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The Health | june, 2020
| Hot Topic |
Covid-19
Covid-19 and sepsis
Sepsis is one of the contributing factors associated
with deaths in Covid-19 patients
The median length of fever
was about 12 days in both
survivors and non-survivors,
and 45 per cent of survivors
still had a cough at discharge.
On March 11, the World
Health Organisation (WHO)
declared the 2019 Novel
Coronavirus (SARS-CoV-2)
a global pandemic, which
means this disease has spread
far and wide.
As of June 16, there had
been 8,112,577 cases and 439,050 deaths
globally.
Are the deaths from Covid-19 related to
sepsis? Before we answer that question,
let us look at the meaning of sepsis itself.
Sepsis is defined as a life-threatening organ
dysfunction caused by a haywire host
response to infection.
It can also be assessed by looking
at the SOFA (Sequential Organ Failure
Assessment) scoring system. The score
predicts death based on the degree of
dysfunction of six organ systems —
the lungs, the heart, the liver, blood
coagulation, the kidneys and neurological
system.
This score can assess patients who are in
the Intensive Care Unit (ICU).
The Lancet had recently published data
about risk factors for Covid-19 deaths and
on how the disease progresses in criticallyill,
hospitalised adult patients who are
confirmed Covid-19 positive.
The study included clinical features,
type of treatment, laboratory results and
demographic. Data from 191 patients were
extracted from the electronic medical
records and compared between survivors
and non-survivors.
They also looked at the clinical course of
symptoms, viral shedding, and changes in
laboratory findings. Out of these patients,
137 were discharged, and 54 died in the
hospital.
sepsis
Alert
By Assoc Prof
Dr Tan Toh Leong
By Dr. Azlin Ithnin
On average, patients were middle-aged
(median, 56 years), and 62 per cent were
men. The median time is 22 days from
when the illness starts until the patient is
discharged. The average time from onset
to death was 18.5 days. Patients who died
were, on average, 69-years-old, versus 52
years in survivors.
Ninety-one (48 per cent) patients
had an existing medical condition, with
hypertension being the most common,
followed by diabetes and coronary heart
disease. Half of these patients developed
sepsis.
Complications such as respiratory
failure, sepsis, and secondary infections
were also higher in those who died than
in survivors. The median length of fever
was about 12 days in both survivors and
non-survivors, and 45 per cent of survivors
still had a cough at discharge.
The researchers also found the presence
of the virus in throat swabs of survivors
with a mean of 20 days (ranging from 8
to 37) and that viral RNA was detectable
until death. The researchers suggested
poor outcomes in older people were due
to a weak immune system and increased
inflammation that cause viral replication.
This prolonged inflammation response
causes damage to the heart, brain and other
organs.
In conclusion, sepsis is one of the
contributing factors associated with death
in patients affected by Covid-19. Even
though the majority of individuals were
with a milder form of Covid-19, they would
not develop into life-threatening sepsis.
We need to recognise early sepsis
which is caused by different infections,
such as this novel coronavirus, other viral
infections, seasonal influenza viruses,
On average, patients
were middle-aged
(median, 56 years),
and 62 per cent were
men. The median time
is 22 days from when
the illness starts
until the patient
is discharged. The
average time from
onset to death was
18.5 days. Patients
who died were, on
average, 69-yearsold,
versus 52 years in
survivors."
or common bacterial infections such as
lung, urinary tract, abdominal or wound
infections to save lives. — The Health
Assoc. Professor Dr Tan Toh Leong
Senior Lecturer and Emergency Medical
Consultant, UKM Medical Center, Universiti
Kebangsaan Malaysia, President and Founder of
Malaysian Sepsis Alliance and Dr. Azlin Ithnin
Senior Lecturer and Chemical Pathologist
Consultant, UKM Medical Center, Universiti
Kebangsaan Malaysia, Vice President of
Malaysian Sepsis Alliance