What do we know about the incidence of sepsis in coronavirus cases? Very little.
Any infection can activate the body’s immune response, potentially resulting in an intense inflammatory response. Many of the bodily damage seen during COVID-19 results in what could be called a sepsis syndrome of intense inflammatory response affecting multiple organ systems.
The true incidence of sepsis and septic shock in COVID-19 patients is not known, but we can make some inferences to get an estimation.
Data Source 1: Data on more than 17,000 cases in China found that approximately 80% of the cases were mild, with the rest being either severe or critical. This indicates a potential incidence of sepsis or septic shock at approximately 20%.
Data Source 2: In a January 30, 2020 article of 99 cases, 17% developed acute respiratory distress syndrome (ARDS), 3% developed acute kidney injury and 4% had septic shock equaling a total of 24% of the cases which could be considered sepsis or septic shock.
Data Source 3: In a larger study of 138 COVID-19 patients from Wuhan China, nearly all (99%) had fever. It is unclear if this report includes the 99 previously reviewed cases. Thirty-six (26.1%) patients were transferred to the ICU due to the development of organ dysfunction with a median SOFA score of 5. Within the ICU population, 22 patients (16%) developed ARDS, 11 (8%) developed shock and 3 (2%) developed acute kidney injury (26.0% of total group). There was no difference in gender proportions between ICU and non-ICU patients.
Conclusion: At the present time, our limited information indicates the incidence of sepsis or septic shock in the COVID-19 infected patients is in the 24-26% range. By comparison, the incidence of inpatient sepsis admission rates ranges from 6% to 50%, but is most likely in the 20-28% range.