Background and Objectives: Long COVID has been linked with persistent neurological symptoms, but data on its effects on acute stroke presentation, management, and outcomes remain unclear. This study aimed to compare the clinical profile, management, and short-term outcome of acute ischemic stroke patients with and without Long COVID. Materials and Methods: A retrospective cohort study was conducted on 132 patients who presented at admission with code stroke alert in our Emergency Department (ED). Out of those, 26 were identified to have the Long COVID condition and assigned to the Long COVID group, and 106 were without the Long COVID condition and assigned to the No Long COVID group. Baseline demographics, stroke severity by NIHSS (National Institutes of Health Stroke Scale), risk factors, admission symptoms, laboratory findings, Emergency department time targets, reperfusion treatments received, and outcomes between the two groups were compared. Results: There were no significant differences between the two groups in age, gender, baseline NIHSS scores, ED time targets, or laboratory values. The proportion of patients with Long COVID significantly increased among non-smokers (Fisher’s Exact Test chi-squared, p = 0.027). Also, patients suffering from Long COVID exhibited higher incidences of headache (19.2% compared to 5.7%, OR = 3.97, p = 0.040) and facial drooping (42.3% compared to 19.8%, OR = 2.97, p = 0.022). The mechanical thrombectomy was more frequent among the group with Long COVID (30.8% vs. 16.0%), but this difference was not statistically significant. More hemorrhagic transformations happened in the Long COVID group (26.9% vs. 14.2%, p = 0.143). Discharge rates and hospital length of stay in days were similar between groups. Conclusions: Long COVID patients did not present notable differences in emergency department time targets, baseline stroke severity, or short-term outcomes when presenting with code stroke alert. Nevertheless, specific clinical characteristics—such as elevated occurrences of headache and facial drooping—were more frequently observed in patients with Long COVID, alongside non-significant trends indicating a greater utilization of mechanical thrombectomy and increased rates of hemorrhagic transformation. These results imply that Long COVID may have a subtle impact on stroke presentation and potentially on underlying cerebrovascular susceptibility. Further prospective studies with larger sample sizes are necessary to investigate Long COVID’s long-term neurological and vascular consequences.

Background: An early menopause (by definition, menopause that occurs at a woman’s age 40 through 45) is often associated with certain changes in the body that can result in risks for health-related conditions, an extended period later. Thus, scientists have begun examining how vitamin D has been suggested to be associated with endocrine function regulating both hormones and reproductive function during this time. However, it is not yet clear as to whether or not vitamin D provides any benefit to women who have experienced an early menopause. Material and Methods: The data was collected from 272 women in this retrospective, observational study at The County Hospital, Department of Obstetrics and Gynecology, Arad. The method of grouping the sample included two stratifications into early and physiological menopause categories based on amenorrhoea for a minimum of 12 consecutive months. 25-hydroxyvitamin D (25(OH)D) levels were classified into three categories: deficiency (<20 ng/mL), insufficiency (21–29 ng/mL), or adequacy (≥30 ng/mL). Estradiol, progesterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) hormone parameters were measured using standard immunoassays. The analysis employed correlation and regression to evaluate potential relationships between 25(OH)D levels and hormone parameters. Results: A significant proportion of the study group had a vitamin D deficiency. This was supported by the fact that only 24.27% of women were identified as having adequate levels of vitamin D, while the rest (62.03%) did not. Women in the early menopause group had a statistically significant negative relationship between estradiol and FSH (i.e., r = −0.29, p = 0.0016), as well as between progesterone and LH (i.e., r = −0.207, p = 0.026). There was not a statistically significant relationship between total sample vitamin D and estradiol (i.e., r = −0.038, p = 0.686) nor between vitamin D and progesterone (i.e., r = 0.031, p = 0.744). Women with vitamin D blood levels of 30 ng/mL or more showed a strong negative relationship between vitamin D and estradiol (r = −0.780; p = 0.0016) and a moderate positive relationship with progesterone (r = 0.534; p = 0.0104). However, these relationships were inconsistent in other groups. All group comparative analyses showed that women in the early menopause group had much lower estradiol levels than those in the physiological menopause group, regardless of whether they were classified based on their vitamin D levels (p < 0.0001). Conclusions: Women experiencing early or physiological menopause are at risk of having low vitamin D levels. However, our study results do not show a consistent relationship between serum 25(OH)D concentrations and serum estradiol or progesterone concentrations among the study population, suggesting that vitamin D is not a major factor influencing hormonal changes during menopause. These findings were inconsistent across analyses and should be interpreted cautiously. Overall, the results do not support a significant association between serum 25(OH)D concentrations and reproductive hormone levels in our study population.

Background and Objectives: Adolescent pregnancy is traditionally associated with increased obstetric risk, particularly among very young adolescents. Romania continues to report one of the highest adolescent birth rates in the European Union, yet age-stratified clinical data on obstetric outcomes among minors remain limited. This study aimed to evaluate maternal and intrapartum outcomes among underage mothers (<18 years), stratified by age (<15, 15–16, and 17 years), and to identify predictors of adverse obstetric outcomes. Materials and Methods: We conducted a retrospective cohort study of all live births and stillbirths among mothers aged 12–17 years recorded between 2020 and 2024 at a secondary maternity hospital in Romania. Data were extracted from standardized obstetric and neonatal records. Primary outcomes included preterm birth (<37 weeks), cesarean delivery, and intrapartum complications. Group comparisons were performed using non-parametric tests and the χ² test. Multivariable logistic regression models were used to assess independent associations between maternal age and obstetric outcomes. Results: The cohort comprised 763 adolescent mothers aged 12–17 years. No significant differences were observed across age groups in gestational age at birth, preterm birth rate, fetal presentation, or mode of delivery. In multivariable analyses, younger maternal age was not independently associated with preterm birth (adjusted odds ratios [aORs] 0.87–1.21) or cesarean delivery (aORs 0.74–1.08). Obstetric factors, such as non-cephalic presentation and characteristics of membrane rupture, were the main predictors of adverse outcomes. Temporal analyses demonstrated stable outcome patterns across the study period, with no significant interaction between maternal age and year of delivery. Conclusions: In this tertiary-care cohort, very young maternal age (<15 years) was not associated with poorer obstetric outcomes compared with older adolescents. These findings suggest that standardized antenatal surveillance and intrapartum management may mitigate age-related obstetric risk among underage mothers. Further population-based studies are warranted to contextualize these results within broader healthcare access and social determinants of adolescent pregnancy. Cesarean section rates were high across all groups (~50%), with no significant differences by maternal age.

Background and Aims: Severe acute respiratory distress syndrome (ARDS) in patients with long COVID remains associated with extremely high mortality and significant long-term sequelae. Non-invasive ventilatory strategies such as continuous positive airway pressure (CPAP) and high-flow nasal cannula (HFNC) are widely used before endotracheal intubation (ETI). Still, their comparative effectiveness in this population is not well established. Understanding survival outcomes and sequelae can help refine treatment strategies for this high-risk group. This study aimed to evaluate outcomes, sequelae, and treatment strategies in long COVID patients with severe ARDS, focusing on non-invasive ventilatory support before ETI. Materials and Methods: A retrospective cohort analysis was performed using a study comparing severe ARDS patients with and without COVID-19. The inclusion criterion was a Horovitz quotient (PaO₂/FiO₂) < 50 mmHg. Results: The study included a total of 59 patients diagnosed with long COVID-19 ARDS, with a mortality rate of 85%. A significant proportion of the patient population was male, accounting for 75%. The highest survival rate was observed among patients who initially received CPAP support, with a survival rate of 23.08%, in contrast to those treated solely with HFNC or those who alternated between HFNC and CPAP. Among patients who required endotracheal intubation and subsequent mechanical ventilation, survival rates were 40% for those who had previously received CPAP, 10% for those treated with alternating HFNC and CPAP, and 0% for those managed exclusively with HFNC before ETI. Survivors often exhibited sequelae, such as impaired pulmonary function, persistent dyspnea, and diminished physical performance. Conclusions: Patients with long COVID who develop severe ARDS (PaO₂/FiO₂ < 50 mmHg) face exceptionally high ICU mortality, with outcomes determined mainly by age, comorbidities, and profound hypoxemia. Although CPAP showed a trend toward improved survival, the data do not establish superiority and should be regarded as hypothesis-generating. Rather, they highlight the complexity of managing this underrepresented subgroup and underscore the need for larger, multicenter studies with broader inclusion criteria to confirm or refute these preliminary observations.

Background/Objectives: Adolescent pregnancy is associated with an increased risk of adverse neonatal outcomes, including low birth weight, preterm birth, and impaired neonatal adaptation. While maternal age is a well-established determinant, the independent role of parity in this population remains uncertain. This study aimed to assess the association between parity and neonatal outcomes in adolescent mothers. Methods: We conducted a retrospective cohort study including 751 singleton live-birth deliveries to adolescent mothers aged <18 years at a Romanian secondary-care hospital. The unit of analysis was the delivery episode recorded in the institutional birth registry. Mothers were classified according to parity at the time of the index delivery as primiparous or multiparous. Neonatal outcomes included low birth weight (<2500 g), preterm birth (<37 weeks), Apgar score < 7 at 5 min, and a composite adverse neonatal outcome. Multivariable logistic regression models were used to evaluate the association between parity and neonatal outcomes, adjusting for maternal age (<15 vs. ≥15 years), gestational age, and mode of delivery, as appropriate. Results: A total of 751 singleton live-birth delivery episodes were included; 609 (81.1%) occurred in primiparous adolescents and 142 (18.9%) in multiparous adolescents. Parity was not significantly associated with preterm birth (aOR 0.86, 95% CI 0.48–1.56, p = 0.622), Apgar score < 7 at 5 min, or the composite adverse neonatal outcome. Maternal age < 15 years and gestational age were independently associated with Apgar score < 7 at 5 min. Multiparity was associated with lower odds of low birth weight (aOR 0.40, 95% CI 0.17–0.92, p = 0.031). Conclusions: Parity was not independently associated with most neonatal outcomes in adolescent pregnancies. Multiparity was associated with lower odds of low birth weight, but this finding should be interpreted cautiously because residual confounding cannot be excluded.

Background: Acute chest pain is a common cause for presentation to the emergency department (ED), where rapid identification of patients at high risk for acute coronary syndrome is essential. The HEART score combines medical history, electrocardiogram, age, risk factors, and troponin levels to provide structured risk stratification. However, evidence regarding the HEART score in COVID-19 survivors presenting with acute chest pain remains limited. This study examined the distribution of HEART scores and their associations with decisions made in the emergency department, hospital management, rises in cardiac troponin levels, coronary revascularization, and in-hospital mortality. Materials and Methods: In this single-center retrospective observational study, 400 consecutive adult COVID-19 survivors who presented to the ED with acute non-traumatic chest pain were included. HEART scores were retrospectively calculated from routinely available clinical and laboratory data, and patients were categorized as low (0–3), moderate (4–6), or high risk (7–10). Results: The median HEART score was 2 (IQR 0–5); 264 patients (66.0%) were classified as low risk, 50 (12.5%) as moderate risk and 86 (21.5%) as high risk. The distribution of the total score was bimodal, with 128 patients (32.0%) scoring zero and 78 (19.5%) scoring 8–10. Cardiac troponin was above the upper reference limit at presentation or at one hour in 96 patients (24.0%): 3 of 264 low-risk patients (1.1%), 7 of 50 moderate-risk patients (14.0%) and all 86 high-risk patients (100%). Eighty-three patients (20.8%) were admitted to hospital, almost all from the high-risk category (82 of 86, 95.3%), compared with 1 of 50 moderate-risk patients (2.0%) and no low-risk patient. All 51 revascularisation procedures (46 percutaneous coronary interventions and 5 coronary artery bypass grafts) and all five in-hospital deaths (1.2% of the cohort) occurred among high-risk patients. In an exploratory, hypothesis-generating multivariable analysis of troponin elevation, older age (adjusted odds ratio 2.38 per decade, 95% CI 1.88–3.09) and smoking (4.10, 2.12–8.06) were associated with elevation and female sex was inversely so (0.22, 0.11–0.41); renal function was not available for adjustment. Conclusions: HEART score categories were associated with ED disposition and in-hospital management in this retrospective cohort of COVID-19 survivors presenting with acute chest pain. High-risk patients accounted for nearly all hospital admissions, coronary revascularizations, and in-hospital deaths. However, systematic post-discharge follow-up was not available; therefore, 30-day or 6-week MACE could not be assessed, and the prognostic performance of the HEART score or the safety of HEART-based discharge cannot be determined. These findings should therefore be interpreted as descriptive associations reflecting real-world clinical practice and warrant confirmation in prospective studies with systematic follow-up.