Sepsis even more challenging with COVID infections

Did you know that sepsis is the number one cost of hospitalization in the US? Costs for acute sepsis hospitalization and skilled nursing is estimated to be $62 billion annually.

That is only one portion of all sepsis-related costs, since there are even more costs after discharge for many patients.

September is Sepsis Awareness Month and as a sepsis certified facility by the Joint Commission, Cookeville Regional Medical Center’s medical staff takes this illness seriously.

Sepsis is the body’s overwhelming and life-threatening response to infection that can lead to tissue damage, organ failure and death. It’s your body’s overactive and toxic response to an infection. Sepsis is a medical emergency that requires rapid diagnosis and treatment. It can lead to severe sepsis and septic shock.

Some people are at higher risk of developing sepsis because they are at higher risk of contracting an infection. These include the very young, the very old, those with chronic illnesses and those with a weakened or impaired immune system.

Patients are diagnosed when they develop a set of signs and symptoms related to sepsis. Signs include a higher or lower temperature than normal, signs and symptoms of infection, mental decline and severe pain, discomfort, shortness of breath and feeling of extreme illness.

With COVID-19’s second wave hitting the younger, unvaccinated population even harder this time, it’s now even more challenging to treat sepsis.

The effects of COVID-19 on the respiratory system are well known, with a lot of people requiring hospital admission developing pneumonia of varying severity. Other organ systems can be (and often are) affected.

According to the Global Sepsis Alliance, a series of severe COVID-19 cases from the Seattle area had more than 30 percent evidence of liver injury and 75 percent had evidence of a depressed immune response. Another series from the same region reported acute kidney failure in almost 20 percent of affected patients requiring ICU care and both series reported septic shock severe enough to require drugs to support the heart and circulation in almost 70 percent of patients.

A recent study from China reported that in patients hospitalized with COVID-19, 28 percent had evidence of significant heart damage, potentially from direct invasion of cardiac muscle by the virus, resulting in heart failure and abnormal heart rhythms, which was associated with a five-fold increase in the risk of death.

Since sepsis has to be diagnosed quickly, it has to be treated just as quickly.

There are multiple methods of treatment.

Physicians oftentimes prescribe antibiotics based on the type of infection, but those need to work in tandem with other modalities, such as IV fluids, other medications and equipment.

Studies show that on average, approximately 30 percent of patients diagnosed with sepsis do not survive. Up to 50 percent of survivors suffer from post-sepsis syndrome, which has psychological and/or physical long-term effects.