Clinical sepsis phenotypes in critically ill COVID-19 patients

Autor: Niklas Bruse, Emma J. Kooistra, Aron Jansen, Rombout B. E. van Amstel, Nicolette F. de Keizer, Jason N. Kennedy, Christopher Seymour, Lonneke A. van Vught, Peter Pickkers, Matthijs Kox
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Critical Care, Vol 26, Iss 1, Pp 1-6 (2022)
Druh dokumentu: article
ISSN: 1364-8535
DOI: 10.1186/s13054-022-04118-6
Popis: Abstract Background A greater understanding of disease heterogeneity may facilitate precision medicine for coronavirus disease 2019 (COVID-19). Previous work identified four distinct clinical phenotypes associated with outcome and treatment responses in non-COVID-19 sepsis patients, but it is unknown if and how these phenotypes are recapitulated in COVID-19 sepsis patients. Methods We applied the four non-COVID-19 sepsis phenotypes to a total of 52,274 critically ill patients, comprising two cohorts of COVID-19 sepsis patients (admitted before and after the introduction of dexamethasone as standard treatment) and three non-COVID-19 sepsis cohorts (non-COVID-19 viral pneumonia sepsis, bacterial pneumonia sepsis, and bacterial sepsis of non-pulmonary origin). Differences in proportions of phenotypes and their associated mortality were determined across these cohorts. Results Phenotype distribution was highly similar between COVID-19 and non-COVID-19 viral pneumonia sepsis cohorts, whereas the proportion of patients with the δ-phenotype was greater in both bacterial sepsis cohorts compared to the viral sepsis cohorts. The introduction of dexamethasone treatment was associated with an increased proportion of patients with the δ-phenotype (6% vs. 11% in the pre- and post-dexamethasone COVID-19 cohorts, respectively, p
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