{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T09:14:48Z","timestamp":1774689288133,"version":"3.50.1"},"reference-count":70,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,10,29]],"date-time":"2023-10-29T00:00:00Z","timestamp":1698537600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>COVID-19 continues to impact global health systems even after being declared over, with some patients exhibiting severe complications linked to pre-existing conditions. This study aimed to investigate the association between comorbidities, complications, and survival outcomes among COVID-19 survivors in Western Romania. Our hypothesis posited that comorbidities and complications significantly influence survival rates. We conducted a retrospective analysis of 1948 COVID-19 survivors admitted from January to December 2021, with 192 selected for detailed analysis based on inclusion and exclusion criteria. The severity of COVID-19 was classified according to WHO guidelines, and conditions like hypertension and obesity were defined using criteria from the European Society of Hypertension (ESH), the European Society of Cardiology (ESC), and WHO, respectively. Among the 192 patients, 33 had mild, 62 had moderate, and 97 had severe COVID-19. The median age across the severity groups was 63.2 years. Patients undergoing tracheostomy had a mortality rate of 83.3% versus 22.2% for non-tracheostomy patients (p &lt; 0.001) and presented with significantly higher lung injury, hospitalization duration, and complications. Remarkably, tracheostomized patients were 17.50 times more likely to succumb to the disease (95% CI 4.39\u2013116.91, p &lt; 0.001). Furthermore, pneumothorax increased the mortality risk significantly (OR 22.11, 95% CI 5.72\u2013146.03, p &lt; 0.001). Intriguingly, certain conditions like grade I hypertension and grade II obesity showed a protective effect against mortality, whereas type 2 diabetes mellitus increased mortality risk (univariate OR 2.89, p = 0.001). The presence of certain comorbidities and complications significantly impacts the survival rates of COVID-19 patients in Western Romania. Notably, tracheostomy, pneumothorax, and T2DM were associated with increased mortality. This study underscores the importance of personalized patient care and provides insights for healthcare policymakers in Western Romania to improve clinical management strategies.<\/jats:p>","DOI":"10.3390\/jpm13111552","type":"journal-article","created":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T12:07:45Z","timestamp":1698667665000},"page":"1552","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The Effect of Comorbidities and Complications on COVID-19 Mortality: A Detailed Retrospective Study in Western Romania"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1160-9164","authenticated-orcid":false,"given":"Monica Steluta","family":"Marc","sequence":"first","affiliation":[{"name":"Center for Research and Innovation in Precision Medicine of Respiratory Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Department of Infectious Diseases, Discipline of Pulmonology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Rosca","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4711-4315","authenticated-orcid":false,"given":"Felix","family":"Bratosin","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Discipline of Infectious Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9034-5218","authenticated-orcid":false,"given":"Ovidiu","family":"Fira-Mladinescu","sequence":"additional","affiliation":[{"name":"Center for Research and Innovation in Precision Medicine of Respiratory Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Department of Infectious Diseases, Discipline of Pulmonology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2083-0581","authenticated-orcid":false,"given":"Cristian","family":"Oancea","sequence":"additional","affiliation":[{"name":"Center for Research and Innovation in Precision Medicine of Respiratory Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Department of Infectious Diseases, Discipline of Pulmonology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7573-3714","authenticated-orcid":false,"given":"Camelia Corina","family":"Pescaru","sequence":"additional","affiliation":[{"name":"Center for Research and Innovation in Precision Medicine of Respiratory Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Department of Infectious Diseases, Discipline of Pulmonology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8154-6931","authenticated-orcid":false,"given":"Diana","family":"Velescu","sequence":"additional","affiliation":[{"name":"Center for Research and Innovation in Precision Medicine of Respiratory Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Department of Infectious Diseases, Discipline of Pulmonology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norbert","family":"Wellmann","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4297-077X","authenticated-orcid":false,"given":"Alexandru Catalin","family":"Motofelea","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2879-8080","authenticated-orcid":false,"given":"Ioana Mihaiela","family":"Ciuca","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Pediatric Pulmonology Unit, Clinical County Hospital, Evliya Celebi 1-3, 300226 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2893-3116","authenticated-orcid":false,"given":"Karina","family":"Saracin","sequence":"additional","affiliation":[{"name":"Emergency County Hospital Craiova, Strada Tabaci 1, 200642 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4602-7730","authenticated-orcid":false,"given":"Diana","family":"Manolescu","sequence":"additional","affiliation":[{"name":"Center for Research and Innovation in Precision Medicine of Respiratory Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Department of Radiology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, 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Mol. Biol. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1016\/S0140-6736(20)30374-3","article-title":"COVID-19: What is next for public health?","volume":"395","author":"Heymann","year":"2020","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Fisher, D., and Heymann, D. (2020). Q&A: The novel coronavirus outbreak causing COVID-19. BMC Med., 18.","DOI":"10.1186\/s12916-020-01533-w"},{"key":"ref_4","unstructured":"(2023, January 24). WHO\/Europe|Home. Available online: https:\/\/www.who.int\/europe."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1126\/science.1087139","article-title":"Isolation and Characterization of Viruses Related to the SARS Coronavirus from Animals in Southern China","volume":"302","author":"Guan","year":"2003","journal-title":"Science"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1016\/S0140-6736(20)30468-2","article-title":"COVID-19 and the anti-lessons of history","volume":"395","author":"Peckham","year":"2020","journal-title":"Lancet"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"66","DOI":"10.15698\/cst2020.04.216","article-title":"Coronavirus infections: Epidemiological, clinical and immunological features and hypotheses","volume":"4","author":"Raoult","year":"2020","journal-title":"Cell Stress"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Xu, J., Zhao, S., Teng, T., Abdalla, A.E., Zhu, W., Xie, L., Wang, Y., and Guo, X. (2020). Systematic Comparison of Two Animal-to-Human Transmitted Human Coronaviruses: SARS-CoV-2 and SARS-CoV. Viruses, 12.","DOI":"10.3390\/v12020244"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"100802","DOI":"10.1016\/j.nmni.2020.100802","article-title":"The burden and outcomes of COVID-19 among patients with co-morbid disease in Africa: Protocol for a systematic review and meta-analysis","volume":"39","author":"Aberhe","year":"2021","journal-title":"New Microbes New Infect."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"609470","DOI":"10.3389\/fendo.2021.609470","article-title":"Type 2 Diabetes Mellitus and COVID-19: A Narrative Re-view","volume":"12","author":"Corrao","year":"2021","journal-title":"Front. Endocrinol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"100352","DOI":"10.1016\/j.obmed.2021.100352","article-title":"The role of comorbidities on mortality of COVID-19 in patients with diabetes","volume":"25","author":"Emami","year":"2021","journal-title":"Obes. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1159\/000513288","article-title":"The Association between Presence of Comorbidities and COVID-19 Severity: A Systematic Review and Meta-Analysis","volume":"50","author":"Honardoost","year":"2021","journal-title":"Cerebrovasc. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.anorl.2020.04.006","article-title":"French consensus regarding precautions during tracheostomy and post-tracheostomy care in the context of COVID-19 pandemic","volume":"137","author":"Schultz","year":"2020","journal-title":"Eur. Ann. Otorhinolaryngol. Head Neck Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2173","DOI":"10.1007\/s00405-020-05993-x","article-title":"Recommendation of a practical guideline for safe tracheostomy during the COVID-19 pandemic","volume":"277","author":"Takhar","year":"2020","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1016\/j.bja.2021.11.027","article-title":"Association between trache-ostomy timing and outcomes for older critically ill COVID-19 patients: Prospective observational study in European intensive care units","volume":"128","author":"Polok","year":"2022","journal-title":"Br. J. Anaesth."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e265","DOI":"10.1016\/j.surge.2020.12.002","article-title":"The Royal College of surgeons multidisciplinary guidelines on elective tracheostomy insertion in COVID-19 ventilated patients","volume":"19","author":"Jones","year":"2021","journal-title":"Surgeon"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1097\/LBR.0000000000000177","article-title":"Tracheostomy Tube Placement: Early and Late Complications","volume":"22","author":"Mahajan","year":"2015","journal-title":"J. Bronchol. Interv. Pulmonol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"104844","DOI":"10.1016\/j.oraloncology.2020.104844","article-title":"Systematic review of international guidelines for tracheostomy in COVID-19 patients","volume":"108","author":"Lechien","year":"2020","journal-title":"Oral Oncol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"E46","DOI":"10.1148\/radiol.2020200823","article-title":"Performance of Radiologists in Differentiating COVID-19 from Non-COVID-19 Viral Pneumonia at Chest, CT","volume":"296","author":"Bai","year":"2020","journal-title":"Radiology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3021","DOI":"10.1093\/eurheartj\/ehy339","article-title":"2018 ESC\/ESH Guidelines for the management of arterial hypertension","volume":"39","author":"Williams","year":"2018","journal-title":"Eur. Heart J."},{"key":"ref_21","unstructured":"(2023, September 21). Obesity and Overweight. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/obesity-and-overweight."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Fabi\u00e3o, J., Sassi, B., Pedrollo, E.F., Gerchman, F., Kramer, C.K., Leit\u00e3o, C.B., and Pinto, L.C. (2022). Why do men have worse COVID-19-related outcomes? A systematic review and meta-analysis with sex adjusted for age. Braz. J. Med. Biol. Res., 55.","DOI":"10.1590\/1414-431x2021e11711"},{"key":"ref_23","first-page":"41","article-title":"Examining Male Predominance of Severe COVID-19 Outcomes: A Systematic Review","volume":"3","author":"Twitchell","year":"2022","journal-title":"Androg. Clin. Res. Ther."},{"key":"ref_24","unstructured":"Cascella, M., Rajnik, M., Aleem, A., Dulebohn, S.C., and Napoli, R.D. (2023, January 24). Features, Evaluation, and Treatment of Coronavirus (COVID-19), Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK554776\/."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1564","DOI":"10.1056\/NEJMc2004973","article-title":"Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1","volume":"382","author":"Bushmaker","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1038\/s41586-020-2012-7","article-title":"A pneumonia outbreak associated with a new coronavirus of probable bat origin","volume":"579","author":"Zhou","year":"2020","journal-title":"Nature"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1001\/jama.2020.1585","article-title":"Clinical Characteristics of 138 Hospitalized Patients with 2019 Novel Coronavirus\u2013Infected Pneumonia in Wuhan, China","volume":"323","author":"Wang","year":"2020","journal-title":"JAMA"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1001\/jama.2020.2648","article-title":"Characteristics of and Important Lessons from the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72,314 Cases from the Chinese Center for Disease Control and Prevention","volume":"323","author":"Wu","year":"2020","journal-title":"JAMA"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2546","DOI":"10.1002\/lary.28734","article-title":"Utility of Tracheostomy in Patients with COVID-19 and Other Special Considerations","volume":"130","author":"Mecham","year":"2020","journal-title":"Laryngoscope"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1186\/s13054-018-2126-6","article-title":"Epidemiology and patterns of tracheostomy practice in patients with acute respiratory distress syndrome in ICUs across 50 countries","volume":"22","author":"Abe","year":"2018","journal-title":"Crit. Care"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.emc.2018.09.010","article-title":"Tracheostomy Emergencies","volume":"37","author":"Bontempo","year":"2019","journal-title":"Emerg. Med. Clin. N. Am."},{"key":"ref_32","first-page":"511","article-title":"Early complications of tracheostomy","volume":"50","author":"Durbin","year":"2005","journal-title":"Respir. Care"},{"key":"ref_33","first-page":"542","article-title":"Late complications of tracheostomy","volume":"50","author":"Epstein","year":"2005","journal-title":"Respir. Care"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"103350","DOI":"10.1016\/j.amjoto.2021.103350","article-title":"Retrospective analysis of post-tracheostomy complications","volume":"43","author":"Murray","year":"2022","journal-title":"Am. J. Otolaryngol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1016\/j.ijom.2020.08.007","article-title":"Challenges of tracheostomy in COVID-19 patients in a tertiary centre in inner city London","volume":"49","author":"Yeung","year":"2020","journal-title":"Int. J. Oral. Maxillofac. Surg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e12353","DOI":"10.1097\/MD.0000000000012353","article-title":"The role of pelvic lymphocele in the development of early postoperative complications","volume":"97","author":"Neagoe","year":"2018","journal-title":"Medicine"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1016\/j.anl.2021.01.006","article-title":"Management of tracheostomy in COVID-19 patients: The Japanese experience","volume":"48","author":"Yokokawa","year":"2021","journal-title":"Auris Nasus Larynx"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"615845","DOI":"10.3389\/fmed.2020.615845","article-title":"Tracheostomy in 80 COVID-19 Patients: A Multicenter, Retrospective, Observational Study","volume":"7","author":"Tang","year":"2020","journal-title":"Front. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e595","DOI":"10.1002\/hsr2.595","article-title":"Characteristics, complications, and a comparison between early and late tracheostomy: A retrospective observational study on tracheostomy in patients with COVID-19-related acute respiratory distress syndrome","volume":"5","author":"Hansson","year":"2022","journal-title":"Health Sci. Rep."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1016\/j.surg.2022.11.017","article-title":"Optimal timing and outcomes among COVID-19 patients undergoing tracheostomy","volume":"173","author":"Vuu","year":"2023","journal-title":"Surgery"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"15406","DOI":"10.1038\/s41598-022-19567-w","article-title":"Association of mortality and early tracheostomy in patients with COVID-19: A retrospective analysis","volume":"12","author":"Flinspach","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s00405-020-06112-6","article-title":"Long-term intubation and high rate of tracheostomy in COVID-19 patients might determine an unprecedented increase of airway stenoses: A call to action from the European Laryngological Society","volume":"278","author":"Piazza","year":"2021","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1007\/s12070-022-03248-1","article-title":"Outcome of Tracheostomy in COVID-19 Patients","volume":"75","author":"Mishra","year":"2023","journal-title":"Indian J. Otolaryngol. Head Neck Surg."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1016\/j.bjoms.2021.05.011","article-title":"Systematic review and meta-analysis of tracheostomy out-comes in COVID-19 patients","volume":"59","author":"Ferro","year":"2021","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1007\/s00106-021-01021-4","article-title":"Surgical tracheostomy in a cohort of COVID-19 patients","volume":"69","author":"Schuler","year":"2021","journal-title":"HNO"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"477","DOI":"10.5501\/wjv.v11.i6.477","article-title":"Clinical characteristics of COVID-19 patients who underwent tracheostomy and its effect on outcome: A retrospective observational study","volume":"11","author":"Singh","year":"2022","journal-title":"World J. Virol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1177\/0194599820961990","article-title":"Multidisciplinary Safety Recommendations after Tracheostomy During COVID-19 Pandemic: State of the Art Review","volume":"164","author":"Meister","year":"2021","journal-title":"Otolaryngol.\u2013Head Neck Surg."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1177\/0145561321993567","article-title":"Outcomes after Tracheostomy for Patients with Respiratory Failure due to COVID-19","volume":"101","author":"Cardasis","year":"2022","journal-title":"Ear Nose Throat J."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"5240","DOI":"10.3748\/wjg.v28.i36.5240","article-title":"SARS-CoV-2 and the pancreas: What do we know about acute pancreatitis in COVID-19 positive patients?","volume":"28","author":"Brisinda","year":"2022","journal-title":"World J. Gastroenterol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"507","DOI":"10.31925\/farmacia.2022.3.17","article-title":"The evaluation of vitamin D deficiency as a risk factor in the case of patients with moderate COVID-19","volume":"70","author":"Nicolescu","year":"2022","journal-title":"Farmacia"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1111\/nyas.14506","article-title":"The prevalence of depression, anxiety, and sleep disturbances in COVID-19 patients: A meta-analysis","volume":"1486","author":"Deng","year":"2021","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Muntean, D., Horhat, F.-G., B\u0103di\u021boiu, L., Dumitra\u0219cu, V., Bagiu, I.-C., Horhat, D.-I., Co\u0219ni\u021b\u0103, D., Krasta, A., Dug\u0103e\u015fescu, D., and Licker, M. (2018). Multidrug-Resistant Gram-Negative Bacilli: A Retrospective Study of Trends in a Tertiary Healthcare Unit. Medicina, 54.","DOI":"10.3390\/medicina54060092"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1016\/j.hrtlng.2021.04.005","article-title":"The incidence, clinical characteristics, and outcomes of pneumothorax in hospitalized COVID-19 patients: A systematic review","volume":"50","author":"Chong","year":"2021","journal-title":"Heart Lung"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1016\/j.arbres.2020.06.012","article-title":"Comorbidities and Mortality in Patients With COVID-19 Aged 60 Years and Older in a University Hospital in Spain","volume":"56","author":"Posso","year":"2020","journal-title":"Arch. Bronconeumol."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Trinkmann, F., Saur, J., Borggrefe, M., and Akin, I. (2019). Cardiovascular Comorbidities in Chronic Obstructive Pulmonary Disease (COPD)\u2014Current Considerations for Clinical Practice. J. Clin. Med., 8.","DOI":"10.3390\/jcm8010069"},{"key":"ref_56","first-page":"498","article-title":"Pelvic intraoperative iatrogenic oncosurgical injuries: Single-center experience","volume":"21","author":"Neagoe","year":"2016","journal-title":"Off. J. Balk Union Oncol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1067\/j.cpradiol.2021.09.009","article-title":"Imaging of Pulmonary Superinfections and Co-Infections in COVID-19","volume":"51","author":"Naranje","year":"2022","journal-title":"Curr. Probl. Diagn. Radiol."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"De Bruyn, A., Verellen, S., Bruckers, L., Geebelen, L., Callebaut, I., De Pauw, I., Stessel, B., and Dubois, J. (2022). Secondary infection in COVID-19 critically ill patients: A retrospective single-center evaluation. BMC Infect. Dis., 22.","DOI":"10.1186\/s12879-022-07192-x"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"eabg5298","DOI":"10.1126\/science.abg5298","article-title":"Socioeconomic status determines COVID-19 incidence and related mortality in Santiago, Chile","volume":"372","author":"Mena","year":"2021","journal-title":"Science"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.puhe.2020.09.016","article-title":"Socio-economic status and COVID-19-related cases and fatalities","volume":"189","author":"Hawkins","year":"2020","journal-title":"Public Health"},{"key":"ref_61","unstructured":"Mayo Clinic (2023, January 24). COVID-19: Who\u2019s at Higher Risk of Serious Symptoms?. Available online: https:\/\/www.mayoclinic.org\/diseases-conditions\/coronavirus\/in-depth\/coronavirus-who-is-at-risk\/art-20483301."},{"key":"ref_62","unstructured":"CDC Healthcare Workers (2023, January 24). Centers for Disease Control and Prevention, Available online: https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/clinical-care\/underlyingconditions.html."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"2752","DOI":"10.1210\/clinem\/dgaa346","article-title":"Predicting Mortality Due to SARS-CoV-2: A Mechanistic Score Relating Obesity and Diabetes to COVID-19 Outcomes in Mexico","volume":"105","author":"Naveja","year":"2020","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"e043651","DOI":"10.1136\/bmjopen-2020-043651","article-title":"Severity of respiratory failure at admission and in-hospital mortality in patients with COVID-19: A prospective observational multicentre study","volume":"10","author":"Santus","year":"2020","journal-title":"BMJ Open"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"e6","DOI":"10.1016\/j.amjmed.2020.05.033","article-title":"The relationship between diabetes mellitus and COVID-19 prognosis: A retrospective cohort study in Wuhan, China","volume":"134","author":"Shang","year":"2021","journal-title":"Am. J. Med."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"2723","DOI":"10.21037\/apm-20-1278","article-title":"Clinical risk factors for mortality of hospitalized patients with COVID-19: Systematic review and meta-analysis","volume":"10","author":"Xiang","year":"2021","journal-title":"Ann. Palliat. Med."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.cmi.2021.09.010","article-title":"Obesity, diabetes, hypertension and severe outcomes among inpatients with coronavirus disease 2019: A nationwide study","volume":"28","author":"Bailly","year":"2022","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Dessie, Z.G., and Zewotir, T. (2021). Mortality-related risk factors of COVID-19: A systematic review and meta-analysis of 42 studies and 423,117 patients. BMC Infect. Dis., 21.","DOI":"10.1186\/s12879-021-06536-3"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1177\/15598276211029222","article-title":"COVID-19: Implications for Physical Activity, Health Disparities, and Health Equity","volume":"16","author":"Hasson","year":"2022","journal-title":"Am. J. Lifestyle Med."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1215\/03616878-8641518","article-title":"Health Equity, Social Policy, and Promoting Recovery from COVID-19","volume":"45","author":"Lynch","year":"2020","journal-title":"J. Health Polit. Policy Law"}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/13\/11\/1552\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:13:55Z","timestamp":1760130835000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/13\/11\/1552"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,29]]},"references-count":70,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2023,11]]}},"alternative-id":["jpm13111552"],"URL":"https:\/\/doi.org\/10.3390\/jpm13111552","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,29]]}}}