World journal of methodology最新文献

{"title":"Comparison of propofol alone <i>vs</i> propofol-phenylephrine combination for intraoperative hemodynamic stability in glioma surgery.","authors":"Rhea Thotungal, Ashutosh Kaushal, Amit Agrawal, Anuj Jain, Vaishali Waindeskar, Rudrashish Haldar, Pfokreni Lokho","doi":"10.5662/wjm.117220","DOIUrl":"10.5662/wjm.117220","url":null,"abstract":"<p><strong>Background: </strong>Propofol is widely used for induction in glioma surgery for its neuroprotective effects and favorable recovery profile. However, its dose-dependent hypotension is a major limitation in procedures requiring stable cerebral perfusion.</p><p><strong>Aim: </strong>To compare the efficacy of propofol <i>vs</i> propofol-phenylephrine (PPE) combination in maintaining hemodynamic stability in patients undergoing glioma surgery.</p><p><strong>Methods: </strong>Ninety American Society of Anesthesiologists I-II patients scheduled for elective glioma surgery were randomized to receive either propofol (group P) or a PPE admixture (group PPE). Induction was performed with slow titration of the study drug until loss of verbal response and Bispectral index < 60, followed by a continuous infusion (50 μg/kg/minute) until skin closure. Hemodynamic parameters [mean arterial pressure (MAP), systolic blood pressure, diastolic blood pressure, and heart rate] were recorded at baseline, during induction, immediately after intubation, and at predefined intraoperative time points. The incidence of hypotension, vasopressor and esmolol use, and brain relaxation scores were compared.</p><p><strong>Results: </strong>Group PPE demonstrated significantly better preservation of MAP, systolic blood pressure, diastolic blood pressure, and heart rate throughout the peri-induction and intraoperative periods (<i>P</i> < 0.05). The mean maximum MAP reduction during induction was greater in group P compared with group PPE (19.7 mmHg <i>vs</i> 12.5 mmHg; <i>P</i> < 0.01). Hypotensive episodes were significantly more frequent in group P than in group PPE (84.4% <i>vs</i> 6.7%; <i>P</i> < 0.001). Rescue phenylephrine requirements were markedly lower in group PPE (<i>P</i> < 0.001). Esmolol use and brain relaxation scores were comparable between groups.</p><p><strong>Conclusion: </strong>Adding phenylephrine to propofol for induction and maintenance provides superior hemodynamic stability without compromising brain relaxation in glioma surgery.</p>","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"16 3","pages":"117220"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eco-corona: A new frontier in understanding micro- and nanoplastic-gut interactions.","authors":"Jean Demarquoy, Haifa Othman","doi":"10.5662/wjm.v16.i3.111485","DOIUrl":"10.5662/wjm.v16.i3.111485","url":null,"abstract":"<p><p>Plastics released into natural environments undergo complex transformations, ending in the spontaneous formation of an \"eco-corona\", a dynamic layer of adsorbed organic molecules, biomolecules, and microorganisms. This eco-corona profoundly alters the physicochemical identity of micro- and nanoplastics, modulating their environmental fate, pollutant adsorption, cellular uptake, and toxicity. Emerging evidence shows that eco-corona-coated plastics can act as vectors for environmental pollutants and microbial pathogens, raising significant concerns for ecosystems and human health, particularly in the gastrointestinal tract. Eco-corona dynamics influence colloidal stability, pollutant vectorization, immune responses, and interactions with the gut microbiota, potentially contributing to barrier dysfunction, inflammation, and microbiota dysbiosis. However, major knowledge gaps persist regarding the real-world composition and evolution of eco-coronas, their interplay with biological coronas, and their long-term impacts on health. This mini review synthesizes current insights into eco-corona formation, its modulation of micro- and nanoplastic behavior and toxicity, and highlights critical research priorities to better understand and mitigate the emerging risks at the interface between plastic pollution and gastroenterology.</p>","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"16 3","pages":"111485"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening trauma care in low- and middle-income countries through guideline adaptation and scalable system reforms.","authors":"Kim-Long Le, Tri-Nhan Pham, Minh-Quang Tran, My-Tran Trinh, Phu-Cuong Pham, Quynh-Nhu Duong-Ngoc, Khanh-Phat Thai, Nguyen-Khoi Le, Tuong-Anh Mai-Phan, Hoang-Long Luong-Toan","doi":"10.5662/wjm.v16.i3.113355","DOIUrl":"10.5662/wjm.v16.i3.113355","url":null,"abstract":"<p><p>Trauma is a leading global cause of death and disability, with nearly 90% of fatalities occurring in low- and middle-income countries (LMICs), where prehospital care, infrastructure, and trained personnel are limited. This narrative review synthesizes literature (2019-2025) on the initial management of adult polytrauma, and explores strategies to adapt global guidelines in resource-constrained settings. Contemporary frameworks such as advanced trauma life support (ATLS) and World Health Organization essential trauma care emphasize context-sensitive sequencing, permissive hypotension, balanced transfusion, damage-control surgery, and integration of point-of-care ultrasound. Adjuncts including tranexamic acid, viscoelastic-guided transfusion, prehospital whole blood, and selective aortic balloon occlusion offer incremental survival benefits. However, widespread barriers-training deficits, blood bank shortages, lack of imaging, and absent trauma registries-impede implementation. Emerging models demonstrate that scalable solutions such as primary trauma care courses, phased ATLS rollouts, hybrid emergency rooms, and tablet-based registries can reduce mortality and referral delays without requiring wholesale adoption of high-income systems. Meaningful progress requires adapting evidence-based guidelines to local realities, supported by investments in education, diagnostics, transfusion logistics, and national surveillance. Future work should quantify cost-effectiveness and refine context-specific frameworks to close the outcome gap in LMICs.</p>","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"16 3","pages":"113355"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of duodenoscope with disposable distal cap in reducing microbial contamination: A systematic review and meta-analysis.","authors":"Beanie Conceição Medeiros Nunes, Stefano Baraldo, Joao Ricardo Duda, Luiza Fenelon, Matheus Cavalcante Franco, Murilo Cavalcante Netto do Carmo, Diogo Bergesch Diedrich, Marcelo Cristalli Pacheco da Costa, Angelo So Taa Kum","doi":"10.5662/wjm.116174","DOIUrl":"10.5662/wjm.116174","url":null,"abstract":"<p><strong>Background: </strong>Persistent microbial contamination of duodenoscopes remains a critical vector for healthcare-associated infections involving multidrug-resistant organisms. Despite adherence to standard high-level disinfection (HLD) protocols, contamination rates remain alarming. To mitigate this risk, the United States Food and Drug Administration has recommended transitioning to duodenoscopes with disposable components.</p><p><strong>Aim: </strong>To investigate the efficacy of disposable distal cap compared to standard duodenoscope reprocessing with HLD in reducing microbial contamination.</p><p><strong>Methods: </strong>Following Preferred Reporting Items for Systematic Reviews and Meta-analysis and Cochrane guidelines, we conducted a systematic search of MEDLINE, EMBASE, Google Scholar, and grey literature for randomized controlled trials comparing disposable distal cap <i>vs</i> standard duodenoscopes. The primary outcome was the rate of microbial contamination, defined as an adenosine triphosphate level > 40 relative light unit. Risk ratio was pooled using a random-effects model, and the quality of evidence was assessed using the Grading Recommendations Assessment, Development, and Evaluation methodology.</p><p><strong>Results: </strong>Four randomized controlled trials met the inclusion criteria, encompassing 1092 duodenoscopes (543 disposable distal cap, 549 standard). The use of disposable cap demonstrated a significant and substantial reduction in post-HLD contamination rates. The pooled analysis showed a risk ratio of 0.32 (95% confidence interval: 0.16-0.67; <i>P</i> = 0.003), representing a 68% reduction in contamination risk. No statistical heterogeneity was detected (<i>I</i> ² = 0%). The overall quality of evidence for this outcome was rated as high.</p><p><strong>Conclusion: </strong>Disposable distal cap significantly decreases microbial contamination rates compared to standard duodenoscope reprocessing protocols. This technology represents a robust and effective strategy to enhance the safety of duodenoscope reprocessing.</p>","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"16 3","pages":"116174"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Precision management of gastrointestinal tumor-associated osteoporosis driven by cutting-edge technologies: Current status, challenges, and future prospects.","authors":"Peng Wang, Jin-Ke Sun, Dong Li, Zhen Shi, Peng-Yu Lu, Dong-Fang Jin, Sheng-Fan Huang, Yu-Hua Ruan, Wen-Ting Li, Meng-Di Shi, Zhan-Hao Ma, Zi-Hao Wang, Li-Yuan Hu, Meng-En Xue, Chang-Jiang Zhang, Zhi-Peng Li","doi":"10.5662/wjm.121456","DOIUrl":"10.5662/wjm.121456","url":null,"abstract":"<p><p>Gastrointestinal tumor-associated osteoporosis (GTO) is defined as secondary osteoporosis in patients with gastrointestinal tumors caused by tumorderived factors, chemotherapy, surgery, or malabsorption; it is an underrecognized but clinically significant complication that adversely affects skeletal health, treatment adherence, quality of life, and longterm prognosis. Its pathogenesis is multifactorial and involves a metabolic imbalance in the tumor microenvironment, antitumor therapy-related bone toxicity, and nutrient malabsorption caused by gastrointestinal dysfunction. These factors collectively increase the risk of skeletal-related events and worsen clinical outcomes. The aim of this review is to systematically evaluate the methodological quality, clinical validity, and translational evidence of cutting-edge technologies in GTO precision management and to clarify key methodological gaps and standardized directions for future research. In recent years, emerging technologies such as artificial intelligence (AI), nanotargeted drug delivery systems, and multiomics approaches have provided new opportunities for the precision management of GTO. This review summarizes their current applications in AI-assisted early screening and risk prediction, nanoenabled targeted bone protection, and multiomics-based mechanistic exploration of the tumor-bone-gut axis. It also discusses major barriers to clinical translation, including limited AI generalizability, nanomedicine safety and manufacturing challenges, difficulties in multidimensional data integration and standardization, imperfect multidisciplinary collaboration, and ethical concerns. Overall, these technologies are expected to drive the transition of GTO management from empirical practice to precision medicine and ultimately improve long-term patient outcomes.</p>","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"16 3","pages":"121456"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-obesity medications impacting the eye: An emerging concern - a narrative review.","authors":"Srishti Khullar, Arvind Kumar Morya, Sarita Aggarwal, Arshi Singh, Priya Sisodiya, Rannusha Morya","doi":"10.5662/wjm.118520","DOIUrl":"10.5662/wjm.118520","url":null,"abstract":"<p><p>Obesity has reached epidemic proportions globally, with projections indicating that by 2050, nearly 3.8 billion adults will be overweight or obese. Despite the critical need for effective interventions, current obesity treatments ranging from lifestyle changes to bariatric surgery are often limited in efficacy or suitability. Pharmacotherapy is increasingly utilized for individuals with significant obesity or related comorbidities. However, some anti-obesity medications have been linked to ocular complications such as non-arteritic anterior ischemic optic neuropathy and diabetic retinopathy progression. This review analyzes currently approved anti-obesity medications, emphasizing their potential ocular adverse effects and the underlying mechanisms by which these occur. A comprehensive literature search identified the historical evolution, classification, and spectrum of ocular effects associated with these agents. The findings underscore the importance of evaluating both the risks and benefits of anti-obesity pharmacotherapy and highlight the need for vigilant clinical assessment of ocular health in patients undergoing such treatments.</p>","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"16 3","pages":"118520"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glucagon-like receptor-1 agonists and impotence: A meta-analysis.","authors":"Hyder Osman Mirghani, Asawir Mohammed AlQurashi","doi":"10.5662/wjm.119385","DOIUrl":"10.5662/wjm.119385","url":null,"abstract":"<p><strong>Background: </strong>Glucagon-like peptide receptors-1 agonists (GLP-1 agonists) have revolutionized the treatment of obesity and diabetes due to their potent effects on weight and glycemic control, and cardiorenal protection. However, emerging reports and post-marketing surveillance have raised concerns regarding erectile dysfunction (ED) or impotence in a subset of male patients.</p><p><strong>Aim: </strong>To assess the association between GLP-1 agonists, ED, total (TT) and free testosterone (FT), sex hormone binding globulins (SHBG), luteinizing hormone (LH), and follicular stimulating hormone (FSH).</p><p><strong>Methods: </strong>We systematically searched PubMed, Google Scholar, and Web of Science in November and December 2026 for articles examining the association between GLP-1 agonists and ED, with no publication date restriction. However, only articles published in the English language were eligible. The terms used were GLP-1 agonists, ED, semaglutide, liraglutide, ozympic, tirzepatide, dulaglutide, and Impotence.</p><p><strong>Results: </strong>One hundred seventy-two articles were found; after removing duplicates, 63 remained, of which 12 full texts were screened, and 7 studies were included in the final meta-analysis. Seven studies involving 237 males were included. GLP-1 agonist therapy improved ED score with a significant statistical difference, MD = 2.73, 95% confidence interval (CI): 1.64-3.83. A significant increase was found regarding TT, SHBG, and FSH, MD 73.04, 95%CI: 16.91-129.17, MD 7.00, 95%CI: 1.71-12.30, and MD 0.46, 95%CI: 0.01-0.91 respectively.</p><p><strong>Conclusion: </strong>No significant differences were evident regarding the FT, and LH. GLP-1 agonists significantly improved ED, TT, SHBG, and FSH in males, no effects were observed on FT, and LH; larger randomized trials are needed.</p>","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"16 3","pages":"119385"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microwave breast imaging: A review of clinical potential and technological advances.","authors":"Isabella Akesson, Richard Kovac, Hyuna Son, Ana Claudia Teixeira de Castro Gonçalves Ortega, Daniil Fedorov, Arosh S Perera Molligoda Arachchige","doi":"10.5662/wjm.v16.i3.110991","DOIUrl":"10.5662/wjm.v16.i3.110991","url":null,"abstract":"<p><p>Breast cancer is a leading cause of morbidity and mortality among women worldwide, and the limitations of conventional imaging, especially in women with dense breast tissue have sparked interest in safer, more accessible diagnostic alternatives. Microwave breast imaging (MBI) is a promising, non-ionizing, and potentially cost-effective modality that leverages dielectric contrasts between malignant and healthy tissues. This review presents MBI technologies, focusing on microwave tomography and radar-based techniques such as confocal microwave imaging and tissue-sensing adaptive radar. We evaluate system designs, antenna configurations, image reconstruction algorithms, and clinical performance from leading research groups. Additionally, we highlight the growing role of machine learning in enhancing image resolution, segmentation, and lesion classification. Despite encouraging results from early-phase clinical trials, challenges such as limited spatial resolution, anatomical variability, and high computational demands continue to hinder broader adoption. We outline future directions, including real-time motion correction, improved antenna sensitivity, and stronger clinical validation. With continued innovation and regulatory support, MBI has strong potential as an adjunct or alternative to current breast imaging modalities, especially for dense breast tissue and in resource-limited settings.</p>","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"16 3","pages":"110991"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148803942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodology for preventing Botulinum toxin-A eyelid ptosis: Risk index derivation, safety rules, and evidence-graded management algorithm.","authors":"Nadira Diab, Elie Bou Farah, Ahmad Berjawi, Tasha Ghorayeb, Karen Beydoun, Safaa Ghanem, Amira Hamou, Alaa Tarchichi, Yehya Tlaiss","doi":"10.5662/wjm.116523","DOIUrl":"10.5662/wjm.116523","url":null,"abstract":"<p><p>Eyelid ptosis after cosmetic use of Botulinum toxin A, though uncommon, can impair function and patient satisfaction. We aimed to develop a methodological framework that standardizes prevention and management <i>via</i> a derivation-based risk index, explicit safety rules, and an evidence-graded, onset-anchored treatment algorithm. We conducted a structured scoping approach to map existing evidence and anatomical insights, then used consensus-style item generation to derive a practical risk index and codify ten safety rules. Treatments were organized into an onset-anchored algorithm with indicative effect windows and contraindications. The framework introduces a Levator Diffusion Risk Index combining anatomical, technical, and patient factors; a codified ten-rule injection protocol specifying distances, depths, dilution, and needle orientation; and a graded management algorithm for symptomatic ptosis. A standardized, reproducible methodology - risk stratification, measurable technique rules, and a graded treatment pathway - can reduce complication rates and harmonize reporting and care.</p>","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"16 3","pages":"116523"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic impact of right ventricular dilatation and echocardiography use criteria in hospitalized COVID-19 patients.","authors":"Arnold Méndez-Toro, Ingrid Tatiana Rojas-Ruiz, Luis Eduardo Silva-DiazGranados, Andrés Ruano-Cadena, Manuel Agustín Paz-Meneses, Ricardo Andrés Novoa-Alvarez","doi":"10.5662/wjm.v16.i3.117845","DOIUrl":"10.5662/wjm.v16.i3.117845","url":null,"abstract":"<p><strong>Background: </strong>The surge of severe acute respiratory syndrome coronavirus 2 [coronavirus disease 2019 (COVID-19)] infection created unprecedented diagnostic and logistical pressures. Given the established potential for cardiac injury and the critical need to optimize scarce resources, establishing the clinical utility and prognostic value of transthoracic echocardiography (TTE) became imperative.</p><p><strong>Aim: </strong>To evaluate the prognostic predictors and the adherence to appropriate use criteria (AUC) for TTE in a highly affected setting.</p><p><strong>Methods: </strong>We performed a retrospective cohort study analyzing records from patients with confirmed COVID-19 who underwent TTE. Socio-demographic, biochemical, and echocardiographic parameters were collected. Mortality was the primary outcome. We assessed inter-observer agreement (Kappa statistic) for TTE indications (based on American College of Cardiology Foundation 2011 and American Society of Echocardiography 2020 guidelines) and the determination of clinical impact (a subsequent change in patient management).</p><p><strong>Results: </strong>Total 149 patients were analyzed. Median age was 66 years [interquartile range (IQR): 56-73], median hospital stay was 13 days (IQR: 6-23). Overall and intensive care unit mortality rates were 39.6% and 60%, respectively. Elevated biochemical markers (leukocytes, neutrophils, lactate dehydrogenase, and C-reactive protein) were associated with mortality. Crucially, right ventricular (RV) dilatation and/or strain (<i>P</i> = 0.008) was identified as the sole echocardiographic finding significantly predictive of mortality. Inter-observer agreement for classifying AUC was high (κ ≥ 0.798). Furthermore, TTE prompted a change in clinical management in 79.7% of the cases.</p><p><strong>Conclusion: </strong>RV pathology is a potent, quantifiable prognostic indicator. While AUC demonstrated high reliability, the significant and frequent changes in management suggest that the current guidelines may possess inherent limitations when addressing the unique, acute prognostic complexities of severe COVID-19 disease.</p>","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":"16 3","pages":"117845"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}