World J Emerg Med . Development of septic shock and prognostic assessment in critically ill patients with coronavirus disease outside Wuhan, China

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World J Emerg Med


. 2021;12(4):293-298.
doi: 10.5847/wjem.j.1920-8642.2021.04.007.
Development of septic shock and prognostic assessment in critically ill patients with coronavirus disease outside Wuhan, China


Ren-Qi Yao ^{1 2} , Chao Ren ^{1 2} , Di Ren ^{1 3} , Jin-Xiu Li ³ , Ying Li ¹ , Xue-Yan Liu ⁴ , Lei Huang ⁵ , Yong Liu ⁶ , Mian Peng ⁷ , Yong-Wen Feng ¹ , Yong-Ming Yao ^{1 2}



Affiliations

• PMID: 34512826
• PMCID: PMC8390351
• DOI: 10.5847/wjem.j.1920-8642.2021.04.007

Abstract

Background: The study aims to illustrate the clinical characteristics and development of septic shock in intensive care unit (ICU) patients confirmed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and to perform a comprehensive analysis of the association between septic shock and clinical outcomes in critically ill patients with coronavirus disease (COVID-19).
Methods: Patients confirmed with SARS-CoV-2 infection, who were admitted to the ICU of the Third People's Hospital of Shenzhen from January 1 to February 7, 2020, were enrolled. Clinical characteristics and outcomes were compared between patients with and without septic shock.
Results: In this study, 35 critically ill patients with COVID-19 were included. Among them, the median age was 64 years (interquartile range [IQR] 59-67 years), and 10 (28.4%) patients were female. The median ICU length of stay was 16 days (IQR 8-23 days). Three (8.6%) patients died during hospitalization. Nine (25.7%) patients developed septic shock in the ICU, and these patients had a significantly higher incidence of organ dysfunction and a worse prognosis than patients without septic shock.
Conclusions: Septic shock is associated with a poor outcome in critically ill COVID-19 patients and is one of the hallmarks of the severity of patients receiving ICU care. A dysregulated immune response, uncontrolled inflammation, and coagulation disorders are strongly associated with the development and progression of COVID-19-related septic shock.

Keywords: Coronavirus disease; Immune response; Intensive care unit; Septic shock; Severe acute respiratory syndrome coronavirus 2.