Septic shock 3.0 criteria application in severe COVID-19 patients

Detalhes bibliográficos
Autor(a) principal: Cidade, José Pedro
Data de Publicação: 2022
Outros Autores: Coelho, L M, Costa, Vasco, Morais, Rui, Moniz, Patrícia, Morais, Luís, Fidalgo, Pedro, Tralhão, António, Paulino, Carolina, Nora, David, Valério, Bernardino, Mendes, Vítor, Tapadinhas, Camila, Povoa, Pedro
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10362/150160
Resumo: ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
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spelling Septic shock 3.0 criteria application in severe COVID-19 patientsAn unattended sepsis population with high mortality risk©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.BACKGROUND: Coronavirus disease 2019 (COVID-19) can be associated with life-threatening organ dysfunction due to septic shock, frequently requiring intensive care unit (ICU) admission, respiratory and vasopressor support. Therefore, clear clinical criteria are pivotal for early recognition of patients more likely to need prompt organ support. Although most patients with severe COVID-19 meet the Sepsis-3.0 criteria for septic shock, it has been increasingly recognized that hyperlactatemia is frequently absent, possibly leading to an underestimation of illness severity and mortality risk. AIM: To identify the proportion of severe COVID-19 patients with vasopressor support requirements, with and without hyperlactatemia, and describe their clinical outcomes and mortality. METHODS: We performed a single-center prospective cohort study. All adult patients admitted to the ICU with COVID-19 were included in the analysis and were further divided into three groups: Sepsis group, without both criteria; Vasoplegic Shock group, with persistent hypotension and vasopressor support without hyperlactatemia; and Septic Shock 3.0 group, with both criteria. COVID-19 was diagnosed using clinical and radiologic criteria with a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive RT-PCR test. RESULTS: 118 patients (mean age 63 years, 87% males) were included in the analysis (n = 51 Sepsis group, n = 26 Vasoplegic Shock group, and n = 41 Septic Shock 3.0 group). SOFA score at ICU admission and ICU length of stay were different between the groups (P < 0.001). Mortality was significantly higher in the Vasoplegic Shock and Septic Shock 3.0 groups when compared with the Sepsis group (P < 0.001) without a significant difference between the former two groups (P = 0.713). The log rank tests of Kaplan-Meier survival curves were also different (P = 0.007). Ventilator-free days and vasopressor-free days were different between the Sepsis vs Vasoplegic Shock and Septic Shock 3.0 groups (both P < 0.001), and similar in the last two groups (P = 0.128 and P = 0.133, respectively). Logistic regression identified the maximum dose of vasopressor therapy used (AOR 1.046; 95%CI: 1.012-1.082, P = 0.008) and serum lactate level (AOR 1.542; 95%CI: 1.055-2.255, P = 0.02) as the major explanatory variables of mortality rates (R 2 0.79). CONCLUSION: In severe COVID-19 patients, the Sepsis 3.0 criteria of septic shock may exclude approximately one third of patients with a similarly high risk of a poor outcome and mortality rate, which should be equally addressed.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)RUNCidade, José PedroCoelho, L MCosta, VascoMorais, RuiMoniz, PatríciaMorais, LuísFidalgo, PedroTralhão, AntónioPaulino, CarolinaNora, DavidValério, BernardinoMendes, VítorTapadinhas, CamilaPovoa, Pedro2023-03-07T22:27:59Z2022-07-092022-07-09T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article9application/pdfhttp://hdl.handle.net/10362/150160eng2220-3141PURE: 54673395https://doi.org/10.5492/wjccm.v11.i4.246info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T05:32:01Zoai:run.unl.pt:10362/150160Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:53:58.783607Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Septic shock 3.0 criteria application in severe COVID-19 patients
An unattended sepsis population with high mortality risk
title Septic shock 3.0 criteria application in severe COVID-19 patients
spellingShingle Septic shock 3.0 criteria application in severe COVID-19 patients
Cidade, José Pedro
title_short Septic shock 3.0 criteria application in severe COVID-19 patients
title_full Septic shock 3.0 criteria application in severe COVID-19 patients
title_fullStr Septic shock 3.0 criteria application in severe COVID-19 patients
title_full_unstemmed Septic shock 3.0 criteria application in severe COVID-19 patients
title_sort Septic shock 3.0 criteria application in severe COVID-19 patients
author Cidade, José Pedro
author_facet Cidade, José Pedro
Coelho, L M
Costa, Vasco
Morais, Rui
Moniz, Patrícia
Morais, Luís
Fidalgo, Pedro
Tralhão, António
Paulino, Carolina
Nora, David
Valério, Bernardino
Mendes, Vítor
Tapadinhas, Camila
Povoa, Pedro
author_role author
author2 Coelho, L M
Costa, Vasco
Morais, Rui
Moniz, Patrícia
Morais, Luís
Fidalgo, Pedro
Tralhão, António
Paulino, Carolina
Nora, David
Valério, Bernardino
Mendes, Vítor
Tapadinhas, Camila
Povoa, Pedro
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
RUN
dc.contributor.author.fl_str_mv Cidade, José Pedro
Coelho, L M
Costa, Vasco
Morais, Rui
Moniz, Patrícia
Morais, Luís
Fidalgo, Pedro
Tralhão, António
Paulino, Carolina
Nora, David
Valério, Bernardino
Mendes, Vítor
Tapadinhas, Camila
Povoa, Pedro
description ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
publishDate 2022
dc.date.none.fl_str_mv 2022-07-09
2022-07-09T00:00:00Z
2023-03-07T22:27:59Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10362/150160
url http://hdl.handle.net/10362/150160
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 2220-3141
PURE: 54673395
https://doi.org/10.5492/wjccm.v11.i4.246
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 9
application/pdf
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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