{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T12:13:17Z","timestamp":1788437597208,"version":"build-2803163510"},"reference-count":35,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T00:00:00Z","timestamp":1787961600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara"},{"id":[{"id":"https:\/\/ror.org\/00afdp487","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Pulmonary embolism (PE) remains a major cause of cardiovascular morbidity and mortality, and associated infections may modify its clinical course. This study evaluated the impact of viral infections on pulmonary embolism severity, mortality, and the performance of established risk scores. Methods: This retrospective observational study included 729 patients with confirmed PE admitted between January 2020 and December 2025. Patients were grouped according to the presence of associated infections. We analysed clinical data, comorbidities, thrombus localization, laboratory parameters, infection type, treatment, mortality, and Pulmonary Embolism Severity Index (PESI), Wells, Padua, and International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) scores. We performed between-group comparisons, logistic regression, and ROC curve analyses. Results: Patients with associated infections had higher crude mortality than those without infections (27.7% vs. 18.4%, p = 0.006). They also showed higher PESI and IMPROVE scores for venous thromboembolism (VTE), increased white blood cell (WBC) count, markedly elevated D-dimers, longer prothrombin time, and different thrombus localization. Viral infection category was independently associated with mortality, with the IMPROVE score showing the highest ROC discrimination among evaluated scores. Conclusions: Associated infections define a higher-risk PE phenotype. Risk stratification should integrate infection status, laboratory markers, and conventional PE\/VTE scores.<\/jats:p>","DOI":"10.3390\/diagnostics16172779","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T04:24:03Z","timestamp":1788150243000},"page":"2779","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Associated Infections on the Clinical Course and Risk-Stratification Profile of Pulmonary Embolism: Comparative Analysis Using PESI, Wells, Padua, and IMPROVE Scores"],"prefix":"10.3390","volume":"16","author":[{"given":"Daniela Nicoleta","family":"Crisan","sequence":"first","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1790-8130","authenticated-orcid":false,"given":"Raluca","family":"Dumache","sequence":"additional","affiliation":[{"name":"Department of Forensic Medicine, Bioethics, Medical Ethics and Medical Law, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"},{"name":"Center for Ethics in Human Genetic Identifications, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6567-4407","authenticated-orcid":false,"given":"Talida Georgiana","family":"Cut","sequence":"additional","affiliation":[{"name":"Department XIII, Discipline of Infectious Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Square, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Herlo","sequence":"additional","affiliation":[{"name":"Department XIII, Discipline of Infectious Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Square, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marius Florentin","family":"Popa","sequence":"additional","affiliation":[{"name":"Department of Forensic Medicine, \u201cSf. Apostol Andrei\u201d Emergency County Hospital, 900439 Constanta, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucian-Flavius","family":"Herlo","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2187-289X","authenticated-orcid":false,"given":"Nina","family":"Ivanovic","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"},{"name":"Center for Ethics in Human Genetic Identifications, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"},{"name":"Department of Dermatology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5872-4381","authenticated-orcid":false,"given":"Andreea Nelson","family":"Twakor","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, \u201cSf. Apostol Andrei\u201d Emergency County Hospital, 145 Tomis Blvd., 900591 Constanta, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela-Florentina","family":"\u021aapo\u0219","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, \u201cSf. Apostol Andrei\u201d Emergency County Hospital, 145 Tomis Blvd., 900591 Constanta, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adelina Raluca","family":"Marinescu","sequence":"additional","affiliation":[{"name":"Department XIII, Discipline of Infectious Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Square, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/j.annemergmed.2023.01.019","article-title":"Managing Pulmonary Embolism","volume":"82","author":"Westafer","year":"2023","journal-title":"Ann. Emerg. 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