Can COVID-19 cause sepsis?

 

Research is still emerging as to why some people with COVID-19 have mild symptoms while others become seriously ill or die.

What we do know is that among those who become critically ill, many have underlying chronic health conditions, are older or develop sepsis.

The healthy human body is generally prepared to neutralize threats from infections by way of the immune system. Most people with mild illness due to COVID-19 are able to rely on the immune system to recover. In a small fraction of people, the immune system falters and sepsis can result.

What is sepsis?

Sepsis occurs when an infection triggers a chain reaction throughout the body that can rapidly lead to tissue damage, organ failure and death. The fast progression of sepsis makes it extremely important to recognize the symptoms early and treat the infection with medications designed to help the immune system eliminate the germs causing the illness.

Why is sepsis hard to diagnose?

The challenge with recognizing whether someone with COVID-19 has sepsis is the signs and symptoms are similar to those a person may experience with a typical infection. For example, fever, sweating and generalized aches and soreness may occur in people who don’t have sepsis, in part, because a healthy immune response may lead to the same phenomena. 

Because it can be difficult to distinguish between an appropriate and an inappropriate immune response, any person with a known or suspected infection, in addition to any combination of an accelerated heart rate, fevers and/or chills, muscle aches with severe pain, confusion, and shortness of breath or rapid breathing, should be considered at elevated risk for developing sepsis.

When should you seek care by a doctor?

If you experience any of the signs or symptoms of sepsis, you should seek medical attention right away. In some instances, emergency care may be warranted to ensure rapid diagnosis and prompt treatment.

Why is sepsis so dangerous?

Without reversal of the sepsis syndrome, the immune system can inadvertently wreak havoc on the rest of the organ systems and bodily functions. Despite advances in diagnostics and treatment options, sepsis continues to result in an estimated nearly 50 million cases per year worldwide and represents nearly 20% of all global deaths.

How is sepsis treated?

There are an arsenal of tools available to manage the care of patients with sepsis. The key is to identify and eradicate the infection, which typically includes anti-microbial drugs and, in some instances, surgical procedures to remove infected tissue. Artificial support for the function of all major organ systems may be needed while closely monitoring for unexpected changes or improvements in health. This is best accomplished in a hospital setting.

What underlying conditions put you at greater risk of sepsis with a COVID-19 infection?

While we don’t fully know who will get seriously ill, some factors are beginning to emerge to predict who will develop sepsis and other severe complications of COVID-19. Those underlying conditions that seem to put people at higher risk for developing of sepsis include high blood pressure, diabetes, heart disease, obesity and chronic lung disease. But it’s important to point out that many patients with these chronic conditions haven’t had any complications from sepsis as a result of their infection with COVID-19.

If you survived sepsis in the past, are you at greater risk of developing sepsis again if you contract COVID-19?

In general, sepsis survivors are at higher risk of developing subsequent infections and recurrent sepsis. However, there’s no evidence at this time to help estimate the risk to sepsis survivors of developing COVID-19 nor their risk of more serious complications from COVID-19 as a result of having survived sepsis.

How can you protect yourself?

Among all of the unknowns that seem to come with scientific discussions about COVID-19, it’s important to do these three things to help curb the spread of this illness:

• Wear a mask.
• Maintain appropriate distancing.
• Limit all gatherings to the absolute minimum and keep them outdoors as much as possible.

Brian Weiss is a critical care surgeon at The Ohio State University Wexner Medical Center and a professor in the Ohio State College of Medicine.