Sepsis of patients infected by SARS-CoV-2: real-world experience from the international HOPE-COVID-19-Registry and Validation of HOPE Sepsis Score

Media type: E-Article

Title: Sepsis of patients infected by SARS-CoV-2 : real-world experience from the international HOPE-COVID-19-Registry and Validation of HOPE Sepsis Score

Contributor: Abumayyaleh, Mohammad S. A. [Author]; Nuñez-Gil, Iván J. [Author]; El-Battrawy, Ibrahim [Author]; Estrada, Vicente [Author]; Becerra-Muñoz, Víctor Manuel [Author]; Uribarri, Aitor [Author]; Fernández-Rozas, Inmaculada [Author]; Feltes, Gisela [Author]; Arroyo-Espliguero, Ramón [Author]; Trabattoni, Daniela [Author]; López Pais, Javier [Author]; Pepe, Martino [Author]; Romero, Rodolfo [Author]; Ortega-Armas, María Elizabeth [Author]; Bianco, Matteo [Author]; Astrua, Thamar Capel [Author]; D'Ascenzo, Fabrizio [Author]; Fabregat-Andres, Oscar [Author]; Ballester, Andrea [Author]; Marín, Francisco [Author]; Buonsenso, Danilo [Author]; Sanchez-Gimenez, Raul [Author]; Weiß, Christel [Author]; Fernandez Perez, Cristina [Author]; Fernández-Ortiz, Antonio [Author]; Macaya, Carlos [Author]; Akın, Ibrahim [Author]

Published: 14 October 2021

Language: English

DOI: 10.3389/fmed.2021.728102

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Description: Background: Patients with sepsis with a concomitant coronavirus (COVID-19) infection are related to a high morbidity and mortality rate. We investigated a large cohort of patients with sepsis with a concomitant COVID-19, and we developed a risk score for the estimation of sepsis risk in COVID-19.Methods: We conducted a sub-analysis from the international Health Outcome Predictive Evaluation Registry for COVID-19 (HOPE-COVID-19-Registry, NCT04334291). Out of 5,837 patients with COVID-19, 624 patients were diagnosed with sepsis according to the Sepsis-3 International Consensus.Results: In multivariable analysis, the following risk factors were identified as independent predictors for developing sepsis: current smoking, tachypnoea (>22 breath per minute), hemoptysis, peripheral oxygen saturation (SpO2) <92%, blood pressure (BP) (systolic BP <90 mmHg and diastolic BP <60 mmHg), Glasgow Coma Scale (GCS) <15, elevated procalcitonin (PCT), elevated troponin I (TnI), and elevated creatinine >1.5 mg/dl. By assigning odds ratio (OR) weighted points to these variables, the following three risk categories were defined to develop sepsis during admission: low-risk group (probability of sepsis 3.1-11.8%); intermediate-risk group (24.8-53.8%); and high-risk-group (58.3-100%). A score of 1 was assigned to current smoking, tachypnoea, decreased SpO2, decreased BP, decreased GCS, elevated PCT, TnI, and creatinine, whereas a score of 2 was assigned to hemoptysis.Conclusions: The HOPE Sepsis Score including nine parameters is useful in identifying high-risk COVID-19 patients to develop sepsis. Sepsis in COVID-19 is associated with a high mortality rate.

Access State: Open Access

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