Background and Objectives: Obstructive sleep apnea (OSA) is a prevalent disorder associated with increased cardiovascular (CV) risk. Materials and Methods: We conducted a PRISMA-compliant systematic review and meta-analysis of prospective cohort studies assessing OSA and incident CV outcomes. Results: From 2463 records, 18 studies (>25,000 participants; median follow-up 9 years) were included. OSA was associated with increased CV risk (pooled HR 1.82, 95% CI 1.45–2.28). Dose–response analysis showed a progressive risk increase: mild OSA (HR 1.21, 95% CI 0.98–1.50), moderate (HR 1.56, 95% CI 1.20–2.03), and severe (HR 2.45, 95% CI 1.85–3.25). Continuous positive airway pressure (CPAP) adherence (≥4 h/night) reduced risk (HR 0.76, 95% CI 0.60–0.96). Conclusions: OSA confers a severity-dependent CV risk, which is mitigated by adequate CPAP adherence. Systematic screening and adherence support may reduce CV morbidity and mortality. PROSPERO: CRD420251168363.

Background: Systemic inflammation plays a pivotal role in heart failure (HF) progression, yet no meta-analysis has synthesized prospective cohort data on interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), and neutrophil-to-lymphocyte ratio (NLR) as prognostic biomarkers. Objectives: To quantify the independent prognostic value of IL-6, hs-CRP, and NLR for mortality and HF-related outcomes across HF phenotypes. Methods: Following PRISMA and MOOSE guidelines, we searched PubMed, Embase, Scopus, Web of Science, and CENTRAL from January 2014 to October 2025 for prospective cohorts reporting adjusted hazard ratios (HRs). Random-effects meta-analysis pooled HRs; heterogeneity was assessed via I² statistic, with subgroup and sensitivity analyses for robustness. Quality was evaluated using Newcastle–Ottawa Scale (NOS) and GRADE. Results: Thirteen cohorts (n ≈ 19,000) were included. Elevated IL-6 (five studies) was associated with increased all-cause mortality and composite outcomes (low-moderate heterogeneity, I² < 35%). hs-CRP (five studies) showed similar prognostic strength, with trajectories amplifying risk. NLR (three studies) independently predicted adverse events with negligible heterogeneity. Associations persisted across HFrEF and HFpEF, acute/chronic settings, and geographic regions, independent of natriuretic peptides and comorbidities (NOS median 8/9; GRADE moderate-to-high). Conclusions: IL-6, hs-CRP, and NLR are robust, independent prognostic biomarkers in HF, supporting their integration into clinical risk stratification and inflammation-targeted therapies. PROSPERO: CRD420251207035.

Background: Bloodstream infections (BSIs) complicate COVID-19 inpatients, increasing morbidity, mortality, and healthcare burden. This systematic review and meta-analysis evaluated prevalence, antimicrobial resistance (AMR), risk factors, and outcomes of BSIs in RT-PCR-confirmed COVID-19 cases. Methods: We searched PubMed, Google Scholar, ScienceDirect, and MDPI journals (January 2020–August 2025) following PRISMA 2020 guidelines. Twenty-two observational studies (~123,500 patients, ~602,000 blood cultures) were included: 10 prospective and 12 retrospective. Random-effects models estimated pooled prevalence, odds ratios (ORs), and mean differences, with subgroup analyses (ICU, non-ICU, pediatric) and meta-regression.Results: Pooled BSI prevalence was 8.2% (95% CI: 5.7–11.0; I² = 50%). Subgroup prevalence was higher in ICU (12.5%) than non-ICU (5.2%) populations. Pediatric cohorts (n = 3) showed a prevalence of 10.8%. Gram-negative pathogens predominated (61%), particularly Klebsiella pneumoniae (26%) and Acinetobacter baumannii (21%). AMR rates were 36% for MRSA and 31% for ESBL-producing Enterobacterales. Risk factors included mechanical ventilation (OR: 2.6), immunosuppression (OR: 2.3), and corticosteroid use (OR: 2.4). BSIs were associated with increased mortality (OR: 2.6), prolonged hospitalization (+6.8 days), and higher ICU admission (OR: 3.1).Conclusions: BSIs, largely driven by multidrug-resistant pathogens, substantially worsen COVID-19 outcomes. Variability in diagnostic criteria (CDC vs. ECDC) and reliance on retrospective designs are limitations, though moderate heterogeneity (I² = 50%) enhances generalizability across diverse populations. Strengthened infection prevention and antimicrobial stewardship are urgently required.

COVID-19 is associated with gut microbiome alterations that may influence disease outcomes through immune and inflammatory pathways. This systematic review and meta-analysis evaluated global evidence on gut dysbiosis in COVID-19. We searched PubMed/MEDLINE, Embase, Web of Science, Scopus, and Cochrane Library up to 5 October 2025 (PROSPERO CRD420251160970). Alpha-diversity indices and microbial taxa log-fold changes (logFC) were analyzed using random-effects models. The pooled standardized mean difference (SMD) for the Shannon index was −0.69 (95% CI −0.84 to −0.54; I² = 42%), confirming reduced microbial diversity. Faecalibacterium prausnitzii showed a significant pooled depletion (logFC = −1.24; 95% CI −1.68 to −0.80; k = 10; I² = 74%), while Enterococcus spp. was increased (logFC = 1.45; 95% CI 1.12–1.78). Egger’s test did not suggest publication bias (p = 0.32). Gut dysbiosis was consistently associated with reduced microbial diversity and enrichment of pathogenic taxa, correlating with increased disease severity and mortality (HR = 1.67). These findings highlight the potential of microbiome profiling as a prognostic tool in COVID-19, although clinical translation requires further validation.

Hypertension (HTN) remains a major modifiable risk factor for cardiovascular disease (CVD), yet the mechanisms linking environmental and metabolic factors to vascular injury are incompletely understood. Recent evidence implicates gut microbiome dysbiosis and microbial metabolites, particularly short-chain fatty acids (SCFAs) and trimethylamine N-oxide (TMAO), in the pathogenesis of hypertension and its cardiovascular complications. We systematically searched PubMed, Embase, Cochrane, Web of Science, and Scopus from inception to 1 October 2025 for observational studies evaluating gut microbiome composition or circulating TMAO levels in adults with hypertension or related cardiovascular outcomes. Random-effects meta-analyses were conducted using standardized mean differences (SMD) for alpha diversity indices and hazard ratios (HR) for TMAO-associated major adverse cardiovascular events (MACE). Heterogeneity (I²), publication bias (Egger’s test), and certainty of evidence (GRADE) were assessed according to PRISMA 2020 guidelines (PROSPERO CRD420251162222). A total of 22 studies (n = 24,512 participants) were included, of which 15 were eligible for quantitative synthesis (11 for alpha diversity, 4 for TMAO). Pooled analysis showed significantly lower microbial diversity among hypertensive versus normotensive individuals (SMD = −0.15, 95% CI −0.25 to −0.05; p = 0.004; I² = 35%). Circulating TMAO was associated with increased risk of major adverse cardiovascular events (HR = 1.25, 95% CI 1.10 to 1.42; p < 0.001). Funnel plots were symmetric, and Egger’s test indicated no significant bias (p > 0.3). The certainty of evidence was graded as moderate for microbial diversity and high for TMAO-related outcomes. This meta-analysis provides robust evidence that gut microbiome dysbiosis and elevated TMAO levels are associated with hypertension and heightened cardiovascular risk, supporting the concept of a “gut–vascular axis.” Microbiota-targeted interventions such as high-fiber diets, prebiotics, or TMAO-lowering strategies warrant further investigation as adjunctive tools in precision hypertension management.

(1) Background: Pulmonary embolism (PE) is a severe complication of coronavirus disease 2019 (COVID-19), particularly in hospitalized patients. Data from Eastern Europe, including Romania, are limited, despite potential regional differences in demographics, comorbidities, and thromboprophylaxis practices. (2) Methods: This retrospective cohort study included 395 adults hospitalized with RT-PCR-confirmed COVID-19 at the “Victor Babeș” Clinical Hospital of Infectious Diseases and Pneumophthisiology, Timișoara, Romania, from September 2022 to December 2024. Demographic, clinical, laboratory, and imaging data were extracted from medical records. PE was confirmed by computed tomography pulmonary angiography (CTPA). Group comparisons used chi-square and t-tests, with multivariable logistic regression to identify independent PE predictors. (3) Results: PE was diagnosed in 47 patients (11.9%). Compared to those without PE, patients with PE had higher D-dimer (5305.00 ± 1251.00 vs. 537.00 ± 203.00 ng/mL, p < 0.001), fibrinogen (6.33 ± 0.74 vs. 3.51 ± 0.60 g/L, p < 0.001), and PT/INR (1.68 ± 0.21 vs. 1.05 ± 0.09, p < 0.001). Prior venous thromboembolism (VTE; 19.1% vs. 8.3%, p = 0.03) and prolonged immobilization (61.7% vs. 23.0%, p < 0.001) were significant risk factors. Intensive care unit (ICU) transfer occurred in 59.6% of PE cases, with a 25.5% in-hospital mortality rate. All PE patients received anticoagulation; 10.6% underwent thrombolysis. (4) Conclusions: In this Romanian cohort, one of the first large-scale studies in Eastern Europe, PE was prevalent among hospitalized COVID-19 patients, associated with elevated coagulation markers, identifiable risk factors, and high mortality. Early recognition and optimized thromboprophylaxis are critical to improve outcomes.