SEPSIS – sometimes called septicaemia or blood poisoning – is a life threatening reactions to an infection that causes your immune system to damage the body’s tissues and organs.
It’s mostly thought to be caused by bacterial infections and medics are usually on high alert for it in these cases.
But research conducted at Brigham and Women’s Hospital found sepsis also commonly caused by viral infections, such as Covid-19.
The research team found that one in six sepsis cases recorded during the first two and a half years of the pandemic were actually caused by the SARS-CoV-2 virus.
It suggests that Covid-19 is “a more common and deadly cause of sepsis” than previously thought.
“Most people, including medical professionals, equate sepsis with bacterial infections,” said lead author Claire Shappell, from the pulmonary and critical care medicine division in the Department of Medicine at Brigham and Women’s Hospital.
“This is reflected in treatment guidelines and quality measures that require immediate antibiotics for patients with suspected sepsis.
“However, viral infections, including the SARS-CoV-2 virus that causes COVID-19, can trigger the same disregulated immune response that leads to organ dysfunction as in bacterial sepsis.”
Researchers used health record data from five Mass General Brigham hospitals between March 2020 and November 2022 to track the rate of SARS-CoV-2-associated sepsis during the COVID-19 pandemic.
They used criteria developed by the US Centers for Disease Control and Prevention (CDC) that took into account Covid tests and signs of organ dysfunction.
They looked at 431,017 hospitalisations from 261,595 people – 5.4 per cent of them were due to Covid-19 infections.
Twenty eight per cent of the these patients developed Covid-associated sepsis, according to the data.
The mortality rate for people with Covid-associated sepsis was initially high — 33 per over the first three months of the pandemic.
But it declined over time and eventually became similar to the mortality rate for presumed bacterial sepsis – about 14.5 per cent – and remained stable for the rest of the study period.
Researchers said their results – published in JAMA Network Open – suggest doctors should rethink how they treat sepsis and put together a framework to spot cases caused by viral infections.
The framework developed from their data could also be used to identify sepsis associated with other viruses such as flu and respiratory syncytial virus (RSV).
Dr Shappell said: “We hope our findings highlight that sepsis is not a “one-size-fits-all” entity, but one that requires clinicians to tailor their diagnosis and treatment strategy to each patient’s syndrome and probable pathogen.”
What are the signs of sepsis?
According to NHS Inform, our immune system usually keeps an infection limited to one place by producing white blood cells.
They travel to an infection site to destroy the germs causing the infection, triggering tissue swelling, known as inflammation.
This helps to fight the infection and prevent it from spreading.
But an infection can spread to other parts of the body if the immune system is weak or an infection is severe.
Widespread inflammation can damage tissue and interfere with blood flow, causing blood pressure to drop and stopping oxygen from reaching the organs and tissues.
According to NHS Inform, sepsis can be triggered by an infection in any part of the body.
It said the most common sites of infection leading to it are the:
- urinary tract
But sometimes a specific source of infection leading to sepsis can’t be identified.
You should call 999 or go to A&E immediately if someone has any of the following symptoms.
- acting confused, slurred speech or not making sense
- blue, grey, pale or blotchy skin, lips or tongue – on brown or black skin, this may be easier to see on the palms of the hands or soles of the feet
- a rash that does not fade when you roll a glass over it
- difficulty breathing, breathlessness or breathing very fast
For children, you might also notice:
- their crying is weak and high pitched
- they’re not responding like they usually do
- they’re sleepier than normal or difficult to wake up
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