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

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

JOURNAL=Frontiers in Medicine

VOLUME=Volume 8 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.728102

DOI=10.3389/fmed.2021.728102

ISSN=2296-858X

ABSTRACT=Background
Sepsis patients with a concomitant Coronavirus (COVID-19) infection are related to a high morbidity and mortality rate. We investigated a large cohort of sepsis patients 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). 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), haemoptysis, peripheral oxygen saturation (SpO2) < 92%, blood pressure (BP) (systolic BP< 90mmHg and diastolic BP <60mmHg), Glasgow coma scale (GCS) <15, elevated procalcitonin (PCT), elevated troponin I (TnI), and elevated Creatinine > 1.5 mg/dl. By assigning odds ratio 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%); high-risk-group (58.3-100%). A score of 1 was assigned to current smoking, tachypnoea, decreased SpO2, decreased blood pressure, decreased GCS, elevated PCT, TnI, and creatinine, whereas a score of 2 was assigned to haemoptysis.
Conclusions
The HOPE Sepsis Score including 9 parameters is useful in identifying high-risk COVID-19 patients to develop sepsis. Sepsis in COVID-19 is associated with a high mortality rate.