Antibiotics (Basel, Switzerland) · 2026
Impact of the COVID-19 Pandemic on Presentation, Microbiology, and Outcomes of Infective Endocarditis: A Romanian Retrospective Cohort Study.
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Radu Adelina Maria, Talpoși Irina Florentina, Țoțoiu Raluca Elena, Berbecaru Roxana, Dobrin Ana, Melinte Violeta, Văcăroiu Cristina Maria, Holban Tiberiu Sebastian, Popa Matei Cherecheanu, Popa Oana Andreea, Iancu Mădălina Elena, Călinoiu Amalia, Tomescu Luminița, Săndulescu Oana, Gheorghiță Valeriu
Аннотация
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 (2020-2022) and post-pandemic (2023-2025) 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 < 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 < 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.
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 (2020-2022) and post-pandemic (2023-2025) 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 < 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 < 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.