, and 1 HP). 11 patients received oral methylprednisolone (0.40 to 0.82 mg/kg) for 5 to 16 weeks. 2 patients continued oncologic treatment, and 6 discontinued. All patients showed fa-vorable outcomes. Conclusions: Immunotherapy and targeted therapy-induced pneumonitis can express various features and severities, and prompt recognition and diagnosis based on clinical, radiologic and contextual elements is mandatory. Corticotherapy regimens used, based on severity and treatment response, had a favorable outcome. The follow-up can consist only of clinical assessment and chest X-ray, and extensive tests are reserved for non-responsive cases.