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Article: Correlation of Lung Damage on CT Scan with Laboratory Inflammatory Markers in COVID-19 Patients: A Single-Center Study from Romania.

Citu, Cosmin / Gorun, Oana Maria / Motoc, Andrei / Citu, Ioana Mihaela / Gorun, Florin / Malita, Daniel

2022 Volume 11, Issue 15

Abstract: 1) Background: This study aims to evaluate the association of CRP, NLR, IL-6, and Procalcitonin with lung damage observed on CT scans; (2) Methods: A cross-sectional study was performed among 106 COVID-19 patients hospitalized in Timisoara Municipal ... ...

Abstract	(1) Background: This study aims to evaluate the association of CRP, NLR, IL-6, and Procalcitonin with lung damage observed on CT scans; (2) Methods: A cross-sectional study was performed among 106 COVID-19 patients hospitalized in Timisoara Municipal Emergency Hospital. Chest CT and laboratory analysis were performed in all patients. The rank Spearmen correlation was used to assess the association between inflammatory markers and lung involvement. In addition, ROC curve analysis was used to determine the accuracy of inflammatory markers in the diagnosis of severe lung damage; (3) Results: CRP, NLR, and IL-6 were significantly positively correlated with lung damage. All inflammatory markers had good accuracy for diagnosis of severe lung involvement. Moreover, IL-6 has the highest AUC- ROC curve; (4) Conclusions: The inflammatory markers are associated with lung damage and can be used to evaluate COVID-19 severity.
Language	English
Publishing date	2022-07-25
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm11154299
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Article: Predictive Value of SOFA and qSOFA for In-Hospital Mortality in COVID-19 Patients: A Single-Center Study in Romania.

Citu, Cosmin / Citu, Ioana Mihaela / Motoc, Andrei / Forga, Marius / Gorun, Oana Maria / Gorun, Florin

Journal of personalized medicine

2022 Volume 12, Issue 6

Abstract: Two years after the outbreak of the COVID-19 pandemic, the disease continues to claim victims worldwide. Assessing the disease's severity on admission may be useful in reducing mortality among patients with COVID-19. The present study was designed to ... ...

Abstract	Two years after the outbreak of the COVID-19 pandemic, the disease continues to claim victims worldwide. Assessing the disease's severity on admission may be useful in reducing mortality among patients with COVID-19. The present study was designed to assess the prognostic value of SOFA and qSOFA scoring systems for in-hospital mortality among patients with COVID-19. The study included 133 patients with COVID-19 proven by reverse transcriptase polymerase chain reaction (RT-PCR) admitted to the Municipal Emergency Clinical Hospital of Timisoara, Romania between 1 October 2020 and 15 March 2021. Data on clinical features and laboratory findings on admission were collected from electronic medical records and used to compute SOFA and qSOFA. Mean SOFA and qSOFA values were higher in the non-survivor group compared to survivors (3.5 vs. 1 for SOFA and 2 vs. 1 for qSOFA, respectively). Receiver operating characteristic (ROC) and area under the curve (AUC) analyses were performed to determine the discrimination accuracy, both risk scores being excellent predictors of in-hospital mortality, with ROC-AUC values of 0.800 for SOFA and 0.794 for qSOFA. The regression analysis showed that for every one-point increase in SOFA score, mortality risk increased by 1.82 and for every one-point increase in qSOFA score, mortality risk increased by 5.23. In addition, patients with SOFA and qSOFA above the cut-off values have an increased risk of mortality with ORs of 7.46 and 11.3, respectively. In conclusion, SOFA and qSOFA are excellent predictors of in-hospital mortality among COVID-19 patients. These scores determined at admission could help physicians identify those patients at high risk of severe COVID-19.
Language	English
Publishing date	2022-05-26
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662248-8
ISSN	2075-4426
ISSN	2075-4426
DOI	10.3390/jpm12060878
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Article ; Online: Correlation of Lung Damage on CT Scan with Laboratory Inflammatory Markers in COVID-19 Patients

Cosmin Citu / Oana Maria Gorun / Andrei Motoc / Ioana Mihaela Citu / Florin Gorun / Daniel Malita

Journal of Clinical Medicine, Vol 11, Iss 15, p

A Single-Center Study from Romania

2022 Volume 4299

Abstract	(1) Background: This study aims to evaluate the association of CRP, NLR, IL-6, and Procalcitonin with lung damage observed on CT scans; (2) Methods: A cross-sectional study was performed among 106 COVID-19 patients hospitalized in Timisoara Municipal Emergency Hospital. Chest CT and laboratory analysis were performed in all patients. The rank Spearmen correlation was used to assess the association between inflammatory markers and lung involvement. In addition, ROC curve analysis was used to determine the accuracy of inflammatory markers in the diagnosis of severe lung damage; (3) Results: CRP, NLR, and IL-6 were significantly positively correlated with lung damage. All inflammatory markers had good accuracy for diagnosis of severe lung involvement. Moreover, IL-6 has the highest AUC- ROC curve; (4) Conclusions: The inflammatory markers are associated with lung damage and can be used to evaluate COVID-19 severity.
Keywords	COVID-19 ; inflammatory markers ; computed tomography ; Medicine ; R
Subject code	610
Language	English
Publishing date	2022-07-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
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Article ; Online: Predictive Value of SOFA and qSOFA for In-Hospital Mortality in COVID-19 Patients

Cosmin Citu / Ioana Mihaela Citu / Andrei Motoc / Marius Forga / Oana Maria Gorun / Florin Gorun

Journal of Personalized Medicine, Vol 12, Iss 878, p

A Single-Center Study in Romania

2022 Volume 878

Abstract: Two years after the outbreak of the COVID-19 pandemic, the disease continues to claim victims worldwide. Assessing the disease’s severity on admission may be useful in reducing mortality among patients with COVID-19. The present study was designed to ... ...

Abstract	Two years after the outbreak of the COVID-19 pandemic, the disease continues to claim victims worldwide. Assessing the disease’s severity on admission may be useful in reducing mortality among patients with COVID-19. The present study was designed to assess the prognostic value of SOFA and qSOFA scoring systems for in-hospital mortality among patients with COVID-19. The study included 133 patients with COVID-19 proven by reverse transcriptase polymerase chain reaction (RT-PCR) admitted to the Municipal Emergency Clinical Hospital of Timisoara, Romania between 1 October 2020 and 15 March 2021. Data on clinical features and laboratory findings on admission were collected from electronic medical records and used to compute SOFA and qSOFA. Mean SOFA and qSOFA values were higher in the non-survivor group compared to survivors (3.5 vs. 1 for SOFA and 2 vs. 1 for qSOFA, respectively). Receiver operating characteristic (ROC) and area under the curve (AUC) analyses were performed to determine the discrimination accuracy, both risk scores being excellent predictors of in-hospital mortality, with ROC–AUC values of 0.800 for SOFA and 0.794 for qSOFA. The regression analysis showed that for every one-point increase in SOFA score, mortality risk increased by 1.82 and for every one-point increase in qSOFA score, mortality risk increased by 5.23. In addition, patients with SOFA and qSOFA above the cut-off values have an increased risk of mortality with ORs of 7.46 and 11.3, respectively. In conclusion, SOFA and qSOFA are excellent predictors of in-hospital mortality among COVID-19 patients. These scores determined at admission could help physicians identify those patients at high risk of severe COVID-19.
Keywords	SOFA ; qSOFA ; COVID-19 ; prediction ; Medicine ; R
Subject code	310 ; 610
Language	English
Publishing date	2022-05-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Clinical characteristics and outcomes in acute myocardial infarction patients aged ≥65 years in Western Romania.

Caruntu, Florina / Bordejevic, Diana Aurora / Tomescu, Mirela Cleopatra / Citu, Ioana Mihaela

Reviews in cardiovascular medicine

2021 Volume 22, Issue 3, Page(s) 911–918

Abstract: Older age is known as a negative prognostic parameter in patients with acute myocardial infarction (AMI). In this study, we aimed to investigate age-related differences in treatment protocols, in-hospital and 1-year mortality. This retrospective ... ...

Abstract	Older age is known as a negative prognostic parameter in patients with acute myocardial infarction (AMI). In this study, we aimed to investigate age-related differences in treatment protocols, in-hospital and 1-year mortality. This retrospective observational single-center study enrolled consecutive AMI patients with an urgent percutaneous coronary intervention (PCI) as the main method of myocardial revascularization. The patients divided were divided by age into group I (≥65 years) and group II (<65 years). The primary endpoint was in-hospital mortality, the secondary endpoints were 1-year mortality and rehospitalization rates. Of the 522 admitted with AMI, 476 were enrolled in the study. The mean age was 67 ± 13 years; 62% were men. Group I patients had a significantly lower rate of performed PCI (65% vs. 79%,
MeSH term(s)	Aged ; Aged, 80 and over ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Myocardial Infarction/diagnosis ; Myocardial Infarction/therapy ; Percutaneous Coronary Intervention/adverse effects ; Retrospective Studies ; Romania/epidemiology
Language	English
Publishing date	2021-09-13
Publishing country	United States
Document type	Journal Article ; Observational Study
ZDB-ID	2108910-3
ISSN	1530-6550
ISSN	1530-6550
DOI	10.31083/j.rcm2203098
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Article ; Online: Clinical features and management of trophoblastic epithelioid tumors: A systematic review.

Gorun, Florin / Tomescu, Larisa / Motoc, Andrei / Citu, Cosmin / Sas, Ioan / Serban, Denis Mihai / Forga, Marius / Citu, Ioana Mihaela / Gorun, Oana Maria

Medicine

2022 Volume 101, Issue 30, Page(s) e29934

Abstract: Background: This study aimed to systematically review the existing literature on epithelioid trophoblastic tumors (ETTs), the rarest type of gestational trophoblastic neoplasia.: Methods: A systematic review according to PRISMA guidelines was ... ...

Abstract	Background: This study aimed to systematically review the existing literature on epithelioid trophoblastic tumors (ETTs), the rarest type of gestational trophoblastic neoplasia. Methods: A systematic review according to PRISMA guidelines was performed, using ScienceDirect, Web of Science, and Scopus databases. The only filter used was the English language. Eligibility/inclusion criteria: retrospective observational studies (case reports, case series) including full case description of epithelioid trophoblastic tumor lesions. Results: Seventy studies were assessed for synthesis, including 147 cases. 66.7% of patients with ETT presented with irregular vaginal bleeding. Pretreatment β-hCG levels ranged up to 1000 mIU/mL in 58.5% patients. Of most patients, 42.2% had stage I disease, 10.9% stage II, 25.2% stage III, and 21.8% of patients had stage IV. The most common sites of metastatic disease were the lungs, followed by the liver and brain. After treatment, complete remission was achieved in 75.5% of patients, partial remission in 10.2% of patients, and 14.3% of patients died. On univariate and multivariate analyses, stage IV disease was an independent prognostic factor for overall and disease-free survival. Conclusions: Hysterectomy and metastatic lesion resection are essential for controlling ETT. Investigational studies on molecules like EGFR, VEGF, PD-1, CD105, and LPCAT1 are potential therapeutic targets for metastatic ETT.
MeSH term(s)	Female ; Gestational Trophoblastic Disease/diagnosis ; Gestational Trophoblastic Disease/pathology ; Gestational Trophoblastic Disease/therapy ; Humans ; Hysterectomy ; Pregnancy ; Trophoblastic Neoplasms/pathology ; Uterine Neoplasms/pathology
Language	English
Publishing date	2022-07-29
Publishing country	United States
Document type	Journal Article ; Systematic Review
ZDB-ID	80184-7
ISSN	1536-5964 ; 0025-7974
ISSN (online)	1536-5964
ISSN	0025-7974
DOI	10.1097/MD.0000000000029934
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Article: Assessing the Utility of Hemoglobin, HALP Score, FAR Ratio, and Coagulation Parameters as Predictors for Preterm Birth.

Hrubaru, Ingrid / Motoc, Andrei / Dumitru, Catalin / Bratosin, Felix / Fericean, Roxana Manuela / Alambaram, Satish / Citu, Ioana Mihaela / Chicin, Gratiana Nicoleta / Erdelean, Izabella / Gorun, Florin / Citu, Cosmin / Popa, Zoran Laurentiu

Children (Basel, Switzerland)

2023 Volume 10, Issue 3

Abstract: Premature birth is a worldwide health issue, posing a high mortality risk for newborns, as well as causing emotional and financial difficulties, and long-term health issues for patients. Identifying effective predictors for preterm birth is essential for ...

Abstract	Premature birth is a worldwide health issue, posing a high mortality risk for newborns, as well as causing emotional and financial difficulties, and long-term health issues for patients. Identifying effective predictors for preterm birth is essential for prolonging gestation or improving obstetric care. As invasive methods are costly, risky, and not universally available, we aim to assess the predictive capacity of various serum parameters in pregnant women during the third trimester, as a non-invasive alternative. Based on previous studies, it was hypothesized that hemoglobin, the association of hemoglobin, albumin, lymphocyte, and platelets' (HALP) score, and coagulation parameters such as the prothrombin time (PT), activated partial thromboplastin clotting time (aPTT), D-dimers, and fibrinogen to albumin ratio (FAR) have significant prediction capabilities. With a retrospective design, a total of 161 patients with a history of preterm birth were included in the analysis, being matched 1:1 with a control group of women who gave birth at term. All laboratory samples were collected during the third trimester of pregnancy. The computed area under the curve (AUC) ranged between 0.600 and 0.700 in all six studied parameters, suggesting a fair discrimination. The highest predictive value for preterm birth was observed to be represented by the HALP score with AUC = 0.680 and the highest sensitivity (75%,
Language	English
Publishing date	2023-03-08
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2732685-8
ISSN	2227-9067
ISSN	2227-9067
DOI	10.3390/children10030527
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Article: The Predictive Role of NLR, d-NLR, MLR, and SIRI in COVID-19 Mortality.

Citu, Cosmin / Gorun, Florin / Motoc, Andrei / Sas, Ioan / Gorun, Oana Maria / Burlea, Bogdan / Tuta-Sas, Ioana / Tomescu, Larisa / Neamtu, Radu / Malita, Daniel / Citu, Ioana Mihaela

Diagnostics (Basel, Switzerland)

2022 Volume 12, Issue 1

Abstract: 1) Background: Since its discovery, COVID-19 has caused more than 256 million cases, with a cumulative death toll of more than 5.1 million, worldwide. Early identification of patients at high risk of mortality is of great importance in saving the lives ... ...

Abstract	(1) Background: Since its discovery, COVID-19 has caused more than 256 million cases, with a cumulative death toll of more than 5.1 million, worldwide. Early identification of patients at high risk of mortality is of great importance in saving the lives of COVID-19 patients. The study aims to assess the utility of various inflammatory markers in predicting mortality among hospitalized patients with COVID-19. (2) Methods: A retrospective observational study was conducted among 108 patients with laboratory-confirmed COVID-19 hospitalized between 1 May 2021 and 31 October 2021 at Municipal Emergency Clinical Hospital of Timisoara, Romania. Blood cell counts at admission were used to obtain NLR, dNLR, MLR, PLR, SII, and SIRI. The association of inflammatory index and mortality was assessed via Kaplan-Maier curves univariate Cox regression and binominal logistic regression. (3) Results: The median age was 63.31 ± 14.83, the rate of in-hospital death being 15.7%. The optimal cutoff for NLR, dNLR, MLR, and SIRI was 9.1, 9.6, 0.69, and 2.2. AUC for PLR and SII had no statistically significant discriminatory value. The binary logistic regression identified elevated NLR (aOR = 4.14), dNLR (aOR = 14.09), and MLR (aOR = 3.29), as independent factors for poor clinical outcome of COVID-19. (4) Conclusions: NLR, dNLR, MLR have significant predictive value in COVID-19 mortality.
Language	English
Publishing date	2022-01-06
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics12010122
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Article: Assessing SARS-CoV-2 Vertical Transmission and Neonatal Complications.

Citu, Cosmin / Neamtu, Radu / Sorop, Virgiliu-Bogdan / Horhat, Delia Ioana / Gorun, Florin / Tudorache, Emanuela / Gorun, Oana Maria / Boarta, Aris / Tuta-Sas, Ioana / Citu, Ioana Mihaela

Journal of clinical medicine

2021 Volume 10, Issue 22

Abstract: We designed and implemented a prospective study to analyze the maternal and neonatal outcomes associated with COVID-19 and determine the likelihood of viral transmission to the fetus and newborn by collecting samples from amniotic fluid, placenta, ... ...

Abstract	We designed and implemented a prospective study to analyze the maternal and neonatal outcomes associated with COVID-19 and determine the likelihood of viral transmission to the fetus and newborn by collecting samples from amniotic fluid, placenta, umbilical cord blood, and breast milk. The study followed a prospective observational design, starting in July 2020 and lasting for one year. A total of 889 pregnant women were routinely tested for SARS-CoV-2 infection in an outpatient setting at our clinic, using nasal swabs for PCR testing. A total of 76 women were diagnosed with COVID-19. The positive patients who accepted study enrollment were systematically analyzed by collecting weekly nasal, urine, fecal, and serum samples, including amniotic fluid, placenta, umbilical cord, and breast milk at hospital admission and postpartum. Mothers with COVID-19 were at a significantly higher risk of developing gestational hypertension and giving birth prematurely by c-section than the general pregnant population. Moreover, their mortality rates were substantially higher. Their newborns did not have negative outcomes, except for prematurity, and an insignificant number of newborns were infected with SARS-CoV-2 (5.4%). No amniotic fluid samples were positive for SARS-CoV-2, and only 1.01% of PCR tests from breast milk were confirmed positive. Based on these results, we support the idea that SARS-CoV-2 positive pregnant women do not expose their infants to an additional risk of infection via breastfeeding, close contact, or in-utero. Consequently, we do not support maternal-newborn separation at delivery since they do not seem to be at an increased risk of SARS-CoV-2 infection.
Language	English
Publishing date	2021-11-11
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm10225253
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Article: Evaluation of FIB-4, NFS, APRI and Liver Function Tests as Predictors for SARS-CoV-2 Infection in the Elderly Population: A Matched Case-Control Analysis.

Grigoras, Mirela Loredana / Citu, Ioana Mihaela / Citu, Cosmin / Chiriac, Veronica Daniela / Gorun, Florin / Levai, Mihaela Codrina / Manolescu, Diana / Rosca, Ovidiu / Bratosin, Felix / Gurumurthy, Srivathsava / Wulandari, Prima Hapsari / Cretu, Octavian Marius

Journal of clinical medicine

2022 Volume 11, Issue 17

Abstract: Several investigations have revealed that COVID-19 causes a significant death rate due to acute respiratory distress syndrome, alterations in the quantity of ACE2 receptor expression, or the intensity of cytokine storm. Similarly, patients with hepatic ... ...

Abstract	Several investigations have revealed that COVID-19 causes a significant death rate due to acute respiratory distress syndrome, alterations in the quantity of ACE2 receptor expression, or the intensity of cytokine storm. Similarly, patients with hepatic impairment that are co-infected with SARS-CoV-2 are more likely to display upregulations of ACE2 receptors and cytokine storm overload, which exacerbates hepatic impairment, potentially increasing the death rate. Moreover, it is expected that the aging population develops a higher degree of hepatic fibrosis in association with other comorbid conditions that are likely to influence the course of COVID-19. Therefore, this research was developed to describe the differences in liver test parameters in elderly individuals with COVID-19 in relation to other inflammatory markers and outcomes. This current observational single-center research followed a case-control design of elderly patients hospitalized for SARS-CoV-2 infection. The research was conducted at a tertiary emergency hospital in western Romania during a two-year period. There were 632 patients included in the analysis that were split into two equal groups matched 1:1 based on gender and body mass index. Three hundred sixteen patients made the group of cases with COVID-19 patients older than 65 years, while the other half were the 316 patient controls with COVID-19 that were younger than 65 years old. Disease outcomes showed a higher prevalence of ICU admissions (22.8% vs. 12.7%, p-value < 0.001) and in-hospital mortality (17.1% vs. 8.9%, p-value = 0.002) in the group of cases. Specific and non-specific liver biomarkers were identified as risk factors for mortality in the elderly, such as ALP (OR = 1.26), LDH (OR = 1.68), AST (OR = 1.98), and ALT (OR = 2.34). Similarly, patients with APRI and NFS scores higher than 1.5 were, respectively, 2.69 times and, 3.05 times more likely to die from COVID-19, and patients with FIB-4 scores higher than 3.25 were 3.13 times more likely to die during hospitalization for SARS-CoV-2 infection. Our research indicates that abnormally increased liver biomarkers and high liver fibrosis scores are related to a worse prognosis in SARS-CoV-2 infected individuals.
Language	English
Publishing date	2022-08-31
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm11175149
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