Background and Objectives: this study aimed to research links between C-reactive protein (CRP), lactate dehydrogenase (LDH), creatinekinase (CK), 25-OH vitamin D (25-OHD), ferritin (FER), high-density lipoprotein cholesterol (HDL)cholesterol and clinical severity in patients from the western part of Romania, and compare their potential use as biomarkers for intensive care units (ICU) admission and death in children, adults and elders. Materials and Methods: this study is a retrospective cohort study, performed on patients positively diagnosed with COVID-19. Available CRP, LDH, CK 25-OH vitamin D, ferritin, HDL cholesterol and clinical severity were recorded. The following were assessed: median group differences, association, correlation and receiver operating characteristic. Results: 381 children, 614 adults and 381 elders were studied between 1 March 2021 and 1 March 2022. Most children and adults presented mild symptomatology (53.28%, 35.02%, respectively), while most elders presented severe symptomatology (30.04%). ICU admission was 3.67% for children, 13.19% for adults and 46.09% for elders, while mortality was 0.79% for children, 8.63% for adults and 25.1% for elders. With the exception of CK, all other biomarkers showed some significant associations with clinical severity, ICU admission and death. Conclusions: CRP, LDH, 25-OH vitamin D, ferritin and HDL are important biomarkers for COVID-19 positive patients, especially in the pediatric population, while CK was mostly within normal ranges.

Background: The COVID-19 pandemic disproportionately affected vulnerable populations like Roma patients in Western Romania due to marginalization and limited healthcare access. Methods: A retrospective study analyzed COVID-19 cases between March 2020 and August 2022 using data from the Directorate of Public Health in Timis county. Demographic, epidemiological, clinical, and laboratory data were assessed, along with risk factors and biomarkers for ICU admission and mortality prediction. The following biomarkers were assessed: C-reactive protein (CRP), ferritin (FER), IL-6, D-dimers, lactate dehydrogenase (LDH), high density lipoprotein cholesterol (HDL), and 25-OH vitamin D (25-OHD). Results: In comparison with the general population (GP), Roma patients were more overweight (p = 0.0292), came from rural areas (p = 0.0001), could not recall transmission source (p = 0.0215), were admitted to the intensive care unit (ICU, p = 0.0399) more frequently, had worse symptomatology (p = 0.0490), showed more elevated levels of CRP (p = 0.0245) and IL-6 (p < 0.0001) and lower levels of HDL (p = 0.0008) and 25-OHD (p = 0.0299). A stronger, significant correlation was observed between CRP and severity (rho = 0.791 vs. 0.433 in GP), and an inverse stronger significant one was observed between HDL and severity (rho = −0.850 vs. −0.734 in GP) in the Roma patients. The male sex continues to be an important risk factor for ICU admission (OR = 2.379) and death (OR = 1.975), while heavy smoking was more important in relation to ICU admission (OR = 1.768). Although the Roma ethnicity was 1.454 times more at risk of ICU admission than the GP, this did not prove statistically significant (p = 0.0751). CRP was the most important predictive factor in regards to admission to the ICU for both Roma (OR = 1.381) and the GP (OR = 1.110) and in regards to death (OR = 1.154 for Roma, OR = 1.104 for GP). A protective effect of normal values of HDL and 25-OHD was observed in the GP for both ICU admission (OR = 0.947, 0.853, respectively) and death (OR = 0.920, 0.921, respectively), while for the Roma group, normal 25-OHD values were only considered protective in regards to death (OR = 0.703). Cutoff values for ICU admission were 28.98 mg/L for Roma and 29.03 mg/L for GP patients, with high specificity for both groups (over 95). Conclusions: Higher rates of ICU admissions, severe symptomatology, and distinct laboratory biomarker profiles among Roma patients emphasize the critical importance of personalized care strategies and targeted interventions to mitigate the disproportionate burden of COVID-19 on vulnerable communities. CRP values at admission have had a clear impact as a risk assessment biomarker for Roma patients, while the significance of IL-6, HDL, and 25-OHD should also not be overlooked in these patients.

Retatrutide (LY3437943) is an investigational, once-weekly, lipidated 39-residue peptide that activates the glucose-dependent insulinotropic polypeptide, glucagon-like peptide-1, and glucagon receptors. Its molecular design combines incretin activity with glucagon receptor engagement while maintaining glycaemic efficacy. This critical narrative review examines molecular engineering, pharmacokinetics, dose escalation, pharmaceutical development, and clinical evidence available through 11 September 2026. Five phase 3 trials have reported positive primary outcomes, but only TRANSCEND-T2D-1 has a full peer-reviewed report; the obesity trials are currently available as sponsor topline disclosures. In those disclosures, efficacy-estimand mean weight reductions of 28.3% at 80 weeks (TRIUMPH-1) and 28.7% at 68 weeks (TRIUMPH-4) were reported, with a TRIUMPH-1 treatment-regimen estimate of 25.0%; these values remain provisional pending full published trial reports. The peer-reviewed TRANSCEND-T2D-1 report supports glycaemic efficacy in early type 2 diabetes. Interpretation requires attention to estimands, population differences, treatment discontinuation and selection into trial extensions. Gastrointestinal adverse events, dysaesthesia, heart-rate changes and the functional consequences of lean-mass loss require further evaluation. Pharmaceutical priorities include scalable synthesis, impurity and potency control, formulation stability, immunogenicity and reliable dose delivery. Retatrutide provides a clinically advanced example of unimolecular poly-agonism, but comparative effectiveness, long-term outcomes and regulatory review remain essential to defining its therapeutic role.

Background/Objectives: In treated patients, concurrent metabolic and blood pressure (BP) changes are difficult to interpret without complete treatment histories. We examined the association between change in homeostasis model assessment of insulin resistance (HOMA-IR) and systolic BP (SBP), and described trajectories by prescribed management category. Methods: This exploratory retrospective cohort included 150 patients (132 inpatients and 18 outpatients at baseline), with visits labeled baseline, month 3, and month 6; exact dates were unavailable. Four nonrandomized categories were compared by baseline prescription, without adherence data. HOMA analyses excluded two participants with explicit insulin entries; complete-case regression used heteroscedasticity-consistent (HC3) confidence intervals (CIs). Results: The principal SBP coefficient was 2.20 mmHg per HOMA-IR doubling (95% CI −1.90 to 6.31; n = 99). Restrictions to no recorded baseline diabetes (n = 71) or no pharmacological glucose-lowering entry (n = 77) also yielded imprecise estimates. SBP decreased by 2.07–8.23 mmHg across prescribed categories, but adjusted contrasts were uncertain (global p = 0.743). The waist–SBP coefficient did not meet the multiplicity criterion (q = 0.107). Of 724 recorded BP values, 720 were multiples of 5 mmHg. Conclusions: The association between HOMA-IR change and recorded SBP change remained uncertain, and the efficacy of prescribed diet or omega-3 supplementation could not be assessed. The principal contribution of the study is to show how incompletely documented medication exposure, adherence, visit timing, and measurement conditions limit the interpretation of serial HOMA-IR and routine BP values in treated patients.

Background/Objectives: Hypertension damages the microcirculation, endothelium, and large arteries, yet these domains are rarely assessed together. We examined whether nailfold microvascular abnormalities track the standardized in-hospital blood-pressure phenotype and carotid wall thickness. Methods: Cross-sectional secondary analysis of 217 treated hypertensive adults hospitalized July 2025–June 2026. Phenotyping included nailfold capillaroscopy, flow-mediated dilation, reactive hyperemia index, pulse wave velocity, and carotid ultrasonography. A prespecified exploratory 0–10 microvascular score summarized rarefaction, impaired flow, and morphological abnormalities. Outcomes were the uncontrolled standardized in-hospital BP phenotype (SBP ≥ 140 and/or DBP ≥ 90 mmHg) and mean carotid intima–media thickness (cIMT). Results: Of 217 patients (mean age 61.3 ± 9.9 years; 50.7% men), 145 (66.8%) met the uncontrolled standardized in-hospital BP phenotype. The score was higher in that group (median 3 [IQR 2–4] vs. 2 [1–3], p < 0.001) and correlated with cIMT (Spearman ρ = 0.536; FDR-adjusted p < 0.001). Each point was associated with higher adjusted odds of the uncontrolled standardized in-hospital BP phenotype (OR 1.70, 95% CI 1.31–2.20; p < 0.001) and 0.0076 mm higher cIMT (95% CI 0.0004–0.0147; p = 0.040), attenuated in the expanded sensitivity model (p = 0.138). Conclusions: Greater nailfold microvascular abnormality burden was associated with the uncontrolled standardized in-hospital BP phenotype and an adverse multidomain vascular phenotype. The cIMT association was modest and adjustment-sensitive. These cross-sectional findings concern a protocolized in-hospital BP measurement session and do not establish 24 h, home, or long-term BP control or distinguish sustained uncontrolled hypertension from white-coat or masked uncontrolled BP patterns. Prospective external validation is required.

Background/Objectives: Obesity is a major modifier of COVID-19 outcomes, contributing to increased disease severity and complications. This study aimed to assess the impact of obesity on clinical severity, pulmonary involvement, and in-hospital mortality among COVID-19 patients and to identify independent predictors of severe disease. Methods: We conducted a retrospective cohort study of 3005 hospitalized adults with RT-PCR-confirmed COVID-19 between 1 January 2020 and 1 March 2023. Patients were stratified by obesity status (body mass index (BMI) ≥ 30 kg/m²). Clinical, comorbidity, imaging, and laboratory data, as well as vaccination status (vaccinated or unvaccinated), were collected. Multivariate regression and gradient boosting models were used to identify predictors of severe outcomes. Effect estimates are expressed as relative risks (RRs) with 95% confidence intervals (CIs). Results: Obese patients (n = 894) showed significantly higher rates of severe COVID-19 (31.7% vs. 22.4%, p < 0.001) and more extensive lung damage (>50% involvement: 27.9% vs. 22.0%, p < 0.001), with lower admission SpO₂ (92.1 ± 4.0% vs. 94.2 ± 3.2%, p < 0.001). Hypoxemia (SpO₂ < 90%) was more frequent in obese individuals. The relative risk (RR) for severe disease was 1.41 (95% CI 1.25–1.60), and for >50% lung involvement, it was 1.27 (95% CI 1.11–1.45). Age > 65 years was the strongest predictor of mortality, particularly in non-obese patients. Gradient boosting models outperformed logistic regression (AUC = 0.92 vs. 0.87). Conclusions: Obesity independently predicts severe COVID-19 and pulmonary impairment. These findings support obesity-based risk stratification for clinical management and public health interventions.