Clin Res Cardiol (2021)
DOI DOI https://doi.org/10.1007/s00392-021-01843-w
Sepsis of Patients infected by SARS-CoV-2: Real world experience from the International HOPE-COVID-19-Registry and validation of HOPE Sepsis Score
M. Abumayyaleh1, I. J. N. Gil2, I. El-Battrawy1, V. Estrada2, V. M. Becerra-Muñoz3, A. Uribarri4, I. Fernández-Rozas5, G. Feltes6, R. Arroyo-Espliguero7, D. Trabattoni8, J. López-País9, M. Pepe10, R. Romero11, M. E. Ortega-Armas12, M. Bianco13, T. C. Astrua14, F. D'Ascenzo15, O. Fabregat-Andres16, A. Ballester17, F. Marín18, D. Buonsenso19, R. Sanchez-Gimenez20, C. Christel Weiß21, C. Fernandez22, A. I. Fernández Ortiz23, C. Macaya23, I. Akin1, für die Studiengruppe: HOPE
1I. Medizinische Klinik, Universitätsklinikum Mannheim, Mannheim; 2Instituto de Investigación, Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico San Carlos, Madrid, ES; 3Hospital Clínico Universitario Virgen de la Victoria, Málaga, ES; 4Hospital Clínico Universitario de Valladolid, Valladolid, ES; 5Hospital Severo Ochoa, Leganés, ES; 6Hospital Nuestra Señora de América, Madrid, ES; 7Hospital Universitario Guadalajara, Guadalajara, ES; 8IRCCS, Centro Cardiologico Monzino, Milano, IT; 9Complejo Hospitalario Universitario de Santiago de Compostela Santiago de Compostela, Santiago de Compostela, A Coruña, ES; 10Azienda ospedaliero-universitaria consorziale policlinico di Bari, Bari BA, IT; 11Hospital Universitario Getafe, Getafe, Madrid, ES; 12Hospital General del norte de Guayaquil IESS Los Ceibos, Guayaquil, EC; 13Orbassano and Rivoli Infermi Hospital, San Luigi Gonzaga University Hospital, Orbassano TO, IT; 14Hospital Virgen del Mar, Madrid, ES; 15San Giovanni Battista, Torino TO, IT; 16Hospital IMED Valencia, Burjassot, Valencia, ES; 17INCLIVA, Hospital Clínico de Valencia, Valencia, ES; 18IMIB-Arrixaca, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, ES; 19Policlinico A. Gemelli IRCSS, Roma RM, IT; 20University Hospital Joan XXIII, Tarragona, ES; 21Department for Statistical Analysis, University Medical Center Mannheim, Mannheim; 22Hospital Universitario de Santiago de Compostela, santiago de compostela, ES; 23Universidad Complutense de Madrid, Instituto de Investigación, Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico San Carlos, Madrid, ES;

Aims

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 to determine clinical characteristics, laboratory and radiological findings, and predictors of mortality. We developed a risk score for estimation of sepsis risk in patients with COVID-19. 

 

Methods and results 

In the present study, 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. 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< 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 of SpO2, decreased of blood pressure, decreased of GCS, elevated PCT, TnI, and creatinine, whereas a score of 2 was assigned to hemoptysis.

 

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.
https://dgk.org/kongress_programme/jt2021/aP1077.html