{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T09:41:13Z","timestamp":1786700473192,"version":"build-2736575974"},"reference-count":19,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Medicine and Pharmacy Carol Davila"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Objectives: This study aimed to assess the impact of the COVID-19 pandemic on the epidemiology, microbiology, clinical presentation, management, and outcomes of infective endocarditis (IE). Methods: A retrospective cohort study was conducted, including 100 adult patients with definite IE diagnosed between January 2020 and December 2025 at a Romanian tertiary care centre. Patients were stratified by year of admission into pandemic (2020\u20132022) and post-pandemic (2023\u20132025) groups. Results: Among the 100 patients (47 in the pandemic period and 53 in the post-pandemic period), the time from symptom onset to diagnosis was significantly shorter in the post-pandemic period (median of 24 days versus 40 days; p &lt; 0.01). We observed changes in the microbiological profile. The proportion of staphylococcal IE was lower, while the proportions of enterococcal and streptococcal IE were slightly higher in the post-pandemic period. In-hospital mortality decreased significantly from 51.1% to 24.5% (p = 0.006). Embolic events were more frequent in the post-pandemic period (62.3% vs. 39.1%; p = 0.022). Vegetation size was associated with embolic risk (OR: 1.05 per mm; p &lt; 0.01). Pandemic-period admission (aOR 3.11; p = 0.020) and sepsis (aOR 11.30; p = 0.006) were independently associated with higher in-hospital mortality. Conclusions: The COVID-19 pandemic was associated with delayed presentation and worse outcomes in IE. Post-pandemic improvements likely reflect healthcare system adaptation and earlier diagnosis. Microbiological aetiology remains a key determinant of prognosis.<\/jats:p>","DOI":"10.3390\/antibiotics15080786","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T09:04:01Z","timestamp":1786698241000},"page":"786","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of the COVID-19 Pandemic on Presentation, Microbiology, and Outcomes of Infective Endocarditis: A Romanian Retrospective Cohort Study"],"prefix":"10.3390","volume":"15","author":[{"given":"Adelina Maria","family":"Radu","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Agrippa Ionescu Clinical Emergency Hospital, 011356 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina Florentina","family":"Talpo\u0219i","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Agrippa Ionescu Clinical Emergency Hospital, 011356 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raluca Elena","family":"\u021ao\u021boiu","sequence":"additional","affiliation":[{"name":"Agrippa Ionescu Clinical Emergency Hospital, 011356 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxana","family":"Berbecaru","sequence":"additional","affiliation":[{"name":"Agrippa Ionescu Clinical Emergency Hospital, 011356 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9222-7400","authenticated-orcid":false,"given":"Ana","family":"Dobrin","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Agrippa Ionescu Clinical Emergency Hospital, 011356 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4370-9250","authenticated-orcid":false,"given":"Violeta","family":"Melinte","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Agrippa Ionescu Clinical Emergency Hospital, 011356 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina Maria","family":"V\u0103c\u0103roiu","sequence":"additional","affiliation":[{"name":"Agrippa Ionescu Clinical Emergency Hospital, 011356 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiberiu Sebastian","family":"Holban","sequence":"additional","affiliation":[{"name":"Agrippa Ionescu Clinical Emergency Hospital, 011356 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matei Cherecheanu","family":"Popa","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Agrippa Ionescu Clinical Emergency Hospital, 011356 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oana Andreea","family":"Popa","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Agrippa Ionescu Clinical Emergency Hospital, 011356 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u0103d\u0103lina Elena","family":"Iancu","sequence":"additional","affiliation":[{"name":"Agrippa Ionescu Clinical Emergency Hospital, 011356 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amalia","family":"C\u0103linoiu","sequence":"additional","affiliation":[{"name":"Agrippa Ionescu Clinical Emergency Hospital, 011356 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lumini\u021ba","family":"Tomescu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Agrippa Ionescu Clinical Emergency Hospital, 011356 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2586-4070","authenticated-orcid":false,"given":"Oana","family":"S\u0103ndulescu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"\u201cProf. Dr. Matei Bal\u0219\u201d National Institute for Infectious Diseases, 021105 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7819-5464","authenticated-orcid":false,"given":"Valeriu","family":"Gheorghi\u021b\u0103","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Agrippa Ionescu Clinical Emergency Hospital, 011356 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Chen, H., Zhan, Y., Zhang, K., Gao, Y., Chen, L., Zhan, J., Chen, Z., and Zeng, Z. 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