Meeting the Challenges of Sepsis in Severe COVID-19: A Call to Arms


 Sepsis is a life-threatening organ dysfunction, which is caused by a dysregulated host response to infection. Sepsis may be caused by bacterial, fungal, or viral pathogens.
 The clinical manifestations exhibited by patients with severe COVID-19-related sepsis overlap with those exhibited by patients with sepsis from secondary bacterial or fungal infections and can include an altered mental status, dyspnea, reduced urine output, tachycardia, and hypotension. Critically ill hospitalized patients with SARS-CoV-2 infections have increased risk for secondary bacterial and fungal infections. The same risk factors that may predispose to sepsis and poor outcome from bloodstream infections (BSIs) converge in patients with severe COVID-19. Current diagnostic standards for distinguishing between critically ill, septic, COVID-19 patients, and patients with sepsis from other causes leave health care providers with two suboptimal choices. The first choice is to empirically administer broad-spectrum, antimicrobial therapy for what may, or may not, be sepsis. Such treatment may not only be ineffective and inappropriate, but also has the potential to cause harm. The development of better methods to identify and characterize antimicrobial susceptibility will guide more accurate therapeutic interventions and reduce the evolution of new antibiotic-resistant strains The ideal rapid diagnostic test would: be rapid and reliable, have a lower limit of detection (LOD) than blood culture and would be able to detect a specific organism directly from a clinical specimen. Rapid direct detection of antimicrobial resistant pathogens would allow targeted therapy and improvement of outcome in patients with severe COVID-19 and sepsis.