Why Septic Patients Remain Sick After Hospital Discharge?

Abstract

Sepsis is well known to cause a high patient death rate (up to 50%) during the intensive care unit (ICU) stay. In addition, sepsis survival patients also exhibit a very high death rate after hospital discharge compared to patients with any other disease. The addressed question is then: why septic patients remain ill after hospital discharge? The cellular and molecular mechanisms involved in the high rate of septic patient deaths are still unknown. We described herein the studies that investigated the percentage of septic patients that died after hospital discharge ranging from 90 days up to 5 years. We also reported the symptoms of septic patients after hospital discharge and the development of the recently called post-sepsis syndrome (PSS). The most common symptoms of the PSS are cognitive disabilities, physical functioning decline, difficulties in performing routine daily activities, and poor life quality. The PSS also associates with quite often reinfection and re-hospitalization. This condition is the cause of the high rate of death mentioned above. We reported the proportion of patients dying after hospital discharge up to 5 years of followed up and the PSS symptoms associated. The authors also discuss the possible cellular and metabolic reprogramming mechanisms related with the low survival of septic patients and the occurrence of PSS.

Diabetes, Heart Failure, and COVID-19: An Update

“…Sudre et al (2021)]. It may be that Long-COVID is a form of post-sepsis syndrome (Prescott and Girard, 2020;Gritte et al, 2021), and, if so, we might expect increased re-hospitalization of these patients who have prior comorbidities. It will be interesting to study these individuals' demographics, risk factors, biomarkers, and cardiac imaging and evaluate whether there might be lingering myocarditis or even pre-heart failure.…”

Commentary: A Machine-Generated View of the Role of Blood Glucose Levels in the Severity of COVID-19. A Metabolic Endocrinology Perspective

“…With over 271 million COVID-19 cases in the world as of 16 th December 2021 ( ), which represents 3.5% of the global population, this indicates that long-COVID will be a very large long-term burden on society. The etiology of long-COVID symptoms is still not clear but it has been suggested to be a form of post-sepsis syndrome ( 20 , 21 ) and autoimmunity has been proposed to play a role ( 22 ).…”

Impact of sepsis education for healthcare professionals and students on learning and patient outcomes: a systematic review

“…This is because sepsis is a frequent complication of severe COVID-19, and sepsis incidence has increased substantially during the COVID-19 pandemic [5][6][7]. Survivors of sepsis are known to face long-term sequelae of sepsis including cognitive impairment and functional disability, and also exhibit a high mortality rate post-hospital discharge compared to patients with other disease [8][9][10]. As a burdensome condition worldwide in terms of morbidity, mortality and financial cost to health systems [11], early diagnosis and immediate treatment of sepsis is crucial to reduce the burden sepsis imposes on global health [1].…”