Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Oct 14:8:728102.
doi: 10.3389/fmed.2021.728102. eCollection 2021.

Sepsis of Patients Infected by SARS-CoV-2: Real-World Experience From the International HOPE-COVID-19-Registry and Validation of HOPE Sepsis Score

Mohammad Abumayyaleh  1 , Iván J Nuñez-Gil  2 , Ibrahim El-Battrawy  1 , Vicente Estrada  2 , Víctor Manuel Becerra-Muñoz  3 , Aitor Uribarri  4 , Inmaculada Fernández-Rozas  5 , Gisela Feltes  6 , Ramón Arroyo-Espliguero  7 , Daniela Trabattoni  8 , Javier López Pais  9 , Martino Pepe  10 , Rodolfo Romero  11 , María Elizabeth Ortega-Armas  12 , Matteo Bianco  13 , Thamar Capel Astrua  14 , Fabrizio D'Ascenzo  15 , Oscar Fabregat-Andres  16 , Andrea Ballester  17 , Francisco Marín  18 , Danilo Buonsenso  19 , Raul Sanchez-Gimenez  20 , Christel Weiß  21 , Cristina Fernandez Perez  22 , Antonio Fernández-Ortiz  2 , Carlos Macaya  2 , Ibrahim Akin  1
Affiliations

Sepsis of Patients Infected by SARS-CoV-2: Real-World Experience From the International HOPE-COVID-19-Registry and Validation of HOPE Sepsis Score

Mohammad Abumayyaleh et al. Front Med (Lausanne). .

Abstract

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.

Keywords: COVID-19; SARS-CoV-2; outcome; score; sepsis.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
HOPE Sepsis Score, C-index = 0.763 (N = 5,837); tachypnoea >22 breath per minute; SpO2, peripheral oxygen saturation; BP, blood pressure; GCS <15 (Glasgow coma scale); PCT, elevated procalcitonin; TnI, elevated troponin; creatinine, elevated creatinine > 1.5 mg/dl; HOPE, the international Health Outcome Predictive Evaluation.
Figure 2
Figure 2
Estimating the risk of mortality in COVID-19 according to HOPE Sepsis Score.
See this image and copyright information in PMC

References

    1. Guan WJ Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. . Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. (2020) 382:1708–20. 10.1056/NEJMoa2002032 - DOI - PMC - PubMed
    1. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. . Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. (2020) 395:507–13. 10.1016/S0140-6736(20)30211-7 - DOI - PMC - PubMed
    1. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. . Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. (2020) 323:1061–9. 10.1001/jama.2020.1585 - DOI - PMC - PubMed
    1. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese center for disease control and prevention. JAMA. (2020) 323:1239–42. 10.1001/jama.2020.2648 - DOI - PubMed
    1. Li H, Liu L, Zhang D, Xu J, Dai H, Tang N, et al. . SARS-CoV-2 and viral sepsis: observations and hypotheses. Lancet. (2020) 395:1517–20. 10.1016/S0140-6736(20)30920-X - DOI - PMC - PubMed