The following is a summary of “Use of Electronic Clinical Data to Track Incidence and Mortality for SARS-CoV-2–Associated Sepsis,” published in the September 2023 issue of Infectious Diseases by Shappell et al. 

A retrospective cohort study including adults hospitalized at five Massachusetts hospitals from March 2020 to November 2022 aimed to delineate the incidence and outcomes of SARS–CoV–2–associated sepsis compared to presumed bacterial sepsis using precise electronic clinical criteria.

The researchers examined 431,017 hospital encounters involving 261,595 individuals, with a mean age of 57.9 years. Among these, 23,276 encounters (5.4%) were linked to SARS-CoV-2, 6,558 (1.5%) had SARS-CoV-2–associated sepsis and 30,604 patients (7.1%) had presumed bacterial sepsis without SARS-CoV-2. Notably, the crude in-hospital mortality for SARS–CoV–2–associated sepsis declined from 33.4% to 14.9% over different quarters. In contrast, presumed bacterial sepsis mortality remained stable at 14.5%. A review of 200 SARS–CoV–2–positive hospitalizations confirmed the reliability of the electronic health record-based SARS–CoV–2–associated sepsis criteria against sepsis-3 criteria (90.6% sensitivity, 91.2% specificity).

The results showed that during the initial 33 months of the COVID-19 pandemic, SARS-CoV-2 was linked to about one-sixth of sepsis cases. The mortality rates for SARS–CoV–2–associated sepsis were initially high but decreased gradually, eventually aligning with presumed bacterial sepsis. These results underscore the substantial impact of SARS–CoV–2–associated sepsis and the effectiveness of electronic health record-based algorithms in monitoring both viral and bacterial sepsis.

Source: jamanetwork.com/journals/jamanetworkopen/fullarticle/2809966