Sepsis and COVID-19: outcomes in young adults in intensive care

to verify sepsis incidence among young adults admitted to intensive care due to COVID-19 and to analyze its association with demographic, clinical and outcome variables.

Methods:

a quantitative, longitudinal, retrospective and analytical study, consisting of 58 adults aged 20 to 40 years in intensive care for SARS-CoV-2. It was carried out in a university hospital, from March 2020 to December 2021, with data collected from electronic medical records.

Results:

sepsis incidence was 65%. Sepsis was associated with acute kidney injury, use of vasoactive drugs and mechanical ventilation, being admitted to the emergency room, severity according to the Simplified Acute Physiology Score III and bacterial pulmonary co-infection, the latter being the most frequent etiology for sepsis.

Conclusions:

there was a high sepsis incidence, with 42% of deaths, which points to the importance of investing in preventive measures, especially in relation to bacterial pulmonary coinfections.

Descriptors:
Young Adult; Sepsis; Critical Care; Intensive Care Units; COVID-19

Variables	With sepsis (n= 38)	Without sepsis (n=20)	p value
Age in years			0.902^* * Mann-Whitney test;
Mean ± SD	33.63 ± 5.39	33.3. ± 5.60
Minimum and maximum	22-40	23-40
Sex, n (%)			0.475^# # Chi-square test;
Male	23 (60.53)	14 (70.0)
Female	15 (39.47)	6 (30.0)
Ethnicity, n (%)			0.797 ^† † Fisher’s exact test.
White	19 (50.0)	12 (60.0)
Brown	14 (36.84)	6 (30.0)
Black	5 (13.16)	2 (10.0)

Variables	With sepsis (n= 38)	Without sepsis (n=20)	p value
SAPS III^≠			0,008^* * Mann-Whitney test; #Chi-Square Test; †Fisher’s exact test; ICU - Intensive Care Unit.
Minimum-maximum	29 - 74	24-61
Unit of origin, n (%)			0.015^#
Emergency Room	20 (52.63)	17(85.0)
Inpatient unit	18 (47.37)	3 (15.0)
Pre-existing comorbidities, n (%)			0.173 ^†
Present	33 (86.84)	14 (70.0)
Absent	5 (13.16)	6 (30.0)
Delirium, n (%)			0.544 ^†
Present	3 (7.89)	-
Acute kidney injury, n (%)			<0.001 ^†
Present	27 (71. 05)	6 (40.0)
KDIGO¥ 1	2 (5.26)	3 (15.0)
KDIGO 2	2 (5.26)	2 (10.0)
KDIGO 3	23 (60.53)	3 (15.0)
Mechanical ventilation, n (%)			<0.001^#
Yes	33 (86.34)	5 (25.0)
No	5 (13.16)	15 (75.0)
Vasoactive drug, n (%)			<0.001^#
Yes	35 (92.11)	3 (15.0)
No	3 (7.89)	17 (85.0)
Focus of infection, n (%)			<0.001 ^†
Pulmonary	27 (71.05)	-
Bloodstream	1(2.63)	-
Pulmonary and bloodstream	8 (21.05)	-
Others	2 (5.26)	-
Outcome, n (%)
ICU discharge	22 (57.89)	20 (100.0)	<0.001^#
Death	16 (42.11)	-

Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
E-mail: reben@abennacional.org.br

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[1] Corresponding author: Carla Roberta Monteiro Miura, E-mail: carla.monteiro@usp.br