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In-Hospital Mortality Evaluated for SARS-CoV-2-Linked Sepsis

March 2020 to November 2022 saw decline in crude in-hospital mortality for SARS-CoV-2-linked sepsis from 33.4 to 14.9 percent

By Elana Gotkine HealthDay Reporter

WEDNESDAY, Oct. 4, 2023 (HealthDay News) — From March 2020 to November 2022, there was a decline in crude in-hospital mortality for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-associated sepsis, according to a study published online Sept. 29 in JAMA Network Open.

Claire N. Shappell, M.D., M.P.H., from Harvard Medical School/Harvard Pilgrim Health Care Institute in Boston, and colleagues conducted a retrospective cohort study of adults hospitalized at five Massachusetts hospitals between March 2020 and November 2022 to describe trends in the quarterly incidence and in-hospital mortality for SARS-CoV-2-associated and presumed bacterial sepsis.

Data were included for 431,017 hospital encounters from 261,595 individuals. Of these, 5.4 percent were from SARS-CoV-2, 1.5 percent had SARS-CoV-2-associated sepsis, and 7.1 percent had presumed bacterial sepsis without SARS-CoV-2 infection. The researchers found a decline in the crude in-hospital mortality for SARS-CoV-2-associated sepsis from 33.4 to 14.9 percent in the first and last quarter (adjusted odds ratio, 0.88 per quarter). For presumed bacterial sepsis, crude mortality was 14.5 percent and was stable across quarters. Electronic health record (EHR)-based SARS-CoV-2-associated sepsis criteria performed well relative to sepsis-3 criteria on medical record reviews of 200 SARS-CoV-2-positive hospitalizations (sensitivity, 90.6 percent; specificity, 91.2 percent).

“These findings highlight the high burden of SARS-CoV-2-associated sepsis and demonstrate the feasibility of using EHR-based algorithms to conduct surveillance for viral sepsis,” the authors write.

One author disclosed ties to UpToDate and Cytovale.

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