AUTHOR=Abumayyaleh Mohammad , Nuñez-Gil Iván J. , El-Battrawy Ibrahim , Estrada Vicente , Becerra-Muñoz Víctor Manuel , Uribarri Aitor , Fernández-Rozas Inmaculada , Feltes Gisela , Arroyo-Espliguero Ramón , Trabattoni Daniela , López Pais Javier , Pepe Martino , Romero Rodolfo , Ortega-Armas María Elizabeth , Bianco Matteo , Astrua Thamar Capel , D'Ascenzo Fabrizio , Fabregat-Andres Oscar , Ballester Andrea , Marín Francisco , Buonsenso Danilo , Sanchez-Gimenez Raul , Weiß Christel , Fernandez Perez Cristina , Fernández-Ortiz Antonio , Macaya Carlos , Akin Ibrahim 

TITLE=Sepsis of Patients Infected by SARS-CoV-2: Real-World Experience From the International HOPE-COVID-19-Registry and Validation of HOPE Sepsis Score

JOURNAL=Frontiers in Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.728102

DOI=10.3389/fmed.2021.728102

ISSN=2296-858X

ABSTRACT=<p><bold>Background:</bold> Patients with sepsis with a concomitant coronavirus (COVID-19) infection are related to a high morbidity and mortality rate. We investigated a large cohort of patients with sepsis with a concomitant COVID-19, and we developed a risk score for the estimation of sepsis risk in COVID-19.</p><p><bold>Methods:</bold> We conducted a sub-analysis from the international Health Outcome Predictive Evaluation Registry for COVID-19 (HOPE-COVID-19-Registry, NCT04334291). Out of 5,837 patients with COVID-19, 624 patients were diagnosed with sepsis according to the Sepsis-3 International Consensus.</p><p><bold>Results:</bold> In multivariable analysis, the following risk factors were identified as independent predictors for developing sepsis: current smoking, tachypnoea (&gt;22 breath per minute), hemoptysis, peripheral oxygen saturation (SpO<sub>2</sub>) &lt;92%, blood pressure (BP) (systolic BP &lt;90 mmHg and diastolic BP &lt;60 mmHg), Glasgow Coma Scale (GCS) &lt;15, elevated procalcitonin (PCT), elevated troponin I (TnI), and elevated creatinine &gt;1.5 mg/dl. By assigning odds ratio (OR) 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%); and high-risk-group (58.3–100%). A score of 1 was assigned to current smoking, tachypnoea, decreased SpO<sub>2</sub>, decreased BP, decreased GCS, elevated PCT, TnI, and creatinine, whereas a score of 2 was assigned to hemoptysis.</p><p><bold>Conclusions:</bold> The HOPE Sepsis Score including nine parameters is useful in identifying high-risk COVID-19 patients to develop sepsis. Sepsis in COVID-19 is associated with a high mortality rate.</p>